Seeking funding for radiology outcomes research? With best practices, you can develop a winning application and capture the grant.
By Gina Graham
Competitive grant funding for outcomes, implementation, and effectiveness research is available in the United States and overseas. Sources include US government agencies such as the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality (AHRQ), CMS Innovation Center, and US Agency for International Development (USAID). Private foundations, such as the Bill & Melinda Gates Foundation, Susan G. Komen, and Robert Wood Johnson Foundation, Wellcome Trust, and the UK National Institute of Health Research, also fund studies on health-related topics. New on the scene is the Patient-Centered Outcomes Research Institute (PCORI), established in 2010 by the Affordable Care Act as an independent, nonprofit organization with a budget of approximately $250 million in 2013 and $500 million per year from 2014 until 2019, when the current legislative mandate ends.1
The development of grant applications that align to organizational and business need, and at the same time respond to funder interest, is a specific skill set that can be acquired. The ability to envision, develop, write, and subsequently “package” research and other health services projects into successful grant applications is a fundamental skill for researchers in academic or research institute settings. This is true in the R&D world, where new products are brought to life, as well as in the world of postmarket comparative effectiveness research, where products, services, and solutions are tested out in the real world of health care delivery. It is also increasingly relevant for clinicians and other health care providers in a myriad of care settings, given organizational budget constraints and the growing focus on evidence-based medicine. Many excellent resources and references on the topic are available, both online and in print.2-4
For a short course on grant development, here are a handful of best practices that are critical to the development of a successful grant application, and a few others that are important to consider when private sector industry collaborates on a grant application.
Plan Well in Advance
Possibly one of the most difficult best practices to employ is to start planning early. Some say that an ideal planning timeline would allow at least 9 months—roughly divided between planning (2-3 months), writing (3-4 months) and review, internal approvals, and submission (1-2 months). Unfortunately, unexpected funding announcements, short turnaround deadlines, and the time constraints of everyone’s “day job” make this best practice extraordinarily hard to implement. Here are a few tips that can help. Consider your organization’s existing partnerships as an arena for external funding support, rather than the daunting, and less successful, task of forging new collaborations for the purposes of external funding. Before a specific funding opportunity is spotted, consider forming an ad hoc “incubator” working group with key partners, the charter of which would be to explore the topic of how external funding might support strategic shared priorities in research or innovation. This group might eventually serve as a start-up grant team when the right opportunity turns up. Required trust will have already been developed and early dialogue held to jump-start grant project planning.
As the grant development process ensues, be superconservative with your internal deadlines and allow plenty of time to continuously review, revise, and edit from feedback received from key stakeholder team members and key opinion leaders in your organizations. Be sure to have a good understanding of, and factor in time for, institutional approvals that may be required of your organization or that of your partner organizations before an application for external funding can be submitted. Finally, allow time to seek out input especially from those in your organization or professional network who have previously received grant funding from the same or a similar source—people you can trust will give you honest, tough feedback.
Know Your Subject
An excellent grant application is based on the demonstration of a deep and contextual understanding of the subject and clear communication of your understanding of its relevance. While experience in the field is a necessary prerequisite, a good review of the current literature is crucial. No matter how experienced, don’t assume you or your team know all there is to know on the subject at hand. Be sure to review both peer-reviewed academic publications and related “gray literature”—that is, noncommercially published written content such as monographs, white papers, technical reports from government agencies, or working papers from research groups or committees that is generally available online. This practice will yield an understanding not only of the currently published evidence base, but also future innovations in the field that have not yet made it to the realm of peer-reviewed publication, and, most importantly, the forward-looking thought processes of key opinion leaders in the field.
Get Acquainted with Funder Interests
Another best practice is developing an understanding of funder interest and priorities. The gray literature mentioned earlier can shed important light on funder interests. Many government and private funders develop their funding priorities and strategies from the work of chartered expert committees and workgroups that frequently publish one or even a series of working papers that elucidate the rationale for their chosen approach. PCORI is an excellent recent example of a funder that has enlisted the active participation of key thought leaders and the public in developing its strategy, priorities, and recommended methodologies, which it later published.5 Other mechanisms that can be utilized to understand funder priorities include reviewing the funder’s published Request for Proposals (RFPs) and the organization’s track record of previous grants awarded. Following a detailed review of the specific funding opportunity you are considering, preparing your own written, detailed summary of its key priorities and criteria is a best practice that will help you clarify the fit, or lack thereof, of the specific opportunity you are considering vis-a-vis the needs and requirements of your organization and collaborators.
Develop a Framework
The bedrock of a good grant application, and good project planning, is in aligning the evidence with the goals, objectives, and proposed outcome of your project. This alignment can be effectively accomplished and demonstrated through the use of a logic model or some other results-based organizing framework.6,7 Many variations exist on the elements included in such a framework, but essentially it should show the linkages between the theoretical and evidential underpinnings of your project with its required resources, activities, outputs, and outcomes.8-10 Exploring an evidence-based “theory of change”11 also can be a valuable exercise in planning that will strengthen your project. Some funders, in fact, specifically request an organizing framework such as a logic model or theory of change, or they will build components of these type frameworks into the requirements of their application process. Combined with a strong evidence base and theory of change, the logic model becomes not only an effective graphical representation familiar to funders of exactly why and how the proposed program or topic of research is expected to be successful, but it also becomes an important planning tool and reference guide for your work moving forward.
