Ava Jones, PhD, RN, explains her role as a Director of Quality Management for UnitedHealthcare.
This week we’re profiling another UnitedHealth Group employee playing a critical role in the quest to improve health care. Ava Jones is a Director of Quality Management – but what does that mean? And why is the role so important to the future of health care?
Ira Apfel 00:05
Hello and welcome to UnitedHealth Group’s Weekly Dose Podcast, where we’ll get you up to speed on the latest trends shaping the future of health care. I’m your host Ira Apfel. This week we’re profiling another UnitedHealth Group employee playing a critical role in the quest to improve health care. As health care becomes more consumer centric, the industry’s racing to improve the quality of patient care. But what does that mean? And why is it such a challenge? UnitedHealthcare employs hundreds of workers around the globe whose sole job is to measure and improve health care quality. In this episode, we’re going to talk to one of them. Ava Jones is a director of quality Florida Community and State, she leads UnitedHealthcare’s quality efforts in the state of Florida. She’s a registered nurse with a master’s in management. And she recently earned a PhD in organizational leadership. Ava and her team of eight oversee for the 11 regions in Florida, including Jacksonville, Tampa, Orlando and Miami Dade, roughly 350,000 members.
Ava Jones 01:06
But in the most simplistic terms, we are charged with ensuring very good health care outcomes for our Medicaid members. And so heat is presents a data set if you will have about 4041 clinical measures. And those clinical measures speak to the health and wellness of our members. So he this amounts to clinical indicators of health and wellness. I have an incredible team of eight extremely talented nurses, public health, medical dental experts, and the most awesome data and analytics professionals. They refer to themselves as data whispers, and they are able to extract intelligence from any data set given to them.
Ira Apfel 02:03
Ava is eager to explain what she and her team do without jargon and acronyms.
Ava Jones 02:08
Quality is an enigma. So what we do is we’re are referred to us and my team, you know, their eyes will just glaze over when I say this, but it just presents a very good picture. I see us as the wheel within the wheel. And oftentimes we’ll use a wagon wheel on a stagecoach right. And so you have that, that centermost wheel, and then you have the spokes that go out to that outermost wheel. And so we are the wheel within the wheel, we’re behind the scenes, just making sure that the spokes that go to that outer wheel are in check. And so we extract intelligence from data, we’re certainly driven by data. And we use this data to develop strategies to help our members live healthier lives. And that may sound an easy feat to accomplish, it can be very challenging, because we come to work every day to strengthen our strengths as revealed by our data, and then to identify obvious and less than obvious barriers, which result in opportunities for us to be more excellent. That’s a very high level of what we do.
Ira Apfel 03:36
Just how does Ava measure health care Quality? And how does the measurement influence clinical practice and patient care?
Ava Jones 03:44
Um, the question that we ask, as health care quality professionals is, what is the overall health and wellness of the individual? What are those indicators of success in the community in which they live? how productive are the individual how productive is the community? I wrote a white paper many years ago, and suggested that healthy adults can go to work and earn and healthy children can go to school and learn. And when this happens, the individual the community and the society benefit and prosper. And so then it’s a holistic health care quality.
Ira Apfel 04:27
Ava and her team track a bunch of metrics, anything to uncover a trend, one metric is net promoter score, which measures a member’s experience
Ava Jones 04:36
the goal is to meet our members where they are right and there is no approach, a one size fits all approach, if you will. So considering Net Promoter Score, we avoid those ethnocentric approaches to member care. We are intent very intention on promoting culturally competent member experiences. And so we want to hardwire into our member interactions and approach that is anticipatory of what they don’t even know that they need before they realize they have a need, right. So the goal of caps, the goal of NPS, when we extract intelligence from that data, is to create loyalty, right, not just satisfaction with our members.
Ira Apfel 05:27
It will also likely take a holistic approach to quality measurement.
Ava Jones 05:31
The conversation that that is ongoing with my team is about our approach to how we look at data. And, and we began with the end in mind, I liked Deming, Deming was a quality guru that predates both you and I. And his philosophy was beginning with the end in mind, you know, what is the defined goal? What does it look like? Right? And, and, and then to inform that end goal. I like B hag, right, that’s the acronym that Jim Collins coined big, hairy, audacious goals. And so, before we look at our data, we we’ve level set, if you will, with those two concepts in mind, what is the end? What do we want this to look like? What is optimal, optimal performance based on big, hairy, audacious goals?
Ira Apfel 06:26
Clearly, aim is a detail-oriented person, but to truly excel at being a director of quality, Ava says she likes to maintain what she calls, quote, healthy dissatisfaction with the status quo, unquote.
