Episode 16: Learn to leverage Lean methodology in your infusion practice with Kari Kalgren of K2 Health Strategies

Transcript: Learn to leverage Lean methodology in your infusion practice with Kari Kalgren

Dylan McCabe: Welcome to We Infuse podcast where we take the confusion out of infusion. And each week we provide you with insights in the infusion industry and interview experts in this space. And in this episode, we have an interview with Kari Kalgren and the director of K2 health strategies. And I think you’re really going to like this episode because she brings some things to light about how to streamline processes in the infusion practice, how to protect the bottom line, and really how to reduce stress for everybody involved from the physician to the back office, to the nurses and she has a really interesting take with a lot of experience all the way from being an occupational therapist to now being the director of K2 health. And they do consulting all over the US with infusion practice. So I think you’re really going to like this episode. So without further ado, let’s jump right into it. Kari. Thanks for being on the show.

Kari Kalgren: Thanks for having me.

Dylan McCabe: Now, before we jump into all of the things I want to talk to Kari about Kari, I’d like to just give you a chance to kind of share your background, some, you know, a little bit of your story and your journey up until this point and to infusion therapy.

Kari Kalgren: Sure. It’s actually trained as a health care provider and occupational therapist, and I round up in the pharmaceutical sales space of it. Now what’s interesting is that I’ve kind of been around infusion and these biologics since I started out my career in occupational therapy, back in the late nineties, we were just seeing some of the very first biologics come to market. So, when I was actually training and we would see patients with rheumatoid arthritis come in with really severe ulnar deviations, which are those really sort of its very severe hand disabilities and deformations. And so I’ve really seen how these drugs that are infused have really changed patients’ lives and really eliminated a lot of disability. So that’s where I started in my career and I went to the pharmaceutical side and did everything from being a salesperson to a trainer. I actually led a national team of strategic account reps for a while, and we were working on a process and workflow in the rheumatology space. And then that sort of led me to where I am now. So I’m now leading this company at K2 and we are teaching and certifying people in healthcare on lean, lean thinking, and also our new product called air approach, which is really helping staff understand how to implement process improvements in things to help your workflow.

Dylan McCabe: Wow, that’s great. So you’ve gone from being an occupational therapist to a rep essentially to now leading, you’ve led sales teams and now you’re leading the agenda K2. So that’s really neat to your background. And of course, now I want to ask a lot more questions, but I’m definitely going to stick to some of the scripts here. For people that don’t know about K2, or haven’t heard about K2 before, what is K2 all about?

Kari Kalgren: Yeah, so we are a training company essentially, and we teach practices to create efficient healthcare experiences that could be in the infusion suite. It could be on the administrative side. A lot of practices are trying to gear up to be more aligned for value-based healthcare initiatives. But really it’s just looking at your workflow, assessing your gaps, and trying to figure out where those barriers or those bottlenecks are occurring and how you can implement change, so just a better experience, not only for the patients but really also the practices. You’ve probably heard a lot about the quadruple aim. And that’s something that is saying, listen, we know that we need to have value-based healthcare with good outcomes, good costs, good patient experiences. But that fourth leg of the stool, which makes it the quadruple aim, it’s really looking at burnout of physicians and practices. So there’s a lot of things that cause burnout, but workflow and a chaotic work life really sort of feed into that.

Dylan McCabe: That’s really good. And so do you guys work with physician offices and hospitals and startups or I mean kind of–. Do you guys have like, a niche that you focus on?

Kari Kalgren: Yeah, we really have kind of a heart for the private practices, but we also do work all the way up to large academic centers. We’re working with two academic centers in the northeast right now. I’m also looking at their process, but I would say the majority of our customers up to this point, we have worked with practices across the United States, predominantly private practices, but, you know, from downtown New York City to rural Montana and everywhere in between. So we see a lot of different settings.

Dylan McCabe: And so, when you talk about coming into a private practice and helping with the four areas that you mentioned a big part of that is workflow, but you mentioned physician burnout. I mean, that’s not something that you hear, people talk a lot about at least in our circles. So kind of, for people that are unfamiliar with that, explain what that means and why that’s important for the infusion practice.

