Perioperative- Peri-Anesthesia Nurse Expert Witness

• Surgical Operations 

I am a highly skilled and decorated Veteran Nurse Corps Lieutenant, honorably discharged in 2006. An experienced RN and perioperative leader, I have successfully influenced high-quality care and service excellence since 2002. I am committed to building strong relationships and providing detailed clinical assistance. Facilitation with relevant stakeholders including C-suite healthcare administrators and Physicians has been a growing responsibility as my career progressed. An expert with quality and safety compliance regulation, I have successfully prepared teams for Joint Commission, AAAHC, Medicare, Inspector General, and State audits. I am experienced managing as many as 20 managers, 4 Lean/Six Sigma process- improvement personnel, 500 total employees, and $1.8 Billion in annual gross revenue.

Clinical Experiences include:

• Medical Surgical Nursing Educator
• Shock / Trauma Intervention
• Procedural Services
• Preoperative, Intraoperative, and Postoperative Care
• Procedural Sedation
• Clinical Educator
• Root Cause Analysis
• Quality and Safety Investigations
• Standard of Care Research
• Surgical Robotics Program Co-Chair
• Value Analysis Director

Leadership Experiences include:

• Multi-site surgical venues – UC Davis Medical Center, Kaiser Permanente
• Level 1 Trauma academic medical center – UC Davis Medical Center
• Integrated health system – Kaiser Permanente
• Military health care – Naval Hospital Camp Pendleton, Operation Iraqi Freedom
• Ambulatory Surgery and Procedural services – Alta Bates Summit Surgery Center
• Clinic management – Perioperative Medicine Clinic, Kaiser Permanente San Francisco
• Capital Construction Planning and Implementation – UC Davis Medical Center

EXPERIENCE & NOTABLE CONTRIBUTIONS

Accreditation Assoc. for Ambulatory Health Care May 2022– Present
AAAHC SURVEYOR
• Perioperative Nurse Surveyor: Responsible for conducting team surveys in ambulatory surgery centers. Per Diem.

Sacramento City College August 2021 – Present

ASSISTANT PROFESSOR, DEPARTMENT OF NURSING
• Nursing Instructor: Lecture and Clinical Rotations for last semester Sacramento Community College Students. Lectures include Emergency Disaster Nursing, Leadership and Management, and other clinical modules such as renal disease, shock, and burns.

Surgical Staff, Inc. July 2020 – August 2021

PERIOPERATIVE / PERI-ANESTHESIA NURSING STAFF
• Staff Nurse: Providing as needed services in Multisite, Multispecialty Surgical Care Environment. Providing Services at several Greater Sacramento Ca. venues on a Per Diem basis.
Sutter Northern Ca. Health System Roseville: March 2016-July 2020

ASSISTANT ADMINISTRATOR, PROCEDURAL SERVICES: Sutter Roseville Medical Center
• Strategic Surgical Access Expansion: Maintained dyad physician partnership resulting in surgical volume growth by over 5% annually (historically 2%) and growing net revenue at 7% during the same period. This was accomplished with optimization of staffing, block schedule management best practices, and surgeon recruitment and engagement.
• Creating Perioperative Predictive Analytics Program: Initiated monthly data driven reports tracking preoperative chart readiness, surgeon readiness with specific provider data, cancellations by reason, and overall length of stay by ASA class.
• Improved Sterile Processing / Supply Chain Systems: Led a coalition of key stakeholders to improve OR readiness, supply chain accuracy, and sterile processing quality and safety. The initiative was called the “OR Supply Chain Transformation.” This project resulted in a substantial reduction in excess supply returns, more accurate procedure cards, tray readiness and visibility, reduced loss and waste, and a quality oversight infrastructure in sterile processing. As of Mar 2020, the project had saved 5% in supply expenses compared to FY2019.