Ava Jones 06:39
I wish I could take credit for that statement as an original Ava thought, but I cannot, at the onset of my quality, professional tenure, if you will, I read as many books as I could to understand what it was. And what I was trying to understand about quality, right? I mentioned earlier, as we began our talk, that that the concept of quality is an enigma. And it’s very hard to conceptualize effective leaders, strong leaders challenge the status quo. And when I read that, I was like, oh, my goodness, what, what, what does that mean? And, and, and again, it was a powerful game changer for me. And as I began to wrap my mind around that, it has just become my mantra on a personal and professional level. And it just means that there’s always better. There’s always an opportunity to improve and welcome opportunities to be more excellent to address and eliminate inefficiencies, to not rest on our laurels, to never rest and thinking that we have arrived, that it cannot get any better and, and resist the temptation to say, this is as good as it can get.
Ira Apfel 07:57
Clearly, Ava is passionate about being a quality director. So it’s surprising to hear her say that she was dragged kicking and screaming into the role.
Ava Jones 08:07
I remember that day, as though it were yesterday. I was still on active duty. I’m a retired Navy nurse, Commander Aaron’s came into the ICU, he was my then leader and just awesome mentor. I’m in scrubs in the in the I was a critical care nurse in the unit. It was on a Friday. I thought he was making rounds, as he frequently did. He was he was very personable. And he motions for me to come over. And he shared an unexpected, unplanned staffing loss of the director of quality and the infection control nurse. And he also said that joint commission would be arriving in a couple of months. And this is during the days when Joint Commission and accrediting bodies would announce when they were coming. And he said, I need you on quality Monday morning. And I’m like, What? I had never been to the department. I said you need me Where? When you need me to do what? And he said, Yeah, I need you on quality Monday morning. And that’s pretty much how it happened. It was a 1992. And at that particular time, there was no quality for dummies book to read over the weekend. And so I left work on Friday, a nurse in our Intensive Care Unit, and I returned on Monday, and I was the leader of the quality department not really clear on what I would be doing what the duties would entail
Ira Apfel 09:40
to help her do a better job. Ava even took the big step of earning her PhD in organizational leadership.
Ava Jones 09:47
And so, yes, and that’s probably why I ended up on a Monday morning in the quality department. I suspect it was evident that I like learning. I love being challenged. I think even at that time as a lieutenant in the Navy NURSE Corps, I had at the very least demonstrated a hunger for challenge and a hunger for learning, and also honing my skills. I love I find research very exciting. I’m naturally curious, I love to write,
Ira Apfel 10:25
not even a pandemic could keep Ava enter team from doing a thorough job.
Ava Jones 10:30
And, and I would say if anything, we became closer. As a work family. It increased our appreciation for one another. We grew I know I grew in my ability to listen, I think we all grew in our ability to be more gracious and understanding. Because we all telecommute working from home was not a new issue for any of us. And, and so I think we just grew and, and, and better developed our humaneness with one another, our support of one another one of our biggest moments of celebration, that in retrospect, I think was the most beautiful distraction, if you will. One of our members was pregnant, became pregnant, and I think she’d be okay with me sharing this. And her baby was due in December in and she had her baby, our newest member of our work family, if you will, on Christmas Eve. And it was it was just probably the most beautiful and awaited moment of the year, it gave us something to look forward to. And it gave us a positive distraction from the from the pandemic.
Ira Apfel 11:49
Ultimately, for Ava, quality remains just out of reach, there’s always something she or her team, or UnitedHealthcare can do better to improve the member experience.
Ava Jones 11:59
It basically amounts to meeting people where they are, and exceeding their key requirements and expectations, right. So it’s not so much what quality means to us. It’s what quality means to them, right? There’s no universally accepted definition of what quality is. However, there’s universal agreement that we know it when we see it, right. And so, so, so what does all of that mean, I am a nurse, I will always be a nurse, I was born to be a nurse, and when I have been at the bedside, taking care of patients is that holistic approach to nursing, right, making sure that body systems are functioning optimally and the interdependencies of each organ are in check. And that that, that that total person is healthy, and in quality. What I do on a daily basis and what my team and I are able to accomplish on a daily basis is very similar. It’s looking at the individual parts of our big company and ensuring that the individual parts are healthy, because when the individual parts are healthy, the interdependencies work better, and so holistically, we’re just better.
Ira Apfel 13:26
Ava Jones, thank you so much for being on the podcast.
Ava Jones 13:29
Thank you, Ira. It was my pleasure. I appreciate your time. Thank you.
Ira Apfel 13:33
That’s it for this episode of UnitedHealth group’s weekly dose podcast. Thanks for listening and have a great rest of your week.