Foreword

Core Values of the Robert Wood Johnson Foundation

In 1994, Stanford University professors J. C. Collins and J. I. Porras published Built to Last, which described the successful habits of visionary companies. Their book explored the life span of 18 successful, visionary companies—and an equal number of less visionary ones—to derive key performance characteristics that distinguished the best institutions from the lesser ones. Although many of their observations are relevant to philanthropy, one appears particularly pertinent: "Visionary companies preserve core purposes and values but also continuously strive for progress."

CORE PURPOSES AND VALUES

The idea is that successful companies resolutely adhere to their core—defined by the authors as consisting of both purpose and values—yet at the same time are extremely flexible in searching for ways to express that core. How does this apply to the Robert Wood Johnson Foundation? What are our core purpose and values? Do our daily actions reflect our core?

It is easy to identify our core purpose because it is the same as our mission—to improve health and health care for all Americans. Our purpose is clear and concise and it is shared by trustees and staff. Core values refer to "the organization's essential and enduring tenets—a small set of timeless guiding principles that require no external justification; they have intrinsic value and importance to those inside the organization." Core values permeate the actions of an organization, are enduring, and can be changed only slowly and with great effort.

Our core values are not as obvious as our core purpose. We are a relatively young organization and our values are still being formed. Nevertheless, I would like to identify a few values that I think do characterize us:

We pursue goals that are important to the health of the American public.

This may seem like a self-evident statement that flows from our mission but it is a helpful guide in our grantmaking. By keeping our focus on the health of the entire population, we can emphasize issues—such as access to health care—that are more germane to vulnerable subgroups. Underlying the value of improving the health of the public is a sense of egalitarianism, because it is the less fortunate members of our society whose health is most in jeopardy. We can also address problems such as substance abuse that affect everyone, including the more economically fortunate. This focus also assures that we value our assets as a public trust for which our actions should be accountable. To make good on this core value, it becomes necessary to be eclectic in whom we choose as partners and in the variety of solutions that we explore. Thus, we have cast a broad net for potential grantees, seeking them in all sectors of the American landscape—both public and private—rather than focusing our support on a particular sector such as hospitals or medical schools.

Fidelity to this value also mandates that all those who might use the knowledge and the wisdom gathered through our grants to advance these goals should have unfettered access to this information. This focus on openness translates into the way we operate our research programs, the content of our in-house publications, and our efforts to help grantees communicate their experiences and findings.

The integrity of our data and our monitoring processes are paramount.

This value is embedded in our early and continuing commitment to evaluation and to rigorous fiscal monitoring. It guides us when our agendas and our findings conflict. For example, we are currently involved in a campaign to decrease the number of uninsured children. The larger the number, the more compelling is the argument for programs to expand coverage. For the past year, the figure "10 million uninsured children" has been widely reported and commonly accepted in the national debate surrounding this issue. Recently, Paul Ginsburg and his colleagues in the Health Tracking project, which is funded by the Foundation, conducted a study that reveals the number may be closer to 8.5 million. In this instance, it is clear that our value of fidelity to the integrity of data will trump our desire to advance a particular issue. We will defend the number that we think is correct, even at the expense of weakening the programmatic argument.

We speak through and about our grantees and do not seek a high institutional profile.

Some foundations seek to advance their causes by elevating their public profiles, thereby adding gravity and credibility to their actions and statements. Given that foundations have limited grant money to achieve ambitious goals, this seems to me a defensible strategy as long as it avoids unseemly perquisites. We have chosen a different path and, in general, it serves us well. One manifestation of this core value is our relatively large investments in training programs that develop young professionals—a strategy that is relatively expensive and has a long and often important payoff, but will not generate media coverage or public recognition. Another expression of this core value is our newsletter, ADVANCES, which exemplifies how we use our communications program to promote the accomplishments of our grantees and of the issues that we support.

