About Us

Julie A. Kliger, MPA, BSN

Julie A. Kliger, MPA, BSN - Principal and CEOJulie A. Kliger
Principal and CEO

Over the last 26 years Julie Kliger has established herself as a leading voice for patient safety and improved outcomes. Her work in addressing practice redesign in healthcare has been nationally recognized for its unprecedented achievements in reducing medication administration error and sepsis mortality.

Ms. Kliger's most recent work concentrates on the critically important work of healthcare’s front-line clinicians. With the University of California at San Francisco's Center for Health Professionals she is directing the Integrated Care Leadership Network (ICLN), which began as an $18 million, multi-year/multi-system project (The Integrated Nurse Leadership Program) to measurably improve outcomes. Current outcomes include:

  • 54.5% reduction in sepsis mortality
  • 30.0% reduction in medication errors

In addition to the above noted work, Ms. Kliger is also working with the California Association of Public Hospitals as the state-wide sepsis consultant, Stanford University’s Clinical Excellence Research Center as coach to the Fellows, Institute for Healthcare Improvement (IHI) as a faculty member, Daughters of Charity Health System as their state-wide sepsis consultant, Agency for Health Research Quality Innovator, 3M, among other private and not-for-profit organizations.

To further her work, Ms. Kliger established The Altos Group (www.thealtosgroup.com), an organizational improvement and management advisory firm that works exclusively with healthcare organizations. With a philosophy focused on outcomes, implementation and partnership, The Altos Group helps clients achieve quantifiable improvements in care by developing the leadership skill-set of front line clinicians.

Prior to establishing her own firm, Ms. Kliger worked for the University of California Office of the President in the Division of Clinical Services Development as Associate Director of Quality. In this position she led the implementation of the first ever system-wide, web based error reporting program which is still active across all five academic medical centers. Due to her work on this project, she was asked to be a member of the National Quality Forum’s task force to develop a national taxonomy standard for error reporting systems.

Ms. Kliger is a published author and her articles can be found in the Archives of Internal Medicine (April, 2010), Joint Commissions' Journal on Quality and Patient Safety (Dec, 2009 and Feb, 2012), Journal of Nursing Administration (March, 2010) among several other notable publications. She has been an invited speaker at numerous national conferences including, Joint Commission, National Quality Forum, University Health Consortium (UHC), RAND Corp., Stanford University, American College of Emergency Physicians (ACEP), BMJ’s International Conference, Robert Wood Johnson Foundation (RWJF), Moore Foundation, Institute for Healthcare Improvement (IHI), American Organization of Nurse Executives (AONE).

Ms. Kliger completed her Master's in Public Administration at Harvard University’s Kennedy School of Government where she focused on patient safety and error reduction policies. aShe holds a Bachelor's of Science in Nursing from Columbia University in New York City and a Bachelor’s of Arts from UC Berkeley.

Martie Mattson, RN, MSN, CNS, CCRN

Martie Mattson, RN, MSN, CNS, CCRNMartie Mattson
Faculty

Ms. Mattson is a Critical Care Clinical Nurse Specialist, Educator and Consultant, and an Assistant Clinical Faculty in UCSF’s Department of Physiological Nursing. She has extensive experience in critical care nursing as a staff nurse, manager, educator and clinical nurse specialist. Currently she is working as the Sepsis Consultant for The Altos Group, which has consulted with the University of California, San Francisco Medical Center and the Daughters of Charity Health System. She was the Sepsis Consultant for the Integrated Nurse Leadership Program Sepsis Project  that spanned nine hospitals in the San Francisco Bay Area and was conducted through the UCSF Center for the Health Professions

Her previous position was the Critical Care Clinical Nurse Specialist at California Pacific Medical Center, San Francisco, California, where she co-chaired the project to implement the Surviving Sepsis Campaign recommendations at CPMC. In addition she consulted with other Sutter affilated hospitals to assist them in setting up their sepsis management programs.

Ms. Mattson has authored two chapters in the Critical Care Nursing Secrets book and has frequently lectured on a variety of critical care topics throughout the Bay Area and the state. She is a member of the American Association of Critical Care Nurses and the Society of Critical Care Medicine. She is a retired Army Nurse Corps Colonel and served in Vietnam, Korea, Colorado, and California.

