July 23, 2013

Wrestling with Impact Potential: Best Practices Versus Innovation

A conundrum exists in philanthropic, service provider, and political arenas. Naturally, programs need to demonstrate that they are going to have significant impacts on our communities and therefore need to exhibit high return on investment for funders. The conflict arises because technical practitioners, political decision makers, private sector stakeholders, and non-governmental organization (NGOs, or nonprofits) largely want to support efforts that are providing cutting-edge solutions to difficult socio-economic problems, and they also want that work to be based in existing best practices, and sometimes those are lacking for a given field or target population. [1]

To help funders gauge your program’s potential impact, presenting mountains of best practices evidence that serve as the basis for your innovative program design is the ideal solution, but in some cases documented best practices simply do not exist. A few examples include:

  • Programs that are ‘too’ innovative may be so extraordinary that existing best practices do not provide support for them.
  • Programs that serve unique populations, such as Native communities, special student populations, and other small groups, may not be able to use best practices established for other populations, because they fail to work well for their unique clients/customers.
  • Programs that serve underserved populations may not have mainstream funder/donor acceptance of practices used traditionally within their communities, most often because application of these practices has not been documented in databases/articles that mainstream funders feel proves that they work.

When best practices fail to present themselves, you can turn to promising and emerging best practices as your next line of design documentation. Emerging best practices are those that require you to:

  • Use and study them to establish what works best.
  • Adapt and mold them appropriately in response to both initial and ongoing findings.
  • Disseminate the information so that other programs can use them.
  • Collaborate with other programs that use your emerging practices to determine their successes, challenges, and learnings.

In some fields, such as clinical health, emerging best practices have to be submitted and approved by specific governmental agencies that are charged with advancing the quality and availability of service provision. To help build a case for innovation in program design when you approach funders or policy advocates, consider the following:

  • Be solution oriented. Link emerging practices directly to outcomes and target goals for your field of service that have already been identified and documented by researchers, funders, and/or governmental agencies. These can take many forms including white papers, position papers, legislative background research, conference publications, and agency program recommendation or requirements listings.
  • Create sound documentation in-house if it is not available elsewhere. If your community needs are unique and understudied, you may have to start by documenting the information on the types, designs, and successes/challenges of programs that have worked with your clients/customers. Be sure to design your data collection methods in ways that are culturally sensitive. For instance, in many Native communities, personal and sacred traditions dictate that some information should only be released to other same-clan members. Using existing kinship networks to help with projects that are intended to benefit the community as a whole can help make data collection easier. Another example of addressing cultural sensitivity is that, due to close familiarity of local residents in smaller communities, it is sometimes possible for survey respondents to be identified even when identity protection procedures are put in place. In this situation, hiring an outside evaluator and ensuring that local organizers do not have access to raw data can make survey respondents more comfortable with study efforts.
  • Be clear about what principles guide your program design efforts. Lay guiding principles out cleanly in your proposal. Guiding principles may include: being community-led/aware, accounting for individual differences among clients, taking all pertinent service models into account, and operating from a strengths/assets model.
  • Rank your program components and goals. Be clear about everyone’s role in developing the program elements and how those relate back to each emerging practice component. Define what is expected of your target service population, the provider, and the community. Emphasize the value of strong leadership and how those leaders will interact with stakeholders throughout program design, delivery, and evaluation.
  • Keep it simple. Scope creep is a real hazard when engaging in research efforts. Start with a written list of how your design relates to outcomes and target goals for your field and refer back to it often during your search to keep you on track. There are a number of registries, including the Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidenced-based Programs and Practices (NREPP). These registries provide data banks of best practices and connect providers to intervention developers who can help them tailor proven approaches to their own communities and situations.
  • Seek pilot grants. Pilot grants can allow you to collaborate with agencies, educators, and other providers to document your processes, successes, and learnings and the tools you have developed to assess your own program’s needs and impacts and disseminate them effectively. You want to show that your ideas have measurable outcomes and that they will be replicable. Some funders specialize in pilot grants and practice development in their focus areas.
  • Concentrate closely on the needs of your target audience. Document your community planning processes (agendas, sign in sheets, meeting minutes, videos of presentations, etc.). These will be invaluable when you need to show that your program is responsive and community-driven.
  • Reach beyond your borders. If you cannot find the support for what you need within national level programs, try looking further. While professional development helps providers stay abreast of what is going in their field, there is a wide world out there with lots of goings on that are beyond the usual scope of most program design background information gathering. In many instances, innovations are taking place in both developing nations and other developed ones that can assist you in documenting your design approach if you cannot locate information closer to home.
  • Discuss the expected return on investment. Do this in terms of actual financial value to the individuals served and the community as a whole. Since the early 1980’s, a body of research has been growing that examines the economic impact of products and services in our communities. It is very likely that a little digging will reveal how much your services are worth at the individual, local, state, regional, and even national levels for every dollar invested in bringing those services to your community.

Innovative programs have the potential to: affect policy; build long lasting, effective networks and partnerships; enhance organizational capacity and performance; and change lives. And innovation that supports existing best practices can be deceptively simple and enormously effective at the same time.

One story perfectly illustrates this point. In the 1930’s, Finland had an appalling-high infant mortality rate relative to other developed countries. The Department of Health determined that they needed to get pregnant women into prenatal care much earlier to ensure better outcomes. Their solution has been helping Finnish babies for 75 years now. They simply provided a free ‘baby box’ – a maternity care package for all expectant mothers that contained infant clothing and personal hygiene goods and toys/books. The box itself, with the enclosed mattress could be used as baby’s first bed. It was initially available for low income mothers, but was expanded in 1941 to all Finnish citizens. To get the box, an expectant mother just had to visit a doctor or municipal prenatal clinic by the end of their first trimester. By combining a known best practice (early prenatal care and its attendant improvements in mother-infant nutrition, health, hygiene, and increased community resources) with an innovation (the free box and its baby-need contents, such as warm clothing and bedding), Finnish healthcare workers were able to foster significantly higher use of the best practices nationally.  Since its introduction, infant mortality has dropped from 65 per 1,000 in the 1930’s to just 2 in 1,000 currently.[2] The box, now a time-honored tradition, and the attendant pre- and postnatal care it fosters, are credited with accounting for much of this drop.[3]

Ultimately, everyone in advocacy and service aims to create programs that provide collaborative resources, services, and supports that allow individuals to become self-sufficient, successful collaborators, and community aware in order to support long term success for our communities. Best practices and emerging best practices help bring our service to its highest level and can work in tandem with innovation. By building a strong case for innovation in program design that incorporates best, promising, and/or emerging best practices, your proposals, advocacy campaign materials, and other program related documentation will carry greater weight and give you a greater return for efforts in your community.


[1] In general: best practices are empirically proven effective to improve target outcomes, replicable, and peer reviewed; promising practices have strong data showing positive outcomes, but not enough to demonstrate replicability; and emerging practices are based on previously effective models but use new approaches while continually evaluating and adapting to improve target outcomes.

[2] Level & Trends in Child Mortality. Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation (UNICEF, WHO, World Bank, UN DESA, UNPD). Mortality Rate: Infant (1,000 per live births): 2011. Retrieved July 14, 2013. http://data.worldbank.org/indicator/SP.DYN.IMRT.IN

[3] Lee, H. Why Finnish Babies Sleep in Cardboard Boxes. June 4, 2013. http://www.bbc.co.uk/news/magazine-22751415


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