Patient Relationship Capital


We recently read with interest “What Gets Measured Gets Done,” an SSIR blog post about the work of the New York State Health Foundation (NYSHealth) to improve outcomes for the state’s 1.8 million diabetes patients. We’ve long admired the foundation and its president, Jim Knickman, so it was no surprise to us that NYSHealth is good at setting clear goals and giving grantees wide latitude in how they do their part to achieve those goals.

It was also no surprise to read that NYSHealth has achieved impressive results. Because of the foundation’s efforts, in six years the number of doctors who achieved recognition for delivering optimal diabetes care increased from 149 to 3,005, improving care for hundreds of thousands of patients with diabetes.

The pleasant surprise was that NYSHealth arrived at its successful strategy by paying close attention to a path-breaking 1962 book that Mario used as a North Star when he was a software entrepreneur: the late Everett Rogers’s classic Diffusion of Innovations. Based on Rogers’s work, NYSHealth determined that it had to reach and then influence the behavior of 20 percent of New York’s primary care physicians if it wanted to have a chance of spreading its innovation across the entire state.

Prompted by this reminder of the value of Rogers’s work, we reread key sections of the book online and saw that its insights are incredibly relevant for our efforts to spread the gospel of high performance. Rogers knew that most innovations are initially perceived as having uncertain benefits. “To overcome that uncertainty, most people seek out others like themselves who have already adopted the new idea,” he wrote. “Thus the diffusion process consists of a few individuals who first adopt an innovation, then spread the word among their circle of acquaintances—a process which typically takes months or years.”

This is precisely why we’re building a community of early adopters, the Leap Ambassadors Community, and then encouraging and helping them to spread the word to those in their networks.

Our rereading of Rogers’s theory also gave us insights into new avenues for our Performance Imperative campaign. For example, two key factors that influence the rate of adoption of innovations are complexity (“the degree to which an innovation is perceived as difficult to understand and use”) and observability (“the degree to which the results of an innovation are visible to others”). We see that we can and must do more to make it clearer to nonprofits and their stakeholders what “high performance” entails, what it looks like in real life, and what the tangible benefits are for the people and causes they care about. If the idea of high performance continues to be unclear or largely theoretical to potential adopters, so too are the chances of broad success.

But even if we do a great job of adhering to Rogers’s playbook, high performance will not proliferate as quickly as a cool Cupertino technology or even improved diabetes care. It’s an inherently slow idea that will only spread through methodical relationship-building, clear communications, and a lot of patience. And we’re prepared for that. Because we’ve seen the benefits of high performance across different organizations and sectors, and we’re committed to seeing this idea through.

And now for some brief updates on and for organizations pursuing high performance:

  • The Aspen Institute’s Program on Philanthropy and Social Innovation’s new report, Thriving in an Outcomes-Based Market, offers well-deserved praise for the Center for Employment Opportunities (CEO). It’s a great profile of an organization whose leaders, including Leap Ambassador Brad Dudding, are relentlessly and rigorously focused on learning and improvement. This learning focus has prepared the organization to benefit from new Pay for Performance funding streams.
  • Congratulations to Leap Ambassador Bill Shore, Josh Wachs, and their colleagues at Share Our Strength/No Kid Hungry on their tenacious and successful advocacy for the children of low-income families in New York City. By the fall of 2017, students in 530 public elementary schools will be offered a healthy breakfast as they come into their classrooms.
  • If you’re a nonprofit leader and are clear that your organization is ready for a performance management system to track your outcomes, the new Urban Institute brief Navigating Performance Management Software Options will be a great help to you. Simone Zhang and Leap Ambassador Mary K. Winkler provide insights for identifying your needs and finding products that align with them.
  • For those of you who were not able to attend TEDxPennsylvaniaAvenue last month, you can now stream all of the videos from the event. We recommend, in particular, the speeches by Communities In Schools President and Leap Ambassador Dan Cardinali, Louisville Mayor Greg Fischer, and Seattle Police Detective Kim Bogucki.
  • Kudos to Leap Ambassador Lissette Rodriguez for her article “The Surprising Alchemy of Passion and Science,” in Nonprofit Quarterly. Lissette shared hard-won wisdom from her work as director of the Edna McConnell Clark Foundation’s PropelNext initiative on how organizations can “harness their passion for justice, love of people and communities, and commitment to better our world while [increasing] their understanding of whether and how they are having an impact.”
  • Tris Lumley, New Philanthropy Capital’s director of development and a Leap Ambassador, shares his insights on the emerging market for impact measurement in an interview conducted by fellow Leap Ambassador Nell Edgington. Lumley believes that there’s no top-down or technology-driven way to make impact measurement the norm in the social sector. “After 11 years of working in the social impact field, I am convinced that we cannot sell impact measurement just by increasing the supply of good technical solutions,” he said. “We need a movement to build the demand for those solutions [and] we need the leaders to demand them, and to harness them to hold themselves accountable, learn and improve, and share what they find.”

Events/Webinars for Raising Performance:

Good luck on your journey,
Mario and Lowell