Lately I've been hearing more and more people in the health and human services world use the phrase "evidence-based practice." This represents real progress in a field that's been widely resistant to the concept.

Why the resistance? The argument among those in the health and human services game was always that any results they might achieve were so heavily dependent on human behavior -- that is, changing human behavior -- or socioeconomic factors beyond anyone's control that it simply wasn't fair to hold those administering and delivering health and human services to the same standards as the people filling potholes, processing small business tax returns or arresting bad guys.

I never had much patience with that argument. After all, if you're accepting public money to run a program that is supposed to reduce drug and alcohol addiction among your clients, or to help mentally-disabled adults find work, then it seems perfectly reasonable that you ought to be held accountable to those that you have agreed to help.

But that kind of resistance to data-informed policy and practice seems to be fading and fading quickly. From juvenile justice, to hospital care, to children and family services, more and more people seem to be figuring out that ignoring data is a losing strategy when it comes to helping people become healthy, productive, engaged citizens.

In fact, one of the most coherent and articulate mini-disquisitions on the necessity of managing to data I have heard lately was delivered to me just last fall by a front-line foster care supervisor in Jefferson Parish, Louisiana. This woman meant business. "In the past we invested in services and had no idea if they were making a difference," said Juanita Beasley. "We had no quantitative way of knowing if we were getting any bang for our buck. Now we're using data to manage our investments; to see if what we're investing in is really helping kids."

How various governments are getting into the evidence-based policy and program game varies. Some agencies are focusing on a handful of what are sometimes called "leverage" measures -- single measures that actually indicate improvement in a wide range of practices. Other governments are trying to track lots of indicators as a way to assess progress. Virginia is a good example of the former approach, Massachusetts of the latter.

In Virginia, outgoing Governor Tim Kaine is handing off that state's ambitious and promising children and family services transformation effort to the incoming administration of Governor Bob McDonnell. A hallmark of the Virginia transformation initiative is that it is centered on a mere six key outcome measures. For example, one of them was the percentage of kids in congregate or residential care. It was a smart number to focus on for two reasons. First, congregate care has been clinically proven in most cases to do more harm than good, particularly when stays extend beyond three months (it also happens to be the most expensive type of foster care any jurisdiction can provide). Second, if local social service agencies are reducing numbers of kids in congregate care, it means those agencies have changed their practice models more broadly -- that they are now focusing on either keeping kids out of the system in the first place, or that they're finding kids more appropriate family-like settings in which to be placed. Keep reading >>