Take Five with Sarah Wolf, MAS, RN, BSN, CCM, Senior Program Officer – Policy at the Quality Institute, and Jamie Agunsday, MA, MSN, RNC-OB, FAWHONN, Program Officer – Quality at the Quality Institute.

Take Five with Sarah Wolf, MAS, RN, BSN, CCM

What drew you from clinical care originally into health care quality and policy?

I started my career as a nurse in pediatric intensive care units first in New York, then at Children’s Hospital of Philadelphia. Early in my career, I also did home care case management, an experience that shifted how I understood systemic barriers. Visiting families in their homes showed me that the barriers they faced went far beyond the clinical setting.

As I moved through different roles—from clinical care into utilization management and leadership—I became increasingly interested in the systems and structures that shape patient experiences and outcomes. I realized that many of the barriers patients face aren’t purely clinical. They involve access issues, hospital and provider workflows, care delivery models, and real implementation challenges. Over time, I realized I wanted to influence care beyond one patient encounter at a time and help create something sustainable that could impact larger populations.

What is one challenge that you saw in clinical practice that you hope to help solve?

I repeatedly saw how difficult it is for patients and caregivers to navigate fragmented systems of care. A provider or care team can be fully engaged and committed, but barriers like inconsistent access, care coordination challenges, and social factors still affect outcomes.

When I was doing home visits, I saw what some families actually had to navigate day-to-day—whether a single parent dependent on Medicaid that may or may not pull through for them, or living in extreme poverty with multiple children and trying to manage day-to-day life on top of a child with complex medical needs. I’m excited about the opportunity to help bridge these gaps so that effective models of care can be adopted and sustained over time.

How will your clinical experience help you succeed in your new role?

My clinical experience gives me an understanding of what care delivery looks like on the frontline and the competing demands that providers, staff, patients, and families navigate every day. I’ve always been a champion of the patient perspective and advocated for patients I serve. My clinical background helps me bridge frontline perspectives and larger system needs, understand the language used at both levels, and translate that into realistic implementation that works for patients, families, and clinical teams.

What excites you most about joining Quality Institute?

I’m excited to work alongside people focused on meaningful change and to support initiatives that improve quality of care and outcomes. What really appeals to me is translating suggestions into real-world implementation and seeing those initiatives through.

What’s one goal you hope to accomplish in your first year?

My first goal is to build a strong understanding of the Quality Institute, its partners, collaborations, and the work already underway. I want to become a reliable resource and contribute meaningfully to policy and implementation efforts and relationship building.

Take Five with Jamie Agunsday, MA, MSN, RNC-OB, FAWHONN

What drew you from clinical care into health care quality and policy?

I made a later-in-career change to become a labor and delivery nurse. During my time at the bedside, we started having nationwide conversations about maternal mortality and morbidity. I remember reading the ProPublica and NPR series “Lost Mothers” in 2017, and it broke open the discussion about what was happening in maternal health, particularly the disparities affecting Black women. I didn’t realize how widespread the issue was until I saw women at the bedside experiencing severe birth-related complications.

That led me to get involved in quality improvement work on my unit and volunteer work with AWHONN, The Association of Women’s Health, Obstetric and Neonatal Nurses. I started working with patient advocates and families who had experienced serious birth-related complications. After a few years, I left the bedside to do maternal mortality work in New Jersey, where it was my job to tell the stories of those who died as a result of their pregnancies. Moving into the quality and safety space feels like a natural progression—from providing care at the bedside, to understanding the causes of death, to now working proactively to improve care.

What’s one challenge you saw in clinical practice that you hope to help solve?

The exclusion of the patient voice and patient perspective from plans of care during labor and debriefs after people experience birth-related complications. We really need to improve how we hear, listen, and respond to patients—making sure they’re at the center and involved in shared decision making, ensuring they have the information they need after they give birth to manage their own health care.

Time and time again, I hear from patients who experienced serious complications that their concerns were minimized, weren’t taken seriously, or weren’t addressed at all, and this led to serious harm. My work has focused on elevating the voices of patients and families and bringing their perspectives and stories into clinical spaces to help improve the care they receive.

How will your clinical experience help you succeed in your new role?

Being at the bedside gave me perspective on what it’s like to be part of a health care team that wants to do right by patients and provide good care while dealing with systemic barriers that get in the way. I understand the importance of creating solutions that work for clinicians who have to implement them. Improvement efforts should include input from frontline health care teams and from patients and families. Those closest to the work and most impacted by it can be meaningfully involved in creating safe, effective, and respectful care pathways. Projects like TeamBirth and Raising the Bar can help organizations do that.

Through my maternal mortality work, I also understand the larger systemic forces that contribute to the outcomes and inequities that persist in maternal health. I’m excited to bring this perspective to this role.

What excites you most about joining the Quality Institute?

I’ve relied on the Quality Institute for years to understand the landscape of health care in New Jersey. It’s easy to feel confined to your institution and limit your focus to what’s happening in the clinical environment. It takes effort to understand all the impacts on people’s health—not just what happens inside the clinical environment, but where people come from and where they go when discharged.

To improve maternal health, we need to understand the complex interplay between large systems and how they impact health in our communities. The Quality Institute creates an accessible place where anyone invested in improving health care in NJ can learn—from patients and families to policy makers to health care practitioners. The Quality Institute has built good relationships across the state and can convene experts to help us understand how health care policy and quality efforts can be advanced. It’s exciting to join such a well-respected organization to do work in my home state that is so meaningful to me.

What’s one goal you hope to accomplish in your first year?

My goal is to learn from the experts at the Quality Institute and determine how my experience and expertise can best serve the organization’s mission. I’m particularly excited to work on TeamBirth and bring a collaborative lens to other projects already underway.