Amanda Wilde (Host): The Rehabilitation Institute at Palmdale Regional Medical Center is uniquely positioned to serve patients with active medical problems who may need multiple therapies. Today we're discussing the Institute's recognition from Netsmart Technologies and national accreditation from the Commission of Accreditation of Rehabilitation Facilities, or CARF. We'll talk about what this means for the organization and for patients. This is Palmdale Regional Radio, a podcast from Palmdale Regional Medical Center. I'm Amanda Wilde and my guest is Dr. Thomas Nasser, Medical Director of the Rehabilitation Institute at Palmdale Regional Medical Center. Dr. Nasser, welcome.

Thomas Nasser, DO: Thank you. Thank you very much. It's great to be here.

Host: Let's start with the CARF accreditation. This is a national accreditation. But the Rehabilitation Institute that you run already features specialized staff and equipment. What does the CARF national accreditation mean to you?

Thomas Nasser, DO: The CARF Accreditation is actually really special and that's something that's special for us as well as for the patients. It gives us a distinction that we're holding a degree of quality care that we're really trying to pursue as a group, as an organization. Not everybody gets to be CARF certified.

 Not every organization in the country gets to say that they met those standards that really show that we're providing an upper level of quality care and taking the best care of the patients possible, according to, you know, industry standards. So, it's very special to us as an organization to know that we were able to achieve that. But it's a very good measuring stick for us as well, that the patients can look at and say, Hey, this is a place I would choose over another particular place because I know that they're meeting the standard of care in the nation.

So, CARF accreditation is really special. We had to go through quite a bit to get it. We had to prove to ourselves and to the CARF certifiers that we met that standard and so it's a big deal.

Host: How did you do that?

Thomas Nasser, DO: Well, it's a rigorous process, you know, you're basically letting someone into your house to look at everything that you're doing and give their approval. So we had to sit before the committee, we had to submit documentation, we had to show them how we were caring for patients. And go through that process, just like, you know, any other hospital might go through JCO certification or have the ability to see Medicare patients or all the other types of certifications.

Similar to when a physician takes their medical boards to say that they're board certified and they can take care of patients in a particular specialty; we had to go through that certification process. And we were awarded a three year certification. It's a one or a three year and we came through with flying colors. We were ordered a three year certification and we're very proud of that.

Host: So the accreditation provides a really high level of confidence and security for patients and their families. Awards sometimes are important, right? What is the award from Netsmart Technologies that the Rehabilitation Institute received?

Thomas Nasser, DO: This is actually pretty special to us because what we use is something called PEM, P-E-M, and it stands for Program Evaluation Model. There are 861 facilities, and we were able to get into the 95th percentile in terms of our how we are evaluating patients, and how we're treating them.

The PEM program evaluates the program as a whole and how it functions. We look at things like functional efficiency. We take into account things like individual patient progress throughout the rehabilitation stay. This program speaks to the quality being delivered in terms of how many patients are being discharged from the rehabilitation unit to home versus to nursing facilities, versus to just the general community, or even to the acute hospital. So this PEM, so to speak, this evaluation model looks at our entire program and it kind of takes apart how effective our therapies are, how effective our social support is, and getting patients discharged.

How effective, we're measuring and and looking at patients progress. And we can take this information and reshape what we're doing on a day to day basis. So that's why we love the program so much, but the fact that we were able to utilize that and score in the 95th percentile tells us that what we're doing is, is good, and it's accurate, and it's right.

So it's very exciting for us to reflect on you know, being there.

Host: These measurements really let you know then in detail how well your therapies and approach are working.

Thomas Nasser, DO: Absolutely. And, so there's the macro view of this and there's the micro view of this, and that's why I like it so much. On the micro view, what we're doing on a, on a weekly basis is we're meeting together as a team. So, I sit in a room with the physical therapists, the occupational therapists, the nurses, our administrators, and we go over each patient in detail.

How much is this patient able to walk now as opposed to two days ago? How much is this patient able to perform their activities of daily living now as compared to two or three days ago? We look at all of the little nuances of the therapies and what they're doing and how they're taking care of the patient. And that's on a micro level. We can look at that and make our changes each day to help the patient advance.