Vizient / Sutter Northern Ca. Shared Services
CONSULTING DIRECTOR, VALUE ANALYSIS AND CLINICAL ENGAGEMENT
• Providing Executive Level Leadership to Perioperative, Cardiac Catheterization, and Interventional Radiology services.
• Creating Robust Clinical and Technology Evaluation Forums: Establishing Value Analysis Committees throughout the Sutter Health Northern California region. These venues were essential for reviewing, initiating, and discontinuing the use of items throughout the system that were not vetted for safety, value, and patient care improvement.

UC Davis Medical Center • Sacramento, CA • November 2013-March 2016
PERIOPERATIVE SERVICES NURSING DIRECTOR
• Large Academic Hospital System Management Oversight: Responsible for 3 surgical venues, 11 cost centers, and 7 direct reports, totaling 600 division FTEs.
• Budget and Revenue Stewardship: Steward for a perioperative division driving $1.8 Billion in annual billed revenue with a 110-million-dollar operating expense budget. Successfully managed UC Davis’ FY 2017 budget resulting a 1% positive variance. Accomplished a 19% reduction in total division overtime for the most recent fiscal quarter, resulting in a savings of over $225,000 in operational expenses.
• Turnover Time Improvement: Managed a team that reduced turnover times from 62 minutes to 35 minutes at a 600 bed Academic, Level I trauma center.
• Lean / Six Sigma Improvement Projects: Sponsored initiatives for supply chain reorganization, visual board management, improving OR efficiency metrics, sterile processing quality and oversight improvement, and organization wide cascading goal implementation.
• Magnet Hospital Cultural Achievement: Maintained a culture of achievement at a U.S. News “Top 50 hospitals in the US” facility while exceeding Magnet status hospital targets.
• Talent Development: Obtained the highest percentage of Board-Certified Nurses at the UC Davis Medical Center; our operating room program helped over 73 nurses obtain their CNOR certification in 2015 -2016;

a 25% certification rate. Administered the largest OR training program on the west coast, training an average of 20 RNs per year, with a 95% retention rate at 3 years.

Kaiser Permanente 2008-2013
KAISER ROSEVILLE, PERIOPERATIVE SERVICES DIRECTOR 2011-2013
• Management Oversight: Responsible for 22 total Operating Rooms at 3 venues including an inpatient operating room, ambulatory surgery center and eye center. Also directed operations in sterile processing, PACU, PREOP, Perioperative Medicine Clinic, and GI procedures. Reporting structure included 6 direct reports and 250 FTEs.
• Innovative Perioperative Solutions: Developed an electronic “Better Book” glitch capture process in the OR that expedited systematic corrections of small process defects in daily staff work. This system gave immediate status feedback to reporting staff. Product was eventually used as a best practice throughout 20 Kaiser Permanente regional operating rooms.
• Perioperative Benchmarking: Benchmark results under my leadership in San Francisco and Roseville were stellar. All Perioperative departments exceeded industry benchmarks, including 60 minute PACU length of stay, 30 minute OR turnovers, 1% Immediate Use Sterilization rate (IUSS), and 85% on time surgery starts.

KAISER SAN FRANCISCO, OR MANAGER 2010-2011
• Management Oversight: Responsible for 12 total operating rooms including an inpatient operating room, inpatient cardiovascular operating room, hybrid interventional suite, and ambulatory surgery unit. Reporting structure included 4 direct reports and 100 FTEs.
• Breaking Isolated Department Communications: Worked to cross influence PACU, OR, and SPD using collaborative staff training, combined messaging, and visibility with staff.
• Visual Management Progress: Instituted a visual board management system using Six Sigma / Lean strategies in our departments to create awareness of problems, encourage front line solutions, and celebrate successes; a best practice used in many of the preeminent highly reliable organizations.
• Perioperative Efficiency: Perioperative departments exceeded industry benchmarks, including Day of surgery cancellation rate < 1%, 60 minute PACU length of stay, and < 1% OR Postop delays.

KAISER SAN FRANCISCO, POST ANESTHESIA CARE / SAME DAY SURGERY / ENDOSCOPY MANAGER 2008-2009
• Management Oversight: Provided front line management presence in a complex series of Post Anesthesia arenas including OR, Endoscopy, Pain Procedures, Interventional Radiology, Cath Lab, and Pulmonology. Reporting structure included 2 direct reports and 50 FTEs.
• Preoperative Clinic Model Innovation: Co-initiated the prototype for a future Kaiser Permanente perioperative medicine clinic regional model for 20 hospitals. This model used Nurse Practitioners and RNs to prep all aspects of the patient record prior to day of surgery.
• Best Practice Leadership: Championed our Highly Reliable Surgical Team (HRST) steering committee.

The Surgery Center at Alta Bates Summit • Oakland, CA • 2006-2008
PERIANESTHESIA, ENDOSCOPY, PAIN PROCEDURES MANAGER
Consistently provided high-quality nursing care across all channels in order to bolster healthcare and facilitate health plan creation. Managed post-anesthesia care unit and optimized internal productivity.

Mira Costa College LVN Program • Oceanside, CA • 2005-2006
Associate Faculty, Pharmacology and Body Systems, Online Curriculum
-Taught part time online courses using blackboard platform.

Nurse Corps Officer, US Naval Service 1995-2006
Medical Surgical RN / Education Officer• Camp Pendleton Naval Hospital • 2002-2003, 2004-2006
Received Navy / Marine Corps Achievement medal for managing the training records of 26 personnel and achieving over 800 continuing education units (CEUs) during my tenure.

Trauma OR Staff RN / Education Officer-Iraqi Deployment: Operation Iraqi Freedom • 2003 – 2004
Deployed with 1st Medical Battalion, Charlie Surgical Company, Forward Resuscitative Surgical Suite (FRSS) units. Performed primary surgical trauma care on the forward edge of the Iraqi war battle area. Surgical and Recovery Care Nurse on life saving surgeries for wounded Marines and Enemy Prisoners of War. Received Navy / Marine Corps Achievement medal for 1) Developing and presenting a curriculum for shock trauma care in the forward edge of battle (FOB). 2) Presenting and managing the education of 84 Doctors, Nurses, and Corpsman (Medics) during the 9-month deployment.
RADIOMAN / DATA PROCESSING TECHNICIAN • U.S.S. Blueridge • Yokosuka, Japan • 1995-1997

OTHER EXPERIENCE / PROFESSIONAL ACCOMPLISHMENTS
• 2 Naval Achievement Medals
• Presidential Unit Citation, Iraqi Campaign Medal – Operation Iraqi Freedom
• 2008 Featured Speaker at 2007 ASPAN Conference | Anaheim, CA
• 2010 Kaiser Permanente Leader Recognition Supplemental Bonus Award
• 2013 IHI Pt. Safety Executive Program – Inst. for Healthcare Improvement, Boston, MA
• 2021 Featured Speaker at National Conference of OR Business Managers
• 2021 Featured Speaker at National Conference of the American Association of Operating Room Nurses (AORN)
• 2021 Featured Speaker at the Pyrotec Beyond Clean Clinical Conference
• 2021 2 Appearances on the Beyond Clean / First Case podcast

EDUCATION AND TRAINING

• UNIVERSITY OF SOUTHERN CALIFORNIA | 2001
Bachelor of Science in Nursing
• UNIVERSITY OF MASS. AMHERST | 2009
Master’s in Public Health and Master’s of Science in Nursing
• Registered Nurse CA
• Certified OR Nurse (CNOR) 2016 – Present
• Certified Post Anesthesia Nurse (CPAN) 2004-2016
• LEAN Performance Improvement Certification – 2013
• Certified Trauma Nurse (TNCC) 2002-2006
• Advanced Cardiac Life Support Certification (ACLS)
• Pediatric Advanced Life Support Certification (PALS)

AFFILIATIONS

• American Society of Perianesthesia Nurses (ASPAN)
• Association of Perioperative Registered Nurses (AORN)
• American College of Healthcare Executives (ACHE)
• American Association of Life Care Planners (AANLCP)