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23 to provide the structure for an effective problem-solving process and support the facilitation of program planning and mon- itoring, the documentation of outcomes, and the sustainability of interventions. Program, evaluator, and funder partners work as a collaborative team throughout the process. is approach is based on the same accountability questions incorporated into the well-known Getting to Outcomes (GTO) evaluation process which was developed by Drs. Abe Wandersman and Pam Imm and which was recognized by the American Evaluation Association with its Outstanding Publication Award in 2008. National Recognition e Synergy Initiative approach has been recognized for its effectiveness among foundations and was featured by FSG Social Impact Advisors in 2007 and again in 2011. In 2017, e Health Foundation's grant- making was identified among the nation's health conversion foundations as leading edge in addressing the social determinants of health by researchers at Wake Forest School of Medicine in a study called "In- novative Health Conversion Foundations" that was supported by the Robert Wood Johnson Foundation. e study, conducted by Dr. Doug East- erling and Laura McDuffee, focused on 33 out of 242 health conversion founda- tions across the country, and results were published in a 2018 article in e Founda- tion Review, an academic, peer-reviewed journal. e Health Foundation was credited for taking an upstream approach to improving health by providing grants to address social and economic issues such as early childhood education, economic well-being, prisoner reentry, homelessness, hunger, and community development. Later, Dr. Easterling conducted a thor- ough evaluation of e Health Founda- tion's Synergy Initiative model and offered recommendations for how to enhance it. Following his in-depth review, he in- dicated his high regard for the model and prepared a manuscript commending the model's effectiveness to the field of philan- thropy. His article "How Can Foundations Promote Impactful Collaboration?" was published in e Foundation Review in 2019. In June 2022, a few months aer her retirement from e Health Foundation, Dr. Jan Yost, founding president and CEO, was recognized with the prestigious Terrance Keenan Leadership Award in Health Philanthropy at the Grantmakers In Health (GIH) annual conference. First presented by GIH in 1993, the award rec- ognizes grantmakers whose thoughtful use of philanthropic dollars has had an impact on health and whose work demonstrates responsiveness to the people in their com- munities, especially to those in the greatest need. In her acceptance speech, Dr. Yost quoted poet Robert Browning: "Ah, but a man's reach should exceed his grasp, Or what's a heaven for?" She encouraged health funders to reach beyond their current grasp and to focus more on im- pactful grantmaking, and she cited several examples of how e Health Foundation has reached beyond its grasp to achieve an outsized impact on improving health in Central Massachusetts, especially through its Synergy Initiative grants. n 1. What are the underlying needs and conditions that must be addressed? (NEEDS/RESOURCES) 2. What are the goals, population of focus, and objectives (i.e., desired outcomes)? (GOALS) 3. Which science- (evidence-) based models and evidence-based programs can be useful in reaching the goals? (BEST PRACTICE)? 4. What actions need to be taken so the selected program "fits" the community context? (FIT) 5. What is the plan for this program? (PLAN) 6. What organizational capacities are needed to implement the plan? (CAPACITIES) 7. Is the program being implemented with quality? (PROCESS) 8. How well is the program working? (OUTCOME EVALUATION) 9. How will continuous quality improvement strategies be included? (IMPROVE) 10. If the program is successful, how will it be sustained? (SUSTAIN) ROGG Accountability Questions "This system ensured high- quality planning as well as evaluation expertise to strategize effective quality improvement. As such, evaluation results of many of the Synergy Initiative projects showed significant outcomes related to high- quality programming as well as meaningful system-level change." Dr. Pam Imm, previous Synergy Initiative evaluator and evaluation consultant Dr. Yost's GIH award