On a more macro level, we can step back and look at the entire hospitalization, whether it was 7 days, 10 days, 30 days, and say, how did the patient evolve over that time period, and were we able to get that patient to home or to accomplish their goals. And even on a more macro level, we can step back and look at the program as a whole, and say, at what percentage of the patients that we're seeing, are we able to get to their goals? Are we able to get those patients, you know, help them get back to home or to wherever they were before their injury or their trauma, et cetera, et cetera.

So this is, there's so much utilization in this program and to see that we utilized it and succeeded and not only utilized it and succeeded it, but, functioned so highly compared to our peers. It was kind of mind blowing to us because the unit is only seven years old. And we're going against units, not necessarily going against, but we're being compared against, facilities that are 20, 30 years old. And they know how to do this. They've been doing it a long time. So this degree of success is a very strong measurement for the effectiveness of what we're doing. And that's why it's so exciting.

Host: How do you consistently achieve this high level of care?

Thomas Nasser, DO: That's a great question. If I'm being really honest, I think we just, we're just very blessed. I have the most amazing team of hardworking therapists. My main administrator, Veronica, she's just amazing. This woman knows rehab like she knows her name. And the liaisons I have and my social worker, my discharge planner, I mean, these people, they live, eat, and breathe this stuff and they show up to work every day with a smile. They're hardworking, they love what they do. We have an amazing, enthusiastic, warm culture in that rehab unit and it trickles down and the patients can feel it. It's palpable. And I think that's really the secret to our success is that, you know, we're all really locked in and engaged. And it helps because nobody is, you know, overly proud. We're all humble. We all want to learn. We all want to work.

We all want to grow and become better at what we're doing. And it just makes for such a fantastic team that these people love doing rehab. They love taking care of patients, and it shows in our product.

Host: I think the key there is creating that culture that you mentioned, that culture of excellence and warmth and caring. And it does trickle down to patients. So teamwork, a close eye on patients, this high level of commitment, and the fact that you're always evaluating and making adjustments to the program means that you can achieve higher levels of success.

What do you see as the future for the Rehabilitation Institute?

Thomas Nasser, DO: Well, I mean, at this time, you know, we have CARF to pay attention to, you know. It's a three year certification. We have to stay certified. When they gave us the certification, they had some stipulations. They said, we're going to give you this, but this is, these are the changes that we want to see.

We'd love to introduce a little bit more of neuropsychology to help with our brain injured population. We would love to continue to grow what we're doing with our amputee program. We have a limb salvage program at the hospital, and then we see a lot of below and above knee amputations. We'd love to continue to grow that. We have a fantastic relationship with a group called Triumph, they help with paraplegic and quadriplegic patients. And we can do a lot in the community to help those patients and, those are some of the things on a very basic level that we're looking at. We're continuing to build our relationships with other facilities in the community, with other hospitals and with other physicians. We've made some really big strides. You mentioned culturally with other physician groups in the hospital to where we're working more collaboratively than anything else to care for patients in terms of managing their medical problems while they're on the rehab unit. So, just like anything, I mean, if you look at a team that just won the NBA championship, you know, what's next for them? They want to win it again. And so we want to win it again. We want to, we want to keep winning every year and just getting better at what we're doing.

Host: Well, I think with a healthy organization, like a healthy body, to continue that metaphor will undoubtedly grow and achieve new things.

Thomas Nasser, DO: Yeah, the future is great. The future is bright and we're very excited about it.

Host: Dr. Thomas Nasser, thank you for explaining the awards, the CARF accreditation, and these advances for patients at the Rehabilitation Institute at Palmdale Regional Medical Center.

Thomas Nasser, DO: My pleasure. Happy to be here. I look forward to talking about it more.

Host: Dr. Thomas Nasser is the Medical Director of the Rehabilitation Institute at Palmdale Regional Medical Center. And that concludes another episode of Palmdale Regional Radio with Palmdale Regional Medical Center.

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