By Elizabeth Joyce Freeman, Senior Advisor, Stanford Medicine Center for Improvement (SMCI)

On October 11-12, 2022, approximately 218 attendees, from 45 institutions and 5 countries participated in this year’s conference at the Francis C. Arrillaga Alumni Center. The theme was Improving Together for All – Patients, Families, and Healthcare Workers. There were 46 presentations and 51 posters from conference participants. The organizing committee received 100 abstracts from which these presentations were chosen.

Following welcoming comments from Dean Minor and Stanford Medicine Children’s Health Chief Medical Officer, Denny Lund, Leilani Schweitzer, PEARL Patient Liaison, Stanford Medicine Health Care, and Alpa Vyas, Vice President and Chief Patient Experience Officer, Stanford Medicine Health Care, gave an extremely moving presentation on the inclusion of patient and family voices in improvement. Delegates then presented on topics including Diversity, Equity and Inclusion in improvement work. Following additional breakout and plenary sessions, Day One closed with a continuation of the discussion from previous conferences on the social and technical aspects of improvement led by Edgar and Peter Schein and John Shook.


The weather and setting were perfect for the evening reception with music provided by Hardy, Hemphill and Friends.

Day Two opened with a welcome from Stanford Medicine Health Care Chief Medical Officer, Niraj Sehgal. Dr. Paul Helgerson, Associate Professor of Internal Medicine at the University of Virginia (UVA) Health, shared fascinating insights on the utility of Lean during the height of COVID and beyond at UVA. Paul spoke with no notes or slides and had the audience hanging on every word. This was followed by a Chief Medical Officer panel with Drs. Chris Longhurst, Chief Medical Officer and Chief Digital Officer, UC San Diego, Niraj Sehgal, Chief Medical Officer, Stanford Medicine Health Care, and Elaine Pretorius, Executive Director of Medical Services, Limestone Coast Health, South Australia. Dr. Terry Platchek and Jakaria Stewart provided expert facilitation of this robust discussion that included how each of these CMOs bring their humanity and care and compassion to their roles. The additional breakout sessions were all outstanding, leaving delegates torn which sessions to attend. Day Two closed with reflections from Jack Billi, MD, Former Chief Engineer for the Michigan Quality System at the University of Michigan, and a recap session with John Shook, during which each participant was asked to draw a relationship map and commit to actions they would take to address gaps between the current and desired state.

Sheri Nakamura, Stanford Medicine Children’s Health, announced the winners of the abstract poster competitions.

William Huen, MD, Associate Chief Medical Officer, Quality and Lean, Zuckerberg San Francisco General, received the best abstract award “We Can’t Achieve Quality without Equity” Advancing Health Equity Leadership Locally with A3 Thinking and Coaching Frameworks.

The People’s Choice Poster Award went to George Lourentzatos, Advisor, Strategic Planning & Innovation, Union Health Center, NY, with Co- Authors, Cody Dashiell-Earp, Monica Guillen, Jacqueline Camacho and Cindy Ruiz for their poster, Creating a Multi-Use Tiered Daily Management System in a 108-year-old Medium Sized Multi-Specialty Medical Home.

The Judge’s Choice Poster Award went to Kimmyrose Palma, RN, Patient Flow Coordinator, VA Palo Alto Health Care System, and Co-Author Lhaarnie Ablao, for their poster Improving Movement Time from ED Admission Order to the Acute Care Units.

Congratulations to all the award winners and thank you to all the conference participants. See you next year!



Alice R. Georgitso, MPH, joins the SMCI Advisory Committee as our first Patient Partner. Alice has served as a Patient Partner with the Stanford Health Care (SHC) Patient & Family Partner Program for over 4 years and was appointed Chairperson of the Adult Congenital Heart Program Patient & Family Advisory Council in January 2020. She assisted in developing the Stanford Adult Congenital Heart Program’s Peer-to-Peer Program and serves as a Mentor to ACHD patients pre-and-post-organ transplantation. Alice has presented Stanford Health Care’s C-I-CARE framework for structuring best practice communications and developing relationship-based care approaches with patients and colleagues to 500+ Stanford Medicine Directors, Managers and Clinical Staff.

Alice is a Patient Relations Manager at Stanford Health Care. Within her role, she provides a channel for problem resolution to promote the highest quality of care and service excellence. Alice has also worked as an Unrelated Donor Search Coordinator with the Blood & Marrow Transplant at Stanford Health Care to coordinate allogeneic hematopoietic stem cell transplants through collaborative planning and partnership with the National Marrow Donor Program and SHC clinicians. Prior to her work with SHC, she was the Community Service Foundation Director at San Mateo County Medical Association where she partnered with local stakeholders and clinicians to expand county-wide community health programs to diverse populations. She has also delivered invaluable community health services through her work with the American Heart Association.

