Kindred Healthcare’s Donna Robacker
Robacker is Director of Clinical Quality Performance at Kindred Healthcare.
Kindred Healthcare, a leader in rehabilitation, is known for its inpatient rehabilitation hospitals and long-term acute care centers that offer cutting-edge rehabilitation technologies.
Donna Robacker, occupational therapist and Director of Clinical Quality Performance, has 20 years of experience in neurological rehabilitation. She has leadership experience as a therapy director and in the field of corporate quality. In this interview, Robacker describes her background as a clinician, the current landscape of neurological rehabilitation, and the value of rehabilitation technology from a clinical, quality and business perspective. She also provides advice to her peers considering integrating a piece of rehabilitation technology into their therapy programs.
An occupational therapist (OT) by background, she supports Kindred’s inpatient rehabilitation hospital therapy directors under its quality umbrella. The hospital’s rehabilitation services line of business includes its free standing IRFS (Inpatient Rehabilitation Facilities) and ARUS (Acute Rehabilitation Units).
“I’m focused on our rehabilitation hospitals,” she says. “Our goal is to provide exceptional outcomes to our patients with high quality.”
What is your background as a clinician and your career journey?
I am primarily a neuro clinician, Certified in NDT (Neuro-Developmental Treatment) and trained in the Neuro-IRAH® (Neuro-Integrative Functional Rehabilitation and Habilitation) treatment approaches, and I have treated stroke, brain, and spinal cord injuries.
When you’re driving patient outcomes to get them home, you learn different strategies, different techniques, what works and what doesn’t work. More recently, the value of technology is something that I’ve added to my bag of tricks.
I was a neuro therapist treating neuro patients for 20 years. Then I went into healthcare administration before coming to this role.
I’m not a typical administrator—I’m very clinically-based. It’s important for me to know what’s important to the clinician and to maintain that pulse of what’s going on at the hospital and what the needs of the hospital are — and that’s ever-changing with Covid. People are leaving the profession and retiring early. Therapy hasn’t been hit as hard as nursing, but we are affected.
Why did you become an OT?
My experience is in gymnastics—I used to own a gymnastics school. A seven-year-old child, one of the students, couldn’t bounce on both feet on the trampoline. When I talked to her mother about why she couldn’t bounce, she said that she had a developmental delay and her occupational therapist recommended that we put her in gymnastics to work on motor skills.
I decided I needed to find out about the OT and why they were supporting gymnastics, so I did some observation work and talked to some OTs, and then became an OT.
Do you miss being a practicing OT?
One of my concerns is losing touch with my clinical skills, which was something I thought about in 2020 when my mom contracted Covid. It was in the beginning of the pandemic and nobody really knew what to do or how to treat it. She spent a good amount of time in acute care after being in skilled nursing, where she most likely contracted Covid.
My sister and I were fortunate enough to get her to one of Kindred’s Rehab Hospitals accepting Covid patients, since in the beginning rehab units and hospitals were not accepting Covid patients. At the time of discharge she still wasn’t doing that well, so my sister and I took care of her. My sister acted as her nurse and I was her OT. Our journey has continued with my clinical skills.
I’m so glad that I had my neuro treatment skills. My mom used the InMotion therapy robot in her rehab, and it definitely helped with her recovery.
It was great for her to be able to see the evaluation screen and her current performance. For her, that was validation that she was improving. For us, being able to have the Kindred RehabTracker™ application that we use in our rehab hospitals and units to engage patients and families with patient progress was very helpful to share my mom’s progress with my siblings. This was very valuable.
What is Kindred’s philosophy on neurological rehabilitation?
The trend that we see is that our patients are sicker and sicker, and a lot of those diagnostic groups come from neurological diagnoses. Having a way to address the needs of those neurological patients without burning out or physically compromising our therapists is important. Being able to give the patient the opportunity for all of those criteria that drive neuroplasticity, that’s really what we’re looking for with technology.
What are the benefits of rehabilitation technology for the patient?
The biggest thing that I see is how it motivates the patient. It takes the patient from a place of “I can’t walk” or “I can’t move my arm” to experiencing that movement with rehabilitation technology. They go from a place of “I can’t” to, “well maybe I can.”
That motivation carries over outside of the device because they’re willing to try harder in traditional treatment. That’s the key with technology: You use it as a tool to jumpstart your patient’s rehabilitation, then follow through with traditional therapy.
Everything must be based on function and returning the patient to the highest functional level that they can achieve. That’s our goal, to give patients the opportunity to engage in their path to improvement.
What are the benefits of the technology for the clinician?
It’s the opportunity for mass practice, for having the means to drive neuroplasticity without requiring constant hands-on assistance, because in this day and age everybody’s feeling a little bit of burnout.
Being able to have something that you can know that your patient is benefiting from, but not having to physically manipulate them, gives the patient the opportunity to get more practice in, and saves the clinician physically.
This is an adjunct to what we’re already doing in therapy and what we have done in traditional treatment. With the InMotion device, it’s easy for the therapist to set up, and it’s easy for the patient to see what the purpose of the device is and why they’re using it.
The InMotion therapy robot is designed to work with upper extremity motor impairments, do you see any other benefits?
Even patients that do not have an affected limb, but have issues with trunk control can benefit. It’s valuable for those patients to gain core strength and progress into functional skills. You can use the therapy robot as a jumping off point for some of those patients. They don’t have to just have an upper extremity deficit to benefit from using it.
Are there benefits of using therapy robots from an administrator’s perspective?
The InMotion ARM is definitely a shiny toy. It’s not just traditional run-of-the-mill treatment, it’s advanced technology. And when you’re marketing your services in your hospital, you want to be able to show that you have the most advanced technology. InMotion definitely fits into that category, so it’s a marketing tool to some degree as well.
What advice would you give to your peers in other hospitals or clinical facilities that want to integrate rehabilitation technology into their therapy programs?
When you’re looking at PHI (protected health information), network access, and compliance issues it doesn’t do you any good to put a piece of technology at your site if you don’t have the network capability to support it. There’s definitely a lot to consider.
Make sure your therapists have bought into the technology. If they don’t think there’s value in it, they’re not going to use it, and it’s not going to help the patient. In that case you’re going to spend a lot of money and you’re not going get a return on that investment. Make sure you include the clinician, understand what their needs and wants are, and choose a technology that fits the bill.