Ms. Mattson earned her nursing diploma from Pittsburgh Hospital School of Nursing, her BSN from Metropolitan State College in Denver, Colorado and her MSN from the University of San Francisco.

Joan Grebe, MA, OT

Joan Grebe, MA, OTJoan Grebe
Faculty

Joan Grebe is an independent healthcare consultant specializing in educating others about quality improvement tools and techniques and facilitating quality improvement teams. She currently works with several national organizations to develop training series geared to strengthen systems at the strategic level and to develop technical support for improving the patient experience and the system’s clinical performance. In addition, Ms. Grebe is an Improvement Advisor for the Institute for Healthcare Improvement (IHI) Sepsis Collaborative. Previously, she was Improvement Advisor for the Improving Outcomes for High Risk and Clinically Ill Patients IMPACT Community of IHI and Assistant Director for IHI in the National Vascular Access Improvement Initiative “Fistula First” large spread project, conducted in conjunction with the Centers for Medicare and Medicaid Services and the End Stage Renal Disease Networks.

Joan received a Bachelor of Science and a Master of Arts degree from Tufts University, Boston School of Occupational Therapy. Her experience as an occupational therapist at both the staff and administrative levels includes acute inpatient, rehabilitation, home health, outpatient, and long-term care.

She is a certified Zenger-Miller trainer and is a member of the American Society for Quality, the American Society for Training and Development, and the American Association of Occupational Therapy. Joan is also trained in Appreciative Inquiry facilitation and the Lean approach to quality improvement.

Paul Carlisle, PT, MPT, GCS

Paul Carlisle, PT, MPT, GCSPaul Carlisle  Faculty

Paul Carlisle received his BA from the University of California at Santa Barbara and his MPT from Emory University in Atlanta, Georgia.  He is currently the Director of Rehabilitation at San Mateo Medical Center in San Mateo, California.  His 25+ years of clinical experience treating geriatric clients spans the spectrum of service delivery, including: outpatient, inpatient, acute rehabilitation, long-term care, prison healthcare, and home care.

Paul has extensive experience leading and facilitating major quality improvement initiatives with an interdisciplinary focus using Lean principles.  He is currently enrolled in a Lean Fellowship program tasked with developing standard work for leaders.  In addition, he is a graduate Fellow from the California Health Care Foundation Leadership Program. He is actively involved in teaching and currently holds an Assistant Clinical Professor faculty appointment at the University of California in San Francisco.  His areas of teaching emphasis are: law, ethics, fundamentals of leadership and management, quality improvement, and contemporary issues in physical therapy.

Cindy Lambdin, RN, MS

Martie Mattson, RN, MSN, CNS, CCRNCindy Lambdin
Faculty

Cindy Lambdin, RN, MS is a graduate of University of California, San Francisco where she received her Master’s as an Emergency/Trauma Clinical Nurse Specialist and a Minor in Education.   Cindy has been on faculty with the University of California, Berkeley's, School of Public Health, serving as the Emergency Operations Specialist providing program development and  technical support as a Program Director and Project/Policy Analyst for UC Berkeley’s, Center for Infectious Disease and Emergency Readiness (CIDER) Team. 

Cindy has worked in the acute hospital setting for twenty-nine years with focused clinical time in the emergency department, critical care, and step-down units.  Cindy maintains a current clinical leadership role which includes in depth knowledge of the emergency departments, performance and process improvement design, development, implementation, and monitoring. 

Cindy's professional roles have focused on  working collaboratively with city, county and state agencies, public sector,  and healthcare organizations to promote and improve clinical excellence, team growth, and focusing on dedicated issues which impact the healthcare industry including early identification of infectious diseases and clinical management, and  disaster preparedness, response, and recovery.

Michael D. Taylor, MD, FACS

Mike Taylor, MD, FACSMichael D. Taylor
Faculty

Dr. Taylor has been a community hospital intensivist for his entire career, also serving as a trauma surgeon for the first seven years. His practice has been primarily at a 450-bed Level 2 trauma center with a 32-bed medical-surgical intensive care unit. He is actively involved in medical student, resident, and nursing education. He showed up to a committee meeting several years ago, and subsequently found himself on a number of hospital and health care system committees, including Patient Safety, Injury Prevention, Utilization Management, IT Clinical Systems, Blood Utilization, and Capital Allocation. He has clinical interests in sepsis, wound care, vascular access, nutrition support, and injury prevention, and he is currently working on a number of initiatives to reduce waste in the hospital.