Three additional quick tips are worthy of added note. One, consider all contributing financial resources that will be brought to bear on the project, leveraging the grant funding and as evidence of collaborators’ vested interest in the proposed project. Examples include the value of staff time; donated equipment, medical devices, space, or facilities; in-kind consulting expertise; or actual dollar contributions. Collaborator letters of support should specifically reference the non-grant-funded resources they bring to bear to the project. Second, be sure to address issues related to future sustainability of the project you are proposing or the service you are researching. Funders need to know their dollars are supporting long-term capacity building that is designed to self-sustain when the external funding is completed. Last, but definitely not least, follow funder instructions to the letter, then double- and triple-check. More grant applications than one would expect are turned away simply because they failed to follow basic instructions of the funder in putting the application together or were submitted a few minutes too late.
Keys to Successful Collaborations
Finally, a few words are in order on private sector engagement in grant development. In response to new funding opportunities, research collaborations including clinicians, health care delivery networks, academics, industry, patient-advocacy groups, and others are forming and together seek external funding to generate evidence of effectiveness or value to inform public and policy debate. While some funders explicitly state a goal to develop industry collaboration,12,13 others more indirectly communicate the value of industry collaboration or implicitly acknowledge that applicants are allowed to bring on private sector collaborators if appropriate and fitting to the project’s goals.
As industry representatives consider collaborating for external funding, two best practices become critically important. One is to work closely with the leaders and managers of the business line most directly linked with the potential collaboration to assess alignment of the goals of the collaboration with current or known future business priorities. Depending on the grant source and the nature of the project, grant funding often does not flow to the private sector partner, so the long-term outcomes of the project are often where the real value lies. Timelines need to be assessed, as the life cycle of external funding is quite often longer than is usual in the corporate environment. This time frame mismatch may lessen as a challenge in the future, however. Many funders are shortening their funding cycle turnaround time, and as tighter corporate financial constraints come into play, private sector industry will come to better understand the strategic value of collaborating for external funding.
Lastly, as innovative collaborations that include industry are developed, extra care should be taken by all stakeholders to follow principles of excellent collaboration focused on good communication, building trust, and being transparent from the start on objectives, priorities, and benefits of the collaboration for all parties. In particular, industry representatives must fully understand and rigorously follow all corporate regulatory and compliance requirements as to research and health care provider relationships.
Greater Rewards
Best practices in grant development continue to be refined in response to new calls for innovation in research, health services delivery, and collaboration. In fact, the use of best practices in grant development can leverage success even beyond the external funding an application might bring to bear. Success will follow projects and collaborations that are developed with the discipline and rigor of these best practices, regardless of a positive funding decision. For example, if your project makes it to review but is not funded, it may (but not in all cases) have the opportunity to benefit from expert reviewer feedback to improve project or research design. This could increase chances of success in a next go-around with the same funder, or in other funding opportunities that come along in the future.
Even more importantly, through the use of best practices in grant development, many teams develop an invigorating new awareness of their strengths, resources, and capacity to forge ahead, even if the potential grant funding that may have brought them together in the first place is not awarded. Benefits of the process “done right” include exciting growth in understanding the rationale and need for the project; the rich external context within which their work resides; linkages between the above with their own program’s goals, outcomes, and methodologies; and finally, a deeper appreciation for the capacities of their own organization, those of their partners, and the combined strengths of collaboration. Some well-developed projects go on to identify previously unidentified sources of internal funding to make their project happen. Using best practices in grant development is truly a win-win, and the possibility of a grant award becomes simply icing on the cake.
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Gina Graham is Director, Health Economics and Outcomes Research on the GEHC Health Economics and Reimbursement team.
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REFERENCES
1. Patient-Centered Outcomes Research Institute. www.pcori.org. Accessed August 20, 2012.
2. Stinson K, Renninger P. Collaboration in Grant Development and Management. http://www.thompson.com/public/offerpage.jsp?prod=GROUP. Accessed January 15, 2013.
3. National Institutes of Health, Office of Extramural Research, Grants & Funding. About Grants. http://grants.nih.gov/grants/about_grants.htm. Accessed January 15, 2013.
4. Miner JT, Miner LE. Proposal Planning & Writing. http://www.minerandassociates.com/tool-box/#books. Accessed January 15, 2013.
5. Primary Investigator: Constantine Gatsonsis, PhD. Standards in the Design, Conduct and Evaluation of Diagnostic Testing for Use in Patient Centered Outcomes Research. March 15, 2012. www.pcori.org. Accessed August 20, 2012.
6. Renger R, Titcomb A. A three-step approach to teaching logic models. American Journal of Evaluation. December 2002;23:493-503. doi:10.1177/109821400202300409
7. Urban JB, Trochim W. The role of evaluation in research—practice integration working toward the ‘‘Golden Spike.’’ American Journal of Evaluation. December 2009;30:538-553. doi:10.1177/1098214009348327
8. MacPhee M. Developing a practice-academic partnership logic model. Nurs Outlook. 2009;57(3):143-7.
9. Anderson LA, Gwaltney M, Kundra DL, et al. Using concept mapping to develop a logic model for the Prevention Research Centers Program. Prev Chronic Dis. 2006;3(1):A06.
10. Centers for Disease Control and Prevention. Other Evaluation Resources. http://www.cdc.gov/eval/resources/index.htm#logicmodels. Accessed January 19, 2012.
11. Posner GJ, Strike KA, Hewson PW, Gertzog WA. Accommodation of a scientific conception: toward a theory of conceptual change. Science Education. 1982;66(2):211-227.
12. National Science Foundation, Grant Opportunities for Academic Liaison with Industry (GOALI). http://www.nsf.gov/pubs/2012/nsf12513/nsf12513.htm. Accessed January 15, 2013.
13. U.K. Medical Research Council Industrial Collaboration Agreement (MICA). http://www.mrc.ac.uk/Fundingopportunities/Grants/MICA/Specification/index.htm. Accessed January 17, 2013.