Kari Kalgren: Yeah. You know, I can say it sort of–. I grew up in South Dakota and there was a saying that we always would say there, it was if mama’s not happy, no one’s happy. And you’ve probably heard that before. I kind of liking that to what we see in healthcare, that if you’ve got burned out, physicians that trickles down all the way through the practice and ultimately to the patient and the experience that they have. And so from an infusion standpoint you know, there is actually the work that’s being done in the infusion suite, but I would guess that most of the listeners that you have for this podcast really see that it impacts the entire practice. So this is from the time that the physician decides to put the patient on the drug. All the people on the back end that are doing the work to get the benefit verifications and the prior authorizations all the way through the different handout to making sure that the patient gets into his seat in the infusion suite, and then all the process that comes afterward as well, which is getting the reimbursement, doing the bile reconciliation. There’s a huge process around copay cards. The pharmaceutical manufacturers supply to the practices. And so this is additional staff and additional administrative burden on the practices and all the different touchpoints in between. And so really trying to think about how do we make that flow so that the physician isn’t getting notes back or alerts back to say, you know, this patient was last to follow up or didn’t get on the drug as we expected. It’s just a lot of things that can, you know hamper that practice or that process.

Dylan McCabe: That is so good. I mean, you are speaking my language. That’s really what we try to do is go in there and find out, with all the different, like you mentioned, handoffs that take place, handing the patient, essentially in that process from one person to the other in the office and different people carrying out different tasks, just trying to make sure that process is smooth. And it’s interesting to hear you say physician burnout because nurses obviously can get burned out too. And we had, recently had a big practice in the Southern part of the United States start using We Infused before that prior to using, We Infused they were, the nurses were charting on paper. And then after charting, after they finished at the end of the day, they would have to go and log into their EMR and put all of that data into their EMR, which took quite a long time because it’s such a high volume practice they’re doing, I think about 500 infusions a month. So as soon as they got on, We Infused and started charting in We Infuse, We Infuse automated that process to where the information is immediately digitized in a lot of detail. No joke, no exaggeration at all, the nurses started leaving on average two hours earlier every day.

Kari Kalgren: Yeah, I can absolutely believe that. I mean, the idea of automation with some human touch still involved, right. It was kind of what you’re explaining. And that is one of the big pillars of the lean certification and lean thinking. So, I mean, that’s really–. Lean came from the world of manufacturing cars. And so people sometimes think that’s sort of funny, you know, how does lean apply to healthcare? But there are so many parallels and that’s why that’s one of the big pillars of what we do here at K2. Everything revolves around lean and being trained on lean. So that’s one of the certifications that we offer.

Dylan McCabe: So for people not familiar with lean, what–. How would you describe that? What is lean thinking? What does it mean to be certified in lean through K2?

Kari Kalgren: Yeah. So K2 actually doesn’t do the certification. That comes from the society of manufacturing, engineers, or SME. This is a very well known, worldwide known certification process and really started in Japan with the Toyota production system. So the way that, you know, they’re looking at how do we manufacture cars? So back in the day, it was Ford and Toyota was looking to see, you know how Ford did things. And it’s a little bit counterintuitive that Ford is doing more of what we call a batching queue. So they are making a ton of product and then pushing it out to the customers. Where in the Toyota production system or lean, what they’re doing is saying, we’re going to make more continuous flow and make the item as the customer needs it, or as the customer holds it versus kind of pushing it out to them. And so it’s sort of a manufacturing principle at its core, but you’ll see lean being practiced in service industries now all different kinds of industries and even at restaurants I’ve seen lean and being employed.

Dylan McCabe: That is so interesting. So, it sounds like K2, it sounds like your expertise is really coming into a practice, identifying areas where it’s not lean and bringing in some efficiencies, bringing in strategy and it helps those four areas, so those four major outcomes that you mentioned, including physician burnout. Is that correct?

Kari Kalgren: That’s right. If you actually look at the paper the physicians that wrote this paper, the quadruple aim they are talking about that fourth leg that I’m talking about, the burnout, they actually call it clinician burnout. And so I’m glad to hear you say, the nurses are burned out too. I’m not glad to hear that they’re burned out, but I’m glad to hear that you’re thinking about that provider of care as both the nurses and the physicians because that’s what they layout in the paper too. And thus kind of the whole comment about, you know, it trickles down. And if people are not happy at the top, where they burned out at the top, it really kind of has this downstream effect.

