Our Team

Bobbi has over 15 years of experience working in healthcare in various roles to improve patient care, organize staff development training, and support operational services. She works collaboratively with cross-functional teams (e.g., Material Services, Facilities, Hospitality, EH&S, D&C, and Patient Safety) to support the opening of new sites (e.g., hospital units, ambulatory clinics, LPPH relocation to Mt. Zion, HDH construction impacts, and Bayfront Medical Building).

During the pandemic, Bobbi served as the Chief Logistics Officer for all UCSF Covid Vaccination sites. She navigated the challenging supply shortages and ensured all sites were fully operational daily.

Bobbi has been recognized by colleagues and leaders for her continuous demonstration of our core values: Professionalism, Respect, Integrity, Diversity, and Excellence. She received the UCSF Health Q3 2021 PRIDE Experience Award.

Dr. Lei Choi is an internal medicine specialist who provides primary care for adults. She is medical director for UCSF's continuous improvement objective and co-director of the UCSF School of Medicine's Health System's Improvement, a curriculum for medical students that incorporates skills in health systems improvement among other professional competencies.

Choi earned her medical degree at Duke University School of Medicine. She completed a residency in internal medicine at Vanderbilt University Medical Center. She earned a master of public health degree at Tufts University.

Choi's passions include teaching, coaching and driving improvements in health care delivery. She serves as an organizational leader in system-wide improvement efforts at UCSF, including those to increase efficiency by streamlining processes, eliminating waste and delivering greater value to patients. She has led numerous initiatives to streamline care processes, and has provided training and coaching to hundreds of faculty and team members. In 2018, as part of a grant from the Accreditation Council for Graduate Medical Education, she co-founded the UCSF Learning Health System Coach Initiative to foster innovation in the subfield focused on analyzing health care data to serve quality improvement.

Choi is a fellow of the American College of Physicians.

Denise Elgarico is the Assistant Director of the Continuous Improvement Department at UCSF Health.

As an effective communicator, motivating educator, and caring leader, she has led numerous successful process improvement initiatives that have drastically improved department morale, increased patient satisfaction, and resulted in millions of dollars of cost savings for the organization.

Born and raised in San Francisco, Denise is a Bay Area native and proud mother of Noa Xavier, who joined her growing family in July 2024.

Brian Holt is a Senior Improvement Advisor as well as the former Program Manager of the Caring Wisely program at UCSF. He has an MHA from Suffolk University in Boston and has over 17 years of healthcare process improvement, project, and change management experience working at Massachusetts General Hospital, Partners in Health, Partners Healthcare International, and UCSF in both the inpatient and outpatient settings as well as domestic and international settings such as Qatar and Peru. His mission is to help the people who help the patients by creating the time, space, and structure for teams to methodically explore improvement opportunities.

Since joining UCSF in 2017, Brian has coached and/or led value improvement efforts, which have generated almost $17 million in direct cost savings/increased revenue while maintaining or improving patient outcomes. Brian has also co-authored articles in Health Affairs, the Journal of Hospital Medicine, and Geriatric Nursing.

Brian enjoys reading, music, movies, and the outdoors (as well as working with his partner Kelsey to desperately try to keep it together with 2 boys under the age of 10).

Emily Ko is a senior program manager who supports Continuous Improvement programs and projects, including the Lean Leadership Development program, Graduate Medical Education (GME) quality improvement incentive program, REFLECT, and Learning Health System Coaching program, to name a few.

During the pandemic in March 2020, Emily mobilized residents' Lean engagement using a novel virtual management system and spread the learning across the health system. In addition, she supported the COVID-19 Provider Communication and Tools team that was formed in response to the pandemic to communicate time-sensitive information to clinicians treating patients with COVID-19.

Emily holds a Bachelor of Science in Business Administration with a concentration in International Business and Management from San Francisco State University.

Edwin Lager is a senior continuous improvement advisor in UCSF’s Continuous Improvement department. He strives to improve the experience of patients and staff at UCSF by coaching and implementing sustained incremental improvement. Edwin received a Bachelor of Science in industrial engineering from Cal Poly San Luis Obispo and has extensive experience in problem-solving and process improvement tools. In his free time, he enjoys spending time with his family, traveling, and all things outdoors, particularly cycling and surfing.

Raj is an Industrial Engineer with extensive experience in performance improvement and operations leadership within the food processing, biologics, and healthcare industries.

His goal is to empower teams and organizations to excel in fulfilling their mission by creating systems and processes that prioritize both the people they serve and those who contribute to the mission's success.

Raj is passionate about problem-solving and thrives on applying industrial engineering principles, lean methodologies, IT, and data analytics to drive efficiency and innovation.

Outside of work, he enjoys exploring the outdoors with his dog, Ace, and finds joy in cooking for family and friends.

Karishma is a dedicated healthcare professional with a wealth of experience in quality improvement and leadership. She began her journey at UCSF Health in 2016, where she led numerous process enhancement initiatives and effectively utilized quality management metrics to drive performance improvements across the sector. Her background reflects a strong commitment to customer service, operations, and management excellence. Recognized for her transparent leadership style, Karishma cultivates a culture of compassion and continually strives for improvement.

She earned a Bachelor of Arts in Anthropology from the University of California, Merced, and a Master of Science in Healthcare Administration and Interprofessional Leadership from the University of California, San Francisco. In her spare time, she enjoys swimming and exploring California's breathtaking coastal trails. Passionate about learning and personal growth, Karishma enriches her intellect through insightful books and meaningful conversations. She also delights in savoring exquisite cuisine and immersing herself in diverse cultures during her travels.