A fast-growing US healthcare provider replaced scattered spreadsheets, forms, and documents with one connected platform — and changed how managers and employees talk.

When the tools couldn’t keep up

Buffalo Rehab Group has always taken its people seriously. As a provider delivering physical and occupational therapy across the US, it had grown fast — and that growth came from real investment in how employees were supported and developed.

The problem was never whether the company cared. It was that the employee experience was scattered — the same task lived in a spreadsheet here, a form there, a document somewhere else. Learning, reviews, goals, and development were all happening, just never in one place. Every review cycle, the People & Culture team pulled the responses together by hand to rebuild the full picture.

“The biggest challenge was having different areas of engagement and our team support siloed — spread across spreadsheets, Microsoft Forms, JOTForms, and documents,” says Hannah Buffa, Senior Director of Learning & Development. “We were looking for the centralization to have things all together.” As the organization grew, the gap between what the team wanted to do and what the tools could support kept widening. “Our existing strategy of having things in different places really didn’t match the growth that we were on a trajectory to achieve.”

From one product to one platform

Buffalo Rehab Group already used Zensai for learning, built natively inside Microsoft 365. This year, it expanded to the full Zensai Platform, bringing performance, goals, engagement, and development together in one place. The move felt less like a new system and more like a next step.

The goal was consistency — not just in reviews, but in how goals linked from company direction to what each teammate was working on. Managers on the clinical teams already met their people every week, but each one ran those conversations their own way. There was no shared framework, and no shared record of how things were actually going.

Reflection becomes routine

The hard part was asking a fast-moving clinical team to stop and reflect every week. “I’ll be totally transparent, that was hard. Our team is not used to that. We work in a very fast-paced environment,” Hannah explained.

So they introduced the check-ins to sit alongside the existing one-to-ones, not replace them. Each week, teammates noted what had challenged them, what they were proud of, and where they’d leaned on support — and their manager saw it before the next conversation. “I really made it a point to let them know that these meaningful reflections each week are going to go to your manager, and this is going to complement your in-person weekly one-on-one.”

The first few weeks took some adjustment. But managers responded right away, using the Friday check-ins to prepare for the week ahead and picking up on the specific wins and struggles their teammates had shared. “There’s a trust built around this check-in,” Hannah says.

What changed, with proof

Four months after rollout:

• 93% company-wide weekly check-in completion — 94% in the first month, steady ever since
• 100% of teammates completed their merit-based performance review in the platform
• Reviews built on a full record, not a scramble to remember

Employees said the process was easier than anything they’d used before. But what Hannah keeps coming back to is the depth of the reviews themselves. Before, people struggled to remember six months of work when review time came around. “Teammates couldn’t recall what happened yesterday and a true review for us is going to be that full look back.” Buffalo Rehab Group runs reviews every six months, covering challenges, wins, growth, and how people were feeling. Without that record, that kind of honest look-back was hard to do well.

Now managers and employees can revisit check-ins, goals, and reflections in one place, and the conversation starts from evidence rather than memory.

When managers can see how someone’s doing, they act

Buffalo Rehab Group’s leaders were already invested in their people. What the check-in added was visibility, and that visibility changed how they acted. When a teammate flagged a genuinely hard week, their manager saw it before the next meeting and reached out.

Hannah and her team set the expectation early: “I want you to be honest in your check-in. But don’t be alarmed if you get a call from a leader when they see you scored yourself a one-out-of-ten.” That’s exactly what happened. Leaders followed up directly, not as a process step but because they wanted their teammate to know they were supported. “People were shocked to honestly know that their wellbeing was something taken seriously, and that our leaders did want to follow up with them.” 

For employees, the support around them stopped being an idea and started to feel real. Leaders, People & Culture, and teammates were finally working from the same picture: career conversations, development, goal progress, and performance data in one place, instead of scattered across systems that didn’t talk to each other.

The takeaway

Buffalo Rehab Group didn’t set out to overhaul its culture. It set out to bring scattered tools together. But connecting learning, performance, and engagement in one place did something bigger: it gave every manager the evidence to coach well, and gave every employee a way to say how they were really doing. “The alignment has been a game changer,” Hannah says, and that’s only four months in. The weekly check-in did the rest.