Dylan McCabe: That’s great. Well, you know, we like to talk about the infusion practice as obviously as something that’s powerful and clinically speaking, because patients’ lives are changed. It’s just amazing what some of these drugs can do for the patients. But also business-wise, we like to talk about how you really need to have a lot of business acumen to have a thriving infusion practice. And it’s clear that you guys helped tremendously on that end. And when I hear about your experience of occupational therapy and then sales and then running sales teams, and now running the strategic agenda with K2; what’s one big takeaway you would want our listeners to learn from your main area of expertise today?

Kari Kalgren: Yeah. You know, I think, you know the market is just changing things; value-based healthcare is just changing how practices have to do business and how they interact with their patients. And so I guess two things we really need to be thinking about that patient experience. The patient value stream and what is valuable to the patient on the one hand. And on the other hand, I would really encourage people to look at their processes. And I know that’s not a fun thing to do. It can seem cumbersome. Some people hear the process and they think your accuracy is sort of a headache. You know, we really look at it as innovation and ways to be more strategic. And so I think just taking small chunks and approaching process improvement in small chunks and trying to make that a culture, what you do every day. These are the practices, the infusion suites, the hospitals that are going to end up being well-positioned to move into this value-based care. The two-sided risk contracts with some of the things that are coming and coming very quickly.

Dylan McCabe: That’s good because I think a lot of these infusion practices everybody’s so busy, no one is taking the time to stop, take a step back, look at the big picture and consider how are, we doing things? How can we do them better? Which is why it’s so great that somebody like you can come in and say, Hey, we better take a moment to figure out how we’re getting from point A to point B because we’re wasting a lot of time and we’re getting off the beaten path and we’re doing things we’re working harder, not smarter. So I think that’s great. Well, let’s switch gears a little bit. We know that in the infusion practice, just like any other business there’s challenges and there’s triumph. So let’s talk about maybe one of the biggest challenges that you faced in the infusion therapy world. If you could give us a specific, you know story or example, or just a trend that you see that stands out as something that’s really challenging for this space.

Kari Kalgren: Yeah, absolutely. I think that the bio reconciliation process is probably one of the most difficult things for practices to put into place. And so it’s the whole concept of a little bit of what we eluded to earlier from the very beginning to the very end. So even as you’re looking at your inventory coming in and being shipped to you as a practice there’s just a lot of different ways of doing things and not necessarily standard protocols written out or trained on teaching staff members. So for example, when that box comes with all the medication, who’s unpacking that box, and what is the process for doing that? And I’ve seen some really great best practices, and I’ve heard of some opportunities where we can really improve on things you know, looking at the expiration dates and sort of that FIFO, or the first in first out way of thinking. This could be even, you know, regarding your saline you know, are you putting the expiration dates that are going to expire sooner at the front and putting the newer inventory in towards the back? Are you having mistake-proofing sort of processes put into place? So for example, I’ll use saline again. You know, when you hang that bag of saline you are looking at the expiration date and we’re teaching practices, you know, take that Sharpie marker and circle the expiration date. So that, you know, it’s kind of a two-step check to make sure that you’re not, you know, doing something with an expired product. There are all sorts of things that kind of happen. And a lot of times it happens in the handoff processes. So in the bio reconciliation process, once we have used drugs and then we’ve restocked it, how are we communicating that back to the rest of the office? And sometimes we’re seeing people use paper logs on a clipboard that sits on a desk somewhere. And it makes me think of a practice that crazily enough, they had flooding issues from their sprinkler system twice in nine months. So you think about this one sheet of paper, that’s logging everything and lots of you know, dollars’ worth of drugs being ruined by a sprinkler system overnight when their office flooded. So do you have a backup record of that somewhere? So I think just that whole process of, you know, thinking it’s not fun, it’s kind of like balancing your checkbook, but it’s so incredibly important because this is one of the biggest revenue pieces for a lot of these offices.