He earned a BS in mathematics from Cleveland State University and his MD from the University of Louisville. After graduating from a General Surgery residency in Cleveland, Ohio, he went on to complete a Critical Care fellowship at Brown University. Prior to his medical career, he was a utility helicopter crewchief in the US Army. He and his wife, Jackie, live in a suburb of Cleveland, Ohio, where they own and manage a large residential rental property.

Kat Russell, MSN, RN, CNL, PHN

Kat Russell, MSNKat Russell
Faculty

Kat Russell is a Registered Nurse and Clinical Nurse Leader with a passion for improving patient outcomes through quality improvement initiatives and cost-effectiveness strategies. Ms. Russell currently serves as a Health Editor with the Integrated Care Leadership Network, championing the development and implementation of an online platform to accelerate the adoption of evidence-based practices and innovative strategies in clinical settings. As a Project Manager and Clinical Advisor for The Altos Group, Ms. Russell supports hospitals within the California Hospital Engagement Network to achieve success in improving patient experience, clinical effectiveness and patient safety. She earned her Master's in Nursing from the University of San Francisco in the Clinical Nurse Leader (CNL) program. Ms. Russell completed her CNL residency in University of California, San Francisco's Clinical & Translational Science Institute, improving research participant satisfaction and comprehension during the informed consent process. She holds a B.A. in East Asian Languages and Literature from the University of Oregon, and is a member of Sigma Theta Tau International Nursing Society.

Michele A. Rubin, PhD

Michele A. Rubin, PhDMichele A. Rubin
Faculty

Dr. Rubin is currently the Accreditation and Licensing Principal Consultant for the UC San Diego Health System, has over 20 years experience in Health Care Regulatory Affairs and Compliance, Quality Improvement, Leadership and Risk Management.

She has extensive experience with Tracer Methodology as well as all aspects of health care licensing and accreditation. Areas of expertise include licensing and regulatory plan development, TJC Accreditation Compliance and TJC Disease-Specific Certification (DSC). This includes managing compliance activities that address all TJC functions and standards, including the Environment of Care, Life Safety, Emergency Management, Patient Rights, and National Patient Safety Goals.

Dr. Rubin also provides support during and after CMS Surveys, including partial and full validation surveys, advice during Immediate Jeopardy Situations, and guidance on compliance with the Emergency Medical Treatment and Active Labor Act, among other functions.

Dr. Michele A. Rubin’s extensive education includes a Ph.D. and Masters from UC San Diego, and a Masters in Management of Health and Human Services from The Florence Heller School of Advanced Studies in Health Administration and Social Welfare from Brandeis University.

Tom Sappington, PhD

Tom Sappington, PhDTom Sappington
Faculty

Dr. Sappington specializes in the fields of strategic planning, leadership development, organizational change, and executive coaching. He has a Ph.D. from the Fielding Institute in Santa Barbara, California. Much of Tom's recent work has been for clients of Duke Corporate Education; namely PriceWaterhouseCoopers, Ford Motor Company, Merck, and the Fuqua School of Business. In his work with PwC, he has been involved in Quality Lens, IFS Coaching Training, Turning Point, and SOAR3. He has also worked with the Pew Center for the Health Professions, the Howard Hughes Medical Institute, NIH, and the Raleigh City Government. Dr. Sappington has been an Altos Group faculty member since 2005.

Thomas Huber, MS

Thomas HuberThomas Huber
Faculty

Thomas is a performance improvement advisor. His primary focus is on creating high performing front line teams that drive organizational performance. As an applied researcher and faculty member at Dartmouth Medical School he helped develop the microsystem model; a comprehensive approach to transforming organizations toward superior cost, quality, and service. Since 1996 he has worked with clients across the care continuum in more than 30 states. He has a MS degree from the Dartmouth Institute of Health Policy, and a BA in Philosophy and Psychology from Dartmouth College. He has taught training seminars at the Institute for Healthcare Improvement, and the Dartmouth Institute for Health Policy and Clinical Practice, and the American Hospital Association. Thomas lives in the Bay Area and enjoys kite surfing in the summer and skiing in the winter.

