School & District Management Opinion

From Health-Care Reform, Lessons for Education Policy

By Greg Anrig — July 09, 2013 6 min read

One of the most important factors that broke decades of political stalemate over national health-insurance reform was the emergence of research demonstrating that some U.S. medical providers were far more cost-effective than others. By showing that institutions like Kaiser Permanente, the Cleveland Clinic, and the U.S. Veterans Health Administration produced better patient outcomes, those studies suggested that policies which encourage other medical providers to emulate successful organizations could make the whole system produce better results over time. Three of the commonalities shared by those model health-care institutions are: highly collaborative cultures built on teamwork; unusually sophisticated attentiveness to testing data to monitor patient progress and respond to problems; and an orientation toward ongoing adaptation rather than rigid adherence to established routines.

In education, off a public radar screen that remains fixated on the relentless conflict between teachers’ unions and their detractors, research is mounting that the most effective public schools also are characterized by unusually high degrees of collaboration, close attentiveness to testing data for diagnostic (not punitive) purposes, and adaptability. Especially in light of how unproductive the so-called education wars have been, greater focus on this research has the potential to point the way toward reforms that would actually improve student outcomes. Given how entrenched today’s conflicts appear to be, that hope might seem fanciful. But it wasn’t that long ago that a major overhaul of the nation’s health-care system also appeared to be out of reach politically.

Perhaps the most significant and persuasive research underscoring the fundamental importance of collaboration to improving school performance was conducted by the University of Chicago’s Consortium on Chicago School Research. Published in 2010 as a book titled Organizing Schools for Improvement, the consortium’s study derived from demographic and testing data from 1990 through 2005 from more than 400 Chicago elementary schools, as well as extensive surveys of stakeholders in those schools, to gain information about their institutional practices. Using advanced statistical methods, the consortium identified, with a high degree of reliability, the organizational traits and processes that can predict whether a school is likely to show above-average improvement in student outcomes.

The consortium’s central finding was that the most-effective schools had developed an unusually high degree of “relational trust” among their stakeholders. The consortium identified five key organizational features to advancing student achievement:

• A coherent instructional guidance system, in which the curriculum, study materials, and assessments are coordinated within and across grades with meaningful teacher involvement;

[A]s with health-care reform, government resources should be devoted to sharing information with districts about how to go about implementing organizational practices that affect school improvement."

• An effective system to improve professional capacity, including making teachers’ classroom work public for examination by colleagues and external consultants, and to enable ongoing support and guidance for teachers;

• Strong parent-community-school ties, with an integrated support network for students;

• A student-centered learning climate that identifies and responds to difficulties any child may be experiencing;

• Leadership focused on cultivating teachers, parents, and community members so that they become invested in sharing overall responsibility for the school’s improvement.

These pillars identified as keys to progress consistently emerge in other studies as well. For example, the National Center for Educational Achievement, a division of the company that develops the ACT college-admissions exam, sent teams of researchers to 26 public schools with a high proportion of low-income students in five states, where students were beating the odds on math and science tests over a three-year period.

The common practices they found in those schools included a high degree of engagement between administrators and teachers in developing and selecting instructional materials, assessments, and pedagogical approaches; embedded time in the workweek for teacher collaboration to improve instruction; an openness among teachers to being observed and advised; close monitoring by administrators and teachers of testing data to identify areas where students needed additional support; and personnel who dedicate time to extensive outreach to parents and coordination with community groups and social-service providers.

Studies examining the urban school districts of Cincinnati and Union City, N.J., which have experienced unusually strong improvement in student outcomes over a sustained period and across grade levels, also reinforce the findings of both the Chicago Consortium and National Center for Educational Achievement. Berkeley professor David Kirp, who spent a year embedded in Union City’s school system to produce his recent book Improbable Scholars, describes in detail how those same practices are pursued in the most densely populated school district in the country.

Describing the relationships among teachers, for example, Kirp writes: “Experience matters, of course, but these teachers improve, the passable ones becoming solid practitioners and the good ones maturing into candidates for a demonstration video, in good measure because of the informal tutelage that the old hands give the newbies, the day-to-day collaboration, the modeling of good practice, and the swapping of ideas about what’s worth trying in their classrooms.”

What does this accumulating research suggest about public policy? At a bare minimum, it supports rolling back or eliminating existing laws that have the effect of exacerbating conflict between administrators and teachers, especially given the lack of evidence that those measures improve outcomes. Those include many of the punitive elements of the No Child Left Behind Act as well as initiatives linking teacher pay to test-score results of students and competition for bonuses, which deter teamwork and pit teachers against each other.

Management experts like MIT’s Peter Senge and Cornell University’s Sally Klingel, who have studied high-performing workplaces in a variety of sectors and reached conclusions in line with recent health-care and education research, believe that building trust and social capital in organizations is paramount. Imposing sanctions through rigid hierarchies has the opposite effect, inducing fear and suspicion, discouraging teamwork, and inhibiting creativity. Instead, as with health-care reform, government resources should be devoted to sharing information with districts about how to go about implementing organizational practices that affect school improvement. Rather than trying to reinvent the wheel district by district, public officials and consultants with experience successfully transforming school district cultures should have the support and platforms to convey their expertise in a broader range of settings. Federal and state governments should provide additional financial support to districts that adopt peer-assistance and -review systems, in which master teachers coach novices while also working with struggling tenured teachers, sometimes helping to facilitate their departure in the absence of progress.

A white paper published in 2012 by U.S. Secretary of Education Arne Duncan’s office stated: “The U.S. Department of Education believes that in the long run, the most promising path to transforming American education is student-centered labor-management collaboration. ... The most dramatic improvements will be made when those responsible for implementing reforms not only endorse them, but also work together to formulate, implement, and continuously improve them. In short, the department proposes that tough-minded collaboration—that is, collaboration built around the success of students and not the needs of adults—will lead to more effective practices and a more sustainable path to elevating education than the ups and downs of adversarial relationships that have long characterized labor-management relations.”

It’s time for the federal government, as well as the states, to align educational policies with that mission.

A version of this article appeared in the July 11, 2013 edition of Education Week as From Health-Care Reform, Lessons for Education Policy


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