Staring Down Death and Building Up Institutions


Leap Update: October 2014

Social entrepreneurs can change the world. Look no further than Malala Yousafzai, the remarkable young woman who won the Nobel Peace Prize two weeks ago. When Malala was 14 years old, a Taliban gunman shot her in the face to silence her voice. But Malala stared down death. She was reborn as the world’s most compelling advocate for girls’ right to learn.

There are so many courageous social entrepreneurs like Malala whom we look to with respect and awe because of the positive change they drive. But while we encourage social entrepreneurship, we must also invest in building the organizations that allow that change to endure and become institutionalized. Don’t get us wrong: Social change simply doesn’t happen without leadership. But the leadership that produces the most change is the kind that can build effective, resilient, and ever-learning institutions.

David Brooks hits this point beautifully in his recent column “Goodbye, Organization Man.” Uncovering the themes that lie beneath the panicked plotlines on Ebola and ISIS, Brooks lays bare America’s aversion to building the institutions that can deliver comprehensive solutions:

We like start-ups, disrupters and rebels. Creativity is honored more than the administrative execution. Post-Internet, many people assume that big problems can be solved by swarms of small, loosely networked nonprofits and social entrepreneurs…. The Ebola crisis is another example that shows that this is misguided. The big, stolid agencies—the health ministries, the infrastructure builders, the procurement agencies—are the bulwarks of the civil and global order. Public and nonprofit management, the stuff that gets derided as “overhead,” really matters…. When the boring tasks of governance are not performed, infrastructures don’t get built. Then, when epidemics strike, people die.

A good way for us to reinforce Brooks’s theme is to share a little-known success story—at a time when we really need good news. You may have read the headline this week that Nigeria effectively defeated the Ebola outbreak that first erupted in July. That was a huge deal, given that a widespread Ebola outbreak in Nigeria, Africa’s most populous country and a major transportation hub, could have ignited a much broader health crisis throughout the continent.

Nigeria succeeded in large part because the Gates Foundation had invested heavily in building the country’s health infrastructure to combat polio. Using institutions and knowledge they gained from the country’s anti-polio mobilization, Nigeria’s top doctors set up Ebola Emergency Operations Centers and quickly, heroically nipped the outbreak in the bud.

Yes, the world needs brave doctors, advocates, and other leaders who have the courage to stare death in the face. But let’s not forget that it also needs enduring, high-performance institutions that consistently deliver meaningful, measurable, financially sustainable results for the people or causes they’re in existence to serve.

And now we turn to updates from around the Leap of Reason community:

  • In a great meeting with National Governors Association Division Director Jennifer Brooks, Mario learned that the current NGA Chairman, Colorado Governor John Hickenlooper, has decided has to focus his chairmanship on “Delivering Results”—that is, the use of data and evidence to drive results in state government. We’ll be looking for ways to lend support to these efforts.
  • We’re big fans of the Institute for Healthcare Improvement. IHI’s recent blog post “Accentuate the Positive: Improving Patient Safety by Focusing on What’s Being Done Well” discusses two recent studies that provide good evidence that the (unfortunately named) “positive deviance” approach is effective in getting lower performers to emulate higher performers. In the words of IHI Fellowship Director Joelle Baehrend, “Looking to the positive, instead of a relentless focus on errors and other problems, can have a measurable effect on outcomes.”
  • BBB Wise Giving Alliance President Art Taylor, GuideStar President and CEO Jacob Harold, and Charity Navigator President and CEO Ken Berger have teamed up once again to help funders understand that we must break our obsession with “overhead ratios” if we want nonprofits to build the organizational muscle that will enable them to perform at a high level. After receiving a huge response to their 2013 “Overhead Myth” open letter to funders, they’ve now issued an “Overhead Solution” open letter to nonprofits. Here’s what they ask of nonprofits: “Demonstrate ethical practice and share data about your performance…. Manage towards results and understand your true costs… Help educate funders (individuals, foundations, corporations and government) on the real cost of results.” Hear, hear!
  • The Huffington Post blog post “‘Thinking Computer’ That Won On Jeopardy Could Help Teachers,” reports that educators are about to begin testing the IBM Watson computer’s ability to provide teachers with answers to their questions “by pulling together education research, videos of master teachers, and online connections to teachers with similar interests.” We believe there’s great promise in this approach—if the developers follow IBM’s lead of focusing on the human side of the equation, not just the technology side. To show how old Mario is, when he worked at General Motors in 1965, he watched in amazement as “inventory control specialists” insisted on using paper records to keep track of millions of auto parts even after an automated inventory-management system had been implemented. The reason they wouldn’t give up their paper: a lack of trust in the new systems.
  • This month, we found five valuable resources for wonks like us who want to understand the strengths and weaknesses of different forms of evaluation. In “Should Controlled Trials Be The Standard for Impact Measurement?” and “An Alternative To RCTs,” Peter York provides an introduction to the observational cohort study (OCS) for laymen. He argues that the OCS, which can be less expensive and more applicable in the real world than a randomized controlled trial (RCT), deserves to be seen as “tied for gold” with the RCT. Scott Cody and Andrew Asher‘s report for the Hamilton Project, Smarter, Better, Faster, offers good examples of how government agencies can use “predictive analytics” and “rapid-cycle evaluation” to drive learning and improvement. (As an example of predictive analytics, if healthcare administrators were to mine the reams of data they collect, they could anticipate which patients are significantly more likely to return to the hospital after discharge—and then provide those patients with services that can prevent expensive readmissions.) And if you want additional insights into the hot (and hot-button) topic of “next generation evaluation” and have some treadmill or travel time coming up, you can listen to this SSIR podcast with our dear colleagues Fay Twersky and Lee Schorr and this one with Lucy Bernholz, Kathy Brennan, and Patricia Bowie.
  • The Baltimore-based Superstar Foundation, started by our good friend and colleague Steve Butz, provides $5,000 awards to direct service workers who can show through stories and numbers incredible performance on the front lines. If you know a human service provider who fits the bill, please consider nominating that person online. Superstar is accepting nominations through November 26.


Events/Webinars for Raising Performance:

Mario and Lowell

Mario Morino is Chairman of the Morino Institute, co-founder and founding chair of Venture Philanthropy Partners, and author of the lead essay in Leap of Reason. Lowell Weiss is president of Cascade Philanthropy Advisors, co-editor of Leap of Reason, and advisor to the Leap of Reason initiative.

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