Martin Luz, MA

Martin Luz, MAMartin Luz
Faculty

Martin has been working in the field of public relations and strategic communications for 20 years. He brings extensive experience in a wide range of disciplines from message development, identity and branding, to media relations and internal communications. His diverse background as a practitioner includes work at PR agencies, in-house (managing corporate PR and communications programs), and as an independent consultant. Martin's industry specialties include insurance (life/health), asset management and banking, energy, management consulting and not-for-profit institutions. As a writer, he brings a specialty in thought leadership programs, having completed white papers and supporting collateral on a breadth of topics. He has written annual reports, identity and banding brochures, product collateral, websites — and entire range of marketing and communications materials. His ghost-written articles for clients have appeared in dozens of business publications in the U.S., Europe, and the Middle East. He holds a BA in Philosophy from Boston University and an MA in Creative Writing from The City University of New York.

Jackie Lebihan, MHA-IL(c)

Jackie Lebihan - Director of OperationsJackie Lebihan
Project Director

Jackie Lebihan joined the Altos Group in April 2012. Previously she helped successfully launch, grow, and manage multiple start-ups across industries. She currently serves on the Board of Directors for a fast-growing engineering and manufacturing business.

After receiving a BA in political science from Texas A&M University, she entered hi-tech in Silicon Valley as a consultant and project manager where she led numerous global technology engagements. Jackie became a successful entrepreneur launching her first business in 2003.  After a recent health crisis, Ms. Lebihan decided to pursue work in health care in an effort to improve health care delivery. Jackie is pursuing a Masters in Health Care Administration and Interprofessional Leadership through the University of California, San Francisco.  Jackie brings considerable experience in consulting, project and program management, operations, and business development. She has a passion for leveraging best practices across industries to improve performance and quality, the strategic use of technology in health care, and for operationalizing best practices.

Robert Duffy, MPA

Robert Duffy, MPARobert Duffy
Director of Strategy & Development

Bob Duffy has devoted his career to developing and implementing strategies that impact key issues in the public service sector. Bob is known nationally for his political acumen, particularly regarding his work on key local, state, and national campaigns and issues. His passion is now focused on making the world a better place through reducing healthcare costs and improving quality. He produces the Massachusetts Teachers Association's (MTA) TV & Radio advertising and earned media campaigns, creates public affairs and cause marketing programs, and provides crisis communications and public relations assistance to MTA locals throughout Massachusetts. Bob created and serves as President of an award winning 501c3 foundation, Reading Matters Inc, which uses cause marketing to promote student achievement in Massachusetts.

Bob has consulted for former U.S. Senator Edward Kennedy, U.S. Sen. John Kerry and numerous candidates and political causes including the President's Summit for America's Future, and other groups that promote volunteerism and public service. As a White House Advance person for the Clinton Gore Administration and the Clinton Gore election committees, he helped organize the 1996 Inauguration and worked on over 75 White House events involving President and Hillary Clinton, Vice President and Tipper Gore and various cabinet secretaries. He represented the White House in planning and conducting high profile diplomatic visits to Bosnia and Egypt. He also has covered politics and government as a print, television, and radio journalist at BusinessWeek Magazine, The Boston Globe, The Boston Business Journal, WMEX Radio and several local television stations in Massachusetts, Vermont, New Hampshire and Alaska.

Bob holds a B.S. in Journalism from Northeastern University and a Masters in Public Administration from Harvard University's Kennedy School of Government.

Cynthia L. Talmadge


Cynthia L. Talmadge
Faculty, Communications Advisory

Cynthia Talmadge has over 30 years of experience in a variety of both internal and external communications.

 As Head of Global Marketing and Communications with RREEF, an international leader in real estate investment management, Ms. Talmadge was responsible for a wide range of marketing and communication initiatives, including successfully extending the RREEF brand globally upon the firm’s acquisition by Deutsche Bank.  She has extensive experience in the multiple components involved to create, build and sustain a firm’s brand identity including public and media relations, collateral materials, client, industry and internal conferences and events, advertising, and website development and maintenance.