A challenge posed by this core value is that it makes it more difficult to improve and influence the policy process. There are two broad pathways to accomplish that—one direct and one indirect. The direct path entails establishing the Foundation itself as active in the policy process. This strategy would influence how we select our staff, as well as how much of a presence the Foundation would establish in Washington. The indirect path—which, in general, is the one we have chosen—is to help position our grantees engaged in health policy research to make the appropriate connections. To accomplish this we have invested in specific training for our grantees and have provided technical assistance to link grantees with the media and with policy-makers. Because it is difficult to navigate the indirect path, we pay a price in the potential attenuation of policy leverage.

We seek to employ and develop a staff that is distinguished by its professionalism and competence.

This might seem paradoxical in an organization that values working through its grantees, but I believe it is an authentic part of our culture. We seek intelligent, motivated, highly ethical staff members who care passionately about our mission. We work them hard, help them develop, and value them highly even after they leave us. We see our professional staff as agents for change while they are with us and in their subsequent positions. We strive to maximize their growth and potential while they are here and even afterward. For our support staff, many of whom make long-term commitments to us, we try to provide a nurturing, dignified atmosphere that is respectful of their contributions, helps them to grow, and encourages them to be creative in their work.

STRIVING FOR PROGRESS

In my view, we do very well at preserving our core purpose, and are still in the process of developing a set of core values. How well do we do in continuously striving for progress? That question leads to two other characteristics of visionary companies.

One characteristic is that visionary companies "try a lot of stuff and keep what works." Collins and Porras found that outstanding companies engaged in a restless search for innovation, which they characterize by phrases such as "stirring the pot," "avoiding routinization," and "tolerating failures." Working in such an environment can be both exhilarating and anxiety-provoking. It is a rare philanthropy that fits such a description, and I cannot honestly say that it describes us. There are strong forces within philanthropies to define characteristic ways of doing things and then to avoid deviating from those norms. I do think that we are relatively flexible, and that we are improving in our experimentation with different forms of grantmaking, monitoring and dissemination. But we can be even more flexible, and should try to be so.

Another characteristic of visionary companies is that they set "big, hairy, audacious goals," or BHAGs. Sony set out to elevate Japanese culture and national status. Henry Ford had the dream of democratizing the automobile. At the time, these aspirations seemed mere wishful thinking to outsiders. But inside the companies they helped to catalyze new ideas and a fierce determination to accomplish these goals.

How applicable are BHAGs to philanthropy? I'm not sure how to answer that question. I used to think that our access and substance abuse goals were pretty audacious. After all, saying that we will "assure access to basic health care services for all Americans" is mighty big talk for a $300-million-a-year foundation operating in a trillion-dollar industry. And trying to reduce harm from substance abuse is also pretty big game. Yet translating audacious goals into effective grantmaking turns out to be difficult. And I sometimes cringe when I hear us oversell the potential impact of a good grant that can't possibly achieve all that its proponents claim.

As I think about the idea of BHAGs, I find myself torn between wanting our reach to exceed our grasp, but also wishing to fashion grants whose goals are achievable. I want to see the Foundation find the balance between stretching as much as possible, while still holding to realistic performance standards for which we can be held accountable.

FINAL THOUGHTS

If a study were to be published on philanthropies, would we be classified as visionary? The only previous such work, The Golden Donors, written by Waldemar Nielsen in 1985, rated the Robert Wood Johnson Foundation as the best of the large philanthropies. That was a wonderful legacy for me to inherit in 1990, but I question whether it really applied to us then—or does today. We are still a very young foundation and it is not clear whether others would share Nielsen's criteria or verdict.

What does seem clear to me is that many of the qualities that distinguish visionary companies are ones we should aspire to. These include preserving core values while continuously searching for improvement, focusing on how to strengthen the organization, putting a high priority on staff development and setting audacious goals. It would be interesting to come back in 25 years and see whether our successors and—more important—others would be able to call us a visionary foundation.