Dylan McCabe: That’s great. That’s something we see a lot. I know that when I step into an office, one of my questions is always, what do you do? How do you manage your inventory? And I’ve seen extremes from, we don’t manage it at all. We just order in bulk to very sophisticated systems. But most of the time, what we see is either something like a spiral notebook or some sort of paper log, or at best an Excel spreadsheet that has to be updated manually. Over the course of about a year or so, it’s impossible not to make any mistakes. And so, that’s one of the things we’re really passionate about with our platform, as well as the nurses can chart the software is going to tell the nurse, pull these two vials. You know, if it’s, Actemra, it’s going to tell the nurse, pull one, 400 and pull two eighties, and it’s automatically going to record the NDC lot and expiration date of those vials. The software also pushes forward. Like you said, first in, first out, it’s going to push those files with the most, closest expiration dates to the present forward and do all of these things and automates that process. And then when the nurse closes out the nursing note, it automatically deducts those vials from the current inventory. And we’re very passionate about that because when I can get an office manager or a head nurse to open up about the challenges they’ve had, or the mistakes they’ve made, some of those mistakes are so costly, whether it’s scheduling a patient before their authorization approval date or scheduling a patient for an infusion and their insurance term three days later, but they went ahead and gave them the infusion anyway. And just the breakdown of communication between the back-office staff and the nurse or mistakes in the inventory, getting the buy and bill inventory, and the specialty pharmacy inventory mixed up. There are just so many little details. And it’s so easy to make a mistake, but as you know, what these vials, I mean, you know, you could be on the line for $10,000 with that mistake.

Kari Kalgren: Yeah, absolutely. We’ve heard of people saying that they, you know, a couple of years down the road, they went to move a refrigerator or something and found a vile under the refrigerator, or just, you know, all of these different stories and or things even just like I was mentioning before when the drug comes in, how are you unpacking that? And I’ve heard some best practices where they actually take the lid off of the last styrofoam piece. And we put it physically somewhere else to make sure that when they’re cleaning everything out that box nothing kind of falls, you know, to a hidden corner or gets left behind that potentially could get thrown out. So just really being vigilant about, you know, tracking every single piece. So I think your software is a fantastic solution for that.

Dylan McCabe: So what’s one big piece of advice with that said, and you mentioned the story with the sprinkler system, I’m going to use that story by the way in the future, but one kind of piece of advice, would that, for people that are listening?

Kari Kalgren: You know, I would say it’s a quote, not my own quote, admittedly, but the quote goes: a bad system will beat a good person every time. And so the people, our staff and the nurses, the people that are doing this work they’re healthcare workers, they have huge hearts. They really want to do the right thing. No, one’s doing anything intentionally incorrectly, but if you don’t have a process and you don’t have a system set up a bad system going to beat a good person every time.

Dylan McCabe: That’s so good. That’s very helpful. I mean, we pushed for that too. To make sure you got, you have a strong process in place so that everything’s not determined on the person in place. And it’s just, that’s so good. That’s a great quote. Well, let’s change gears and share another story with everything you’ve experienced so far. I mean, I’m sure you’ve gone into some practices and helped them with their processes and seeing things turn around or improve in a way that brought the practice to better clinical outcomes, better financial outcomes, and stuff like that. So with everything that you’ve seen, share what’s like a big light bulb moment that you’ve had, or a big aha moment that you’ve had when you’ve been interacting with all these different practices.

Kari Kalgren: Yeah. You know, it sounds kind of simple, but I think just spending time in the workplace. In lean we call that spending time in the Gemba. So, Gamba is a Japanese word for where the work takes place. And every time that we think yeah, we’ve got it solve, right. We work with infusion centers all the time. We know what their problems are and the issues are. Everyone is so unique in the way that they do things, so I would say to really understand that the process and really find the best target condition is to go on, to spend time in the infusion suite. So I encourage offices all the time or practice administrators try to take some time and think it through and spend time just watching the flow, the movement. There’s eight different ways, you know, that we can teach people to look for and also to think about it from the perspective of the patient. So as you’re the patient’s sitting in the chair, sort of what’s happening around you. Oftentimes they’re very cramped spaces and there are ways to set things up differently and try to have more of a continuous flow. We’re working with the practice right now who is kind of making the infusion chair itself almost sort of like the workstation cell. So they’re doing just what they need for every day. They’ve got a little station that kind of rolls up next to the chair, and it has just exactly what they need for that day, for that many patients. So that when they’re doing things they’re not running back and forth to the mixing station or the nurses’ station. So it just sorts of decreases the busy-ness and the chaos, in general of going back and forth and having a lot of wasted motion. So it can be really simple things. But that’s kind of a neat one that I’ve seen. And it kind of came from the idea of the dental chair and dental offices and how the patient stays central and things move around the patient. It’s all right there instead of having to go back and forth a lot.

