Almost 600,000 Americans died of cancer last year. But almost 15 million were living with — and often well beyond — a cancer diagnosis, a figure expected to rise to 19 million by 2024, as cancer treatments continue to improve and Americans live longer than ever.
That trend poses opportunities in the world of outpatient rehab — opportunities Weldon Rehabilitation Hospital in Springfield has embraced.
“We went through a cancer rehab certification program to offer additional services to cancer patients. It’s a large area of growth,” said Jill LeGates, director of Rehabilitation Services at the facility. “More patients are surviving cancer treatments, but now they have fatigue, pain, dysfunction. We can help return them to the activities of daily living, so that’s been a huge focus for us.”
Specifically, Weldon is certified by the STAR Program (Survivorship Training and Rehabilitation) program, a nationally recognized certification that focuses on improving the lives of cancer survivors who experience side effects caused by treatment.
A team of therapists, physicians, and nurses has undergone training to provide patients with individualized cancer rehabilitation treatment to improve the symptoms that affect their daily functioning and quality of life. It’s similar to rehabilitation that people undergo after a serious illness or injury, but tailored to the unique issues they face as a cancer survivor.
“Our rehabilitation professionals can help you with a wide variety of treatment-related conditions and the symptoms they cause, targeting not just pain and fatigue, but balance and gait problems, memory and concentration issues, swallowing and speech problems, and lymphedema.
“You might expect your oncologist to say to you, ‘I did my job; you’re wonderful. This is your new normal,” LeGates said. “But some patients are saying, ‘I still have this pain.’ So, is there a way we can manage their pain and fatigue, increase their endurance, get them back to working, back to caring for their children, back to living? Rehab can be a huge part of that.”
It’s just one example, actually, of how Weldon — founded in 1974 and part of the Sisters of Providence Health System (SPHS), which includes Mercy Medical Center — continues to change with the times to meet rehabilitation needs.
The most obvious change is the new location of its outpatient services, a block away from the main Weldon facility, in the medical office building the health system opened in 2015 on the corner of Carew and Chestnut streets.
“When we were at the old building, we had multiple outpatient services in different places, scattered throughout the building,” LeGates said. “Here, all the outpatient services are together in one suite — physical therapy, occupational therapy, speech therapy, and some specialized programs.”
Those programs include occupational, physical, and speech therapy; hand therapy for a variety of conditions; specialized programs for lymphedema, swallowing disorders, vestibular therapy, and voice disorders; a wheelchair clinic; a driver-advisement program to help people determine whether it’s safe for them to drive; a broad pediatric program; and the STAR program for cancer patients.
“As a mission-driven hospital organization, our focus is on patient-centered care,” LeGates said. “We strive to provide patients with the individualized care and treatment plans they require. If someone needs more specialized care, we have therapists with those specialties to consult and help patients increase their function.”
Patients arrive in Weldon’s outpatient programs in a number of ways, but post-hospital care remains a key focus, especially at a time when the accountable-care model in healthcare is putting a premium on discharging patients sooner than before and emphasizing preventive and rehabilitative care outside the hospital setting.
“They’re coming out of the hospital faster, and health systems are looking at cost containment,” LeGates said. “So the environment where patients receive therapy services is a huge component — how is that patient functioning, and what are their needs?”
While many patients are referred from hospitals, others may be referred directly from physician practices. “They go to the doctor, who identifies an illness, something that requires the services of a therapist. We also see patients that have an injury on the job, and they may need therapy services in order to return to work.”
Since SPHS absorbed the former Hampden County Physician Associates practices and is affiliated with Riverbend Medical Group’s network, these referrals are an especially critical pipeline. “As a huge health system, we want to maintain the integrity of where our patients receive services,” she noted. “Keeping all those services within the health system has been a huge opportunity.”
In short, she went on, “we always knew if we were in strong alignment with referral resources, we would see growth. And we do have a very positive referral base, and we are continuing to grow. Our physical-therapy services are extremely busy, and we’ve added additional therapists to absorb that growth, which is great.”
The growing need for services is also being driven by an aging population, as the Baby Boomers surge into their senior years but are often living with a host of conditions that require therapy. But at the other side of the age spectrum, Weldon has broadened its pediatric services, working with children dealing with autism, sensory-processing disorders, Down syndrome, developmental delays, handwriting difficulty, speech apraxia, language delays and speech issues such as stuttering, neuromuscular disorders, ADHD, and a host of other conditions.
Weldon’s pediatric therapists evaluate each child’s needs and develop an individualized treatment plan that may include one-on-one occupational therapy, speech therapy, and physical therapy, all provided in a colorful, child-centered environment, LeGates said.
“We may work in collaboration with schools or with home services — there’s a lot of collaborating with the pediatric world,” she added. “We’re treating the whole person and all the child’s needs, whether educational, medical, or social. We also have a well-established animal-assisted therapy program with the Zoo at Forest Park; animals seem to bring out a lot in people. That’s a huge piece of what we do as well.”
Since SPHS became part of a much larger, regional health system, Trinity Health New England, Weldon has begun to assess the regional big picture for rehab services, and perhaps find ways to collaborate on population-health initiatives with facilities like Mount Sinai Rehabilitation Hospital in Hartford and St. Mary’s Hospital in Waterbury, which boasts several outpatient rehab centers.
“How can we expand to grow and regionalize some of this?” LeGates said. “As we look to the future, as we move from fee for service into all kinds of payment changes, we may be able to collaborate on this from a regional perspective.”
Despite that big-picture outlook, however, rehabilitation remains, at its core, a one-on-one connection between therapist and patient.
“It’s a wonderful profession,” she told HCN. “You’re helping people and truly seeing people gain back their independence, gain back function, and return to the activities they had stopped doing.”
In the end, success stories are based on more than hard work in the gym; they rest on strong relationships — which don’t necessarily end when the care does.
“We’ve had patients come back and show us how they’re doing, tell us how they went back to school or went back to work,” LeGates said. “It’s a rewarding career, and the people who work here are a people-driven team.”