Five Questions with Jonathan Wolinsky: Building Autonomy and Trust in Childbirth

In our Five-Question series, we highlight the staff and faculty behind the compelling work at Ariadne Labs.

When joining the lab, Jonathan Wolinsky, MPP, was drawn to Ariadne Labs’ commitment to human-centered innovation, and he was surprised how nimble it was. Jonathan, the Assistant Director of Project Management for Delivery Decisions Initiative (DDI), oversees the finance, project management, and planning for the team. 

Jonathan was a program manager for Massachusetts Health Policy Commission, a quasi-independent state agency tasked with monitoring health care costs and quality,  where he worked on quality improvement initiatives around the state, especially focusing on the opioid crisis. Jonathan graduated from Wheaton College with a bachelor’s degree in political science, then went on to achieve a master’s in public policy from Brown University. 

Q: What brought you to Ariadne Labs?

I was previously working with the state, and there were, appropriately, limitations on what the state was able to do. I think I was looking to be less constrained by those limitations and more able to explore what health care quality improvement and process improvement could look like in a different setting. A big focus in health care policy circles is moving upstream. So, instead of providing housing to someone who’s unhoused or providing treatment to someone with opioid use disorder, what can you do before they get to that point? And that’s a really cool idea, and I think you can really move needles in terms of outcomes and cost savings and patient experience.

Ariadne is truly designed to be nimble and be more able to go where the need is and explore that need and hopefully address the need. We’re in this space to help those who are already here to raise up the voices and put forward ideas that might have either not been talked about or been marginalized to provide whatever resources and value we can bring to the equation without being the whole equation. I found that it’s a genuine place to be in terms of actually trying to be savvy and compassionate about making change.

Q: What has been a core memory working for Ariadne Labs?

There are a lot of them, but one is going to Stockholm, Sweden to visit with a research midwife at a leading medical institution. They had taken all of our publicly available TeamBirth information and implemented TeamBirth at two hospitals. It’s now grown to six sites. TeamBirth’s focus is capitalizing on data around improved autonomy and trust in health care providers, all built to the U.S. health care system context. Sweden is a country that does health care really well, so it was interesting to see the concept of TeamBirth still resonating with them. Their outcomes are great by most standards, but patients can still have bad experiences. When a woman goes in to give birth, she’s not sick, she’s going on to do one of the most fundamental things a human can do, but we’ve medicalized it quite significantly. It was really interesting to see how even in a different culture and health care system, people still recognize that birth is an experience that should be amazing, not just an outcome. 

Q: How has our mission impacted your career?

I think the intentionality of the work we do has definitely had an impact and shown me the importance of narrative to drive substantive change. It’s great and important for organizations to track process measures and key metrics for accountability. But Ariadne isn’t looking at those metrics in a vacuum. When DDI is looking at what we’ve done in the last year, sure, we look at how many lives we’ve touched, how many trainings we’ve held, but it’s also a question of have we advanced the conversation, have we advanced the narrative? What are the patient comments saying from a TeamBirth hospital in Oklahoma? Or what is that medical resident focus group discussion talking about? What were those nursing students saying about how TeamBirth impacted how they’re going to be providing care? That narrative is built on people’s experiences and people’s perceptions. And when you have a narrative that is improving and showing success and you’re in an organization that is allowed to count that improvement as a success, that allows us freedom, gives us support, and lets our work be genuine, but also substantive. That’s all had a great impact on my career and how I see my work going forward.

Q: Before Joining Ariadne, what did you expect? What surprised you after joining our team?

I was hesitant to leave my old job because I really liked the people. And I’ve found, even in hectic or challenging positions, the people really make a difference. If you’re in it with people that you respect, admire, and trust, that’s really important.

So coming to Ariadne, it is not that I wasn’t expecting that, but I was happy to find my people again in a different setting. It’s been really fun to find a very diverse group of people, with different goals, work experience, and backgrounds, all trying to swim in a similar direction. When I first joined, I was trying to find the common thread between the programs, since they can feel siloed. My work doesn’t affect what Primary Health Care is doing, and vice versa. But then you sit in on one meeting of DDI and the Serious Illness Care team, for example, and the energy that swaps between our teams is infectious. You realize it doesn’t matter that our teams might have different populations we work with or different metrics that we track because the processes we use, how we use our resources, how we approach questions, and the fact that everyone wants to share those experiences is really heartening and really makes me want to stick around.

Q: Looking ahead, what excites you the most about Ariadne’s future work?

It’s been exciting to see TeamBirth expanding across the country, and I’m really excited to watch that expansion continue and see how it evolves. I think that’s one of the really cool things about Ariadne, is watching so many of our projects move from an idea through the phases of the Ariadne Arc and turn into something that can have an impact on so many lives.