Capabilities Statment

Serrano&Kraemer Medico-Legal Solutions provides:

• Healthcare System Redesign, based on LEAN/Six-Sigma principles, Critical Thinking, and Patient Safety
• Legal Nurse consulting services, saving you time and money on medically related legal cases

Serrano&Kraemer Medico-Legal Solutions has the expertise to provide two major services in the Healthcare and Legal industries. Combined they possess over 65 years of experience in all aspects of adult health care from a clinical, organizational and administrative perspective. Together, they are currently trained and certified in LEAN/Six-Sigma Black Belt (LSSBB) system redesign, project management (PMP), Healthcare Quality (CPHQ) and are both active members of the Minnesota State Bar Association (MSBA) as Law Management Associates. Their skills have been sought on both local and national levels.

In Healthcare System Redesign, they provide expertise and mentoring on High Reliability Organization (HRO) principles in the pursuit of "Zero Harm", focusing on patient safety, leadership mentoring, healthcare processes, and regulatory oversight. Combining LEAN/Six-Sigma methodology and project management skills, they are able to lead and provide teams insight from the medical viewpoint to streamline, standardize, and eliminate waste in current healthcare processes. Results have included improved patient outcomes and patient satisfaction, and timeliness of services, while decreasing costs.

As Certified Legal Nurse Consultants, Serrano & Kraemer have the expertise to identify and interpret medical records in any case involving health, injury or illness. Their unique work experience in investigating adverse healthcare events allows them to assimilate information from all relevant components of the medical record to identify cause and effect relationships. Additionally, their experience with regulatory agencies and current standards of care set them apart from others in their field.

The following healthcare outcomes are directly related to the System Redesign and Facilitation expertise of Linda Kraemer and Sandra Serrano:

• Decreased inappropriate indwelling foley catheter utilization from 15% to 1.2% with projected cost avoidance of 94K annually
• Reduced admissions due to prescribing errors by 50%
• Received (facility) the Goldstone Award 2009-2011 for the quality and timeliness of Root Cause Analyses in a tertiary teaching hospital.
• Improved anticoagulation safety through IT approaches for prescribing and education; Compliance with order initiation reached 83%, utilization of the discharge order set 95% and dietary education 98%
• Inculcated organizational culture change for staff in a tertiary teaching hospital to report near miss and actual adverse patient care events, increasing the number of reported events from 1000 to 3000 annually
• Improved timeliness from Initial ENT Consult to Patient receiving first definitive treatment for cancer from a median of 54 days to a median of 25 days (post-intervention)- a 53% reduction on the number of days to definitive treatment.
• Improved timeliness from initial ENT clinic assessment to Medicine Pre-Op appointment, from a median of 20.5 days to a median of 1.67 days (post-intervention)- a 91.8% reduction on number of days.
• Improved utilization of OR Suites (for a specific service), from a baseline median utilization of 62.8% to a post-intervention utilization of 81.6%.
• Achieved the following improvements in the redesign of the Rapid Response System:
• A decrease in unexpected mortality in the Acute Care setting; from a median of 3.3 deaths/1000 discharges to a median of 2.0 deaths /1000 discharges. This converts to a decrease of 26 unexpected Acute Care deaths/20,000 discharges (a 39.4% decrease).
• A decrease in Cardiopulmonary Arrests in the Non-ICU/ED areas; from a mean of 4.27 arrests to a mean of 2.72/1000 discharges. This converts to a decrease of 31 cardiopulmonary arrests/20,000 discharges (a 36.3% decrease).

Serrano&Kraemer donate to and are involved in the following communities:

• Co-founder and Board Member of the US based 501(c)3 “Friends of TASAAGA” (Tokamalirawo AIDS Support and Action Group Awareness). This non-profit works to improve the lives of disadvantaged youth in the rural communities of Uganda affected by HIV/AIDs and extreme poverty through education, skills training, support of a medical clinic in the Ssese Islands, sponsoring a micro-finance program for Ugandan women, and testing and health counseling for refugees of the Nakivale Refugee Settlement through sponsored Kick HIV/AIDs soccer tournaments.
• Wings of Refuge- Health assessment of HIV orphans- Tanzania, Africa (Kraemer)
• Susan G. Komen 3-Day Race for the Cure: Multiple years of volunteer work as a Medical Staffer during the event (Serrano).