Evidence-Based Management: Looking Back and Forward


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Evidence-Based Management: Looking Back and Forward
Thomas Rundall
AUPHA 2013 Annual Meeting
Monterey, CA

Published in: Education, Health & Medicine
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Evidence-Based Management: Looking Back and Forward

  1. 1. Evidence-Based ManagementLooking Back and ForwardThomas Rundall, PhDUniversity of California, Berkeley
  2. 2. Topics forToday’s Presentation• Looking Back:The Emerging Field of EBMgt– The Origins of the Modern Era– Some Features of the Fields FromWhich EBMgt Is Emerging• Practice• Research• Teaching• Looking Forward: Encouraging Developments• Increasing Institutionalization of EBMgt• Four Recommendations2
  3. 3. What is Evidence-Based Management?Evidence-based management means making decisions aboutthe management of employees, teams or organizationsthrough conscientious, explicit and judicious use of foursources of information1. The best available scientific evidence2. The best available organizational evidence3. The best available experiential evidence4. Organizational values and stakeholder’s concerns3
  4. 4. BestAvailableScientific EvidenceOrganizational Factsand CharacteristicsManagerial Expertiseand JudgementStakeholders’Valuesand ConcernsEvidence-basedDecisionSource: Center for Evidence-Based Management4
  5. 5. Looking BackThe Emerging Field of EBMgt5
  6. 6. The Origins of the Modern EraTowards an Evidence Based Health CareManagementRunoAxelssonInternationalJournal of HealthPlanning and Management, 19986
  7. 7. Management theory and research is not usefulto managers“During the past 10 years organizational theory hasbecome more and more esoteric and largely dissociatedfrom the problems of management.At the same time,organizational research seems to have come to a scientificdead end, where nothing can be proved or disproved anylonger. Knowledge about organizations has reduced to aquestion of culture, language and symbols …7
  8. 8. The research efforts have been limited to understandingdifferent aspects of organizational life, rather than tryingto explain and predict the consequences of managerialaction …With this orientation, the results fromorganizational research have become less and lessrelevant for practical management …8
  9. 9. It is difficult to escape the feeling of resignation in thisresearch on organizations.The research seems to havebecome an end in itself and has very little relevance forpractical management. Instead the field has been leftwide open for consultants and different charlatans toinfluence managers with their fashionable models oforganization and management.”RunoAxelsson, 19989
  10. 10. Yes, it’s quite a noise – but are we having any impact?10
  11. 11. Some Features of the Fields fromWhich EBMgt Is Emerging• Emerging from the field of management practice– in which there is no universally accepted certificationto enter the profession– there has been little collaboration with researchers– in which research has been sparingly used; there is agap between what we know and what we do in manymanagement areas11
  12. 12. Some Features of the Fields fromWhich EBMgt Is Emerging• Emerging from the field of management research– that lacks broad agreement on fundamental issues suchas whether the field should be advancing prescriptiveadvice to improve organizational performance or non-prescriptive understandings of life within organizations– that lacks structures, processes and incentives to produceand disseminate actionable management findings12
  13. 13. Some Features of the Fields fromWhich EBMgt Is Emerging• Emerging from a field of management teaching inwhich there is little emphasis on the steps requiredto practice EBMgt or the skills necessary to applyresearch evidence to managerial decisions13
  14. 14. Looking Forward:Encouraging Developments in HealthCare Management• Practice• Research• Teaching• Institutional Development14
  15. 15. Management Practice inHealth Care Organizations• Increasing interest and receptivity to EBMgt,stimulated by– the patient safety and quality of care movement– widespread demands for reducing the cost of care:risk-based contracts, value-based purchasing, etc.– both forces exemplified by the emergence ofAccountable Care Organizations