Dylan McCabe: That is so neat. You know, it’s very rare that I personally have heard of somebody bringing this kind of strategy when it comes to managing your workflow, even your personal workflow because now you’re talking about the nurse and them not having to make an extra trip to get a supply or get something like that for the patient. I just think that’s so intriguing. Now, let me ask you this, how many people, or how many practices do you come across that are already doing this kind of stuff? Because it seems to me it would be pretty rare.

Kari Kalgren: Yeah. And you know, the ones that get really excited about, you know, implementing new things are typically the ones that are pretty savvy already. And they’re kind of in a place where they can implement some of these new, more innovative ways of thinking. We have an awful lot of practices that say, listen, we’ve been doing business through SPP and doing white banking. And we just want to get more into a buy and bill sort of mentality of doing business because of the sight of care and changes that are coming out from more of a sort of payer and regulatory space. So we see them all across the board, but the ones that have kind of figured out the business side of infusion, they’re not ready for that next level of how do we really improve this and make this good for the patient. When you sit back and look at, okay, what’s the patient watching out of this experience? What do they want at the end of the day? What steps are we taking all along that journey with them? You can start to see a lot of ways and things that the patient doesn’t necessarily need you to do, but we’re doing them because we’ve just been, always doing them, right. It’s sort of the status quo. And so by sort of mapping things out and drawing them out on paper, it makes it come to life so much more. And you kind of sit around as a group and say, gosh, do we need to be doing those things? Can we eliminate some of those things? And there are steps that we have to keep in place too, because of the payers. But it’s very interesting to sit and really with an open mind, look at your processes.

Dylan McCabe: Well, I like that because we’re going back to this scenario like you mentioned with the dentist chair, I mean, that really would make a better experience for the patient. I mean, it’s, you are doing things, putting processes in place that are going to ensure better patient care, a better environment, that the staff is going to have a lower stress level because things are smoother and stuff like that. But I have to ask the question that is going to come to mind for a lot of business people that are thinking about investing in infusions practices or starting one, how do these things impact the bottom line? I mean, what I know they will, but from your, I want to hear you talk about when you come into it and you use this lean strategy, how does it improve the financial situation?

Kari Kalgren: Yeah, it absolutely ties to the bottom line. So, I mean, you think about, I’ll give you kind of a general example and then bring it back to infusion. So if you think about the hospital and the OR suite, and you’ve got all these different teams coming in, right, to use the AUR suite and they weren’t having a standard way to turn over that operating room between each procedure, the hospital then that comes in and says, let’s make this a standard process. So we can really guarantee our turn times because we know if we’re more efficient there, we could get in another procedure in that suite in one day. Transfer that idea, that thinking over to the infusion suite. If we have a more efficient office or more efficient infusion suite, can you feasibly get more seats or you know, more infusions done, or can you stagger the way that you schedule so that you can have more opportunities for more infusions to be done? I have an office that was not using pumps, right? And so we were able to find them a way to get pumps in and kind of rearrange our schedule a bit. So they’re, the one nurse they had was able to still safely and effectively increase the productivity of how infusion she was able to provide.

Dylan McCabe: That’s so good. And I love those examples. Thank you for sharing those. And now there’s about 10 more questions I want to ask you (inaudible). Otherwise, this interview is going to be two hours, but that is so good. And I think that’s great because you have to solve both problems. And obviously, if the physician runs a practice that is making mistakes because of a cumbersome or sloppy process, even though everybody’s trying very hard to do a great job, if you do have financial mistakes, you can’t keep your doors open. So you have to focus on the financial aspect and at the same time, focus on the clinical side, which is why I think the physician practice with the infusion suite, it is a challenging business model. But I think that obviously, it’s also one of the most rewarding because you’re changing people’s lives and you have a lot of revenue running in and out of the office. So I just think that’s great. Well, let’s switch gears another time, one more time here, and tell our listeners what you’re doing now with K2 and everything. What are you most excited about right now in your business?

Kari Kalgren: I’m really excited about this new program. It’s called the Arim certification stands for ARIM, which is to assess, recommend; implement measures. And so what we were really realizing was that it’s great to have the lean certification and really understand the theory. And some of the tools behind that, what people really want to know is how to implement things. So we’re hearing things like you can talk strategy and you can talk theory to me but how do we make this happen, tactically? And so we’ve created a course, really just aimed at the staff workers and people that are going to be in charge of the change management in these practices. And so we’re helping them now understand better, how do we do this? So there’s three parts of that course. And it’s really looking at some of the theory and the rationale behind lean, but also showing them practical tools they get to start using almost essentially the very next day after they learn to use them. And then the last piece of that is how do they lead their teammates through change? So in one of my previous roles, we had done some studies to understand, you know, where are we falling down and we want to implement change? And it’s significant, only 15% were able to go back, implement an idea or a concept that they really bought into. They really wanted to participate in that because of the things we’ve mentioned here today. They’re too busy. They’re burned out. All these different things really hamper them to be able to pull it through. And so the biggest waste of resources is putting time and effort into something that never goes anywhere. And I think we’ve all seen this happen where we do something new, we train on it, two weeks, two months, whatever it goes by, you go back and we’ve kind of gone back into the old way of doing things. So I’m really excited about this course because it’s really talking about leadership and how to lead through change and make sure this sticks. And it’s a really nice opportunity too, for practices to offer to their staff, some sort of professional development. They don’t always get that in private practices.

Dylan McCabe: I don’t know Carrie. I mean, I can’t really identify. Everything I start, I complete. So is this a certification that people get through K2?

Kari Kalgren: It is. Yes.

Dylan McCabe: Okay. And is this like; is this in-person training? Is it an online course? Is it a mixture of the two? How does that work?

Kari Kalgren: Yeah. So we’re going to roll it out so that it’s an online course and offices can get you know, licenses for it, for their staff. We also are going to make it a workshop so we can kind of create it or customize it. We’re going to be doing some experimentation with it. We’re working with the norm group right now, which is the national organization of rheumatology managers. And then we’ll also be working with some other state societies in the retaliatory space and just kind of trying to figure out what works best. But right now it’ll sit online or be available as a workshop.

Dylan McCabe: That is exciting. And so at the end be sure to remind me if I don’t mention it, but I definitely want to ask you, how our listeners can get in touch with you but before we get there and just hearing what we’ve heard, I mean you clearly bring a lot of expertise to the table when it comes to the ideas of lean and improving things. And everything we’ve talked about, what’s this is going to be hard, but, what’s one last parting piece of advice for our listeners when it comes to the infusion practice.

Kari Kalgren: One last piece of advice, I would say, just go ahead and get started. Even if it’s something small, go ahead and get started. And to really try to create this culture of problem-solving so that people are willing to admit when there are mistakes or when they see opportunities for change, they’ll bring them forth and make it more of a learning environment, a culture of problem-solving. I think if you just start small, all these little things over time, do build up into something more significant.

Dylan McCabe: That’s so good because if we do have that attitude and we’re all on the same team and no one is threatened or feels like they’re under attack and we can focus on solutions and process all problem sets. That’s great because then we can actually deal with areas of weakness and not feel like anybody’s going to get, you know, tackled because they did a bad job.

Kari Kalgren: That’s right.

Dylan McCabe: So that’s really good. And so to make sure I don’t forget how can people follow up with you or get in touch with you?

Kari Kalgren: Yeah, so we’re on LinkedIn and Facebook, and on our website is just K2-health.com, and our email is hello@K2-health.com.

Dylan McCabe: So K2-health.com. You guys can check out their website, you can learn more about Kari, connected with her on LinkedIn. And I just think it’s great. And again, I really do want to follow up with you offline and learn more about these things because that’s our goal as well is to really just be helpful as much as we can to improve efficiency and do it not to the level that you guys can, but offer a software solution to help with that process. So Carrie, thank you so much for being on the show today. We really appreciate it.

Kari Kalgren: Absolutely. Thanks for having me.

Dylan McCabe: And for those of you that are listening and have not done so be sure to check out more podcast episodes on weinfuse.com and if you haven’t seen a demo of the software and would like to see one, be sure to request a demo today, just head over to weinfuse.com to get more valuable content on the infusion practice.

Guest Speaker: Kari Kalgren, OT, LBC, LSSGB currently serves as Senior Director of Strategy & Innovation at Premier Inc. With over 20 years of healthcare experience, Kari has held managing positions for more than 10 years. She received her BS in Occupational Therapy from Creighton University, a Professional Certificate in Healthcare Innovation from the University of Pennsylvania, and a Master Certificate in Six Sigma Green Belt & Lean Six Sigma from Villanova University.