Shape the Knowledge Field to Support What Works

The government needs to better orchestrate knowledge about what works.

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The government needs to better orchestrate knowledge about what works. This remains a major gap in most fields of social and public service innovation. There are often hundreds of pilots, and thousands of academics working on research and evaluations. But it is hard to find knowledge about what works, and smart judgements about what lessons can be drawn—often because it’s no one’s job to pull it together.

There are some good foundations to build on. The Cochrane Collaboration in health and its offshoot the Campbell Collaboration in social science, now supported by the Norwegian government, are outstanding examples of third parties that marshal the evidence of what works. They work alongside the many professional networks, conferences, and journals in planning, medicine, law, architecture, and social work to collate evidence and make judgements on whether interventions are effective and what further research is needed.

The National Institute of Health and Clinical Excellence in the United Kingdom is another good example. It is a statutory body that publicly rules on the cost-effectiveness of health interventions, using the common measure of quality-adjusted life years. This means that it can compare the effectiveness of a new cancer drug or a smoking cessation program. It then becomes hard for those that hold purchasing budgets to ignore its advice.

Indeed, the new health care reform law in the United States follows the National Institute for Health and Clinical Excellence’s model by setting up the Patient-Centered Outcomes Research Institute responsible for reporting on the comparative effectiveness of different approaches to prevention, diagnosis, treatment, and management of health conditions.

The government should build on these examples to develop formal bodies charged with making judgements about what works and also about cost-effectiveness in other areas of policy—such as education, housing, employment, and crime reduction. “Institutes for Effective Innovations” should be transparent and easily accessible through user-friendly websites—and should be charged with making judgements about the effectiveness of different approaches. Their judgements can then be used to guide funding decisions, both by government and outside—and approaches that are truly effective at the small scale would attract funding to scale and grow.

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