Alice earned her Bachelor of Arts in Sociology and Biology at Saint Bonaventure University in Olean, NY and her Master of Public Health from SUNY Buffalo in Buffalo, NY. Alice is a member of The Beryl Institute and Adult Congenital Heart Association professional associations, Donor Network West partner advocating for organ, eye, tissue, and blood donation, and remains an active volunteer with SHC. Alice continues to promote patient-and-family-centered care in both hospital and community settings to support precision health and improve the healthcare experience for patients, families, and clinicians.

John Shook learned about lean management while working for Toyota for 11 years in Japan and the U.S., helping it transfer production, engineering, and management systems from Japan to NUMMI and other operations around the world. While at Toyota's headquarters, he became the company's first American kacho (manager) in Japan. In the U.S., Shook joined Toyota’s North American engineering, research and development center in Ann Arbor, Michigan as general manager of administration and planning. His last position with Toyota was as senior American manager with the Toyota Supplier Support Center in Lexington, Kentucky, assisting North American companies adopt the Toyota Production System. Shook co-authored Learning to See, the book that introduced the world to value-stream mapping. He also co-authored Kaizen Express, a bi-lingual manual of the essential concepts and tools of the Toyota Production System. With Managing to Learn, Shook revealed the deeper workings of the A3 management process that is at the heart of Toyota’s management and leadership.
Shook is an industrial anthropologist with a master’s degree from the University of Hawaii, a bachelor’s degree from the University of Tennessee, and is a graduate of the Japan-America Institute of Management Science. At the University of Michigan, he was director of the Japan Technological Management Program and faculty member of the Department of Industrial and Operations Engineering.
Shook is the author of numerous articles, including "How to Change a Culture: Lessons from NUMMI"; Sloan Management Review, January 2010, which won Sloan’s Richard Beckhard Memorial Prize for outstanding article in the field of organizational development.

The Stanford Medicine Center for Improvement benefits from the diversity of its members and the richness of the experiences that they bring. Although the program continues to evolve from when it first launched in October 2019, we continue to reach out to improvers across Stanford Medicine in the School of Medicine, Stanford Health Care, Stanford Children’s Health, Stanford ValleyCare, UHA and PCHA. We welcome everyone from every discipline and recognize that we are stronger together as we value the contributions of every member of our teams.

Dr. Paul Maggio is the Chief Quality Officer of Stanford Health Care. Prior to being appointed the SHC CQO, he was Vice Chair of Surgery for Clinical Affairs, Associate Chief Medical Officer of Operational Effectiveness, and Associate Director of the Adult Intensive Care Unit. He trained in General Surgery at Brown University and obtained advanced training in Adult Surgical Critical Care and Trauma at the University of Michigan. He holds a Masters of Business Administration from the University of Michigan and is triple board certified in General Surgery, Critical Care, and Medical Informatics. In addition to being a clinician and surgeon, Dr. Maggio participates in the National Committee on Healthcare Engineering for the American College of Surgeons, and his research interests are focused on the delivery of high-value care.

Dr. Maggio received the SHC Board of Hospital Director’s Denise O’Leary Award for Clinical Excellence in 2013

Micah Duchesne joined Stanford Medicine in 2020 as a Principal Consultant project managing the deployment and operations of the Hospital Incident Command System (HICS) for COVID-19. He is now the Administrative Director of Performance Improvement at Stanford Health Care where he leads annual operations planning, improvement consulting, and capability development. Micah is also a Fellow at the Stanford Medicine Center for Improvement.

Before joining Stanford, Micah was an independent consultant for his company Silicon Valley Strategy Group, which partnered with Novartis and the Perelman School of Medicine at the University of Pennsylvania to commercialize cellular therapies. He led a team of clinicians from Europe, Japan, and Australia in designing a global logistics model and quality management system for Kymriah, the world's first approved CAR-T therapy, and helped create an international advisory board aimed at improving global capacity.

Prior to independent consulting, Micah was the Director of Performance Improvement at Kaiser's Santa Clara Medical Center, and he previously held improvement roles of increasing complexity within other health systems. Micah has both a Bachelor of Science in Accounting and Master of Health Services Administration from Mississippi College. He also holds certifications as a Lean Six Sigma Master Black Belt and Project Management Professional.

As a professional, Micah enjoys organizing complex stakeholder ecosystems, clarifying ambiguous goals, aligning visions, and driving high-stakes change. As a human, Micah just enjoys breaking a sweat. While he's not at work, he's at his very own gym in San Jose, CrossFit Moxie. You can find him there coaching olympic weightlifting or working out with his wife. He has a daughter in elementary school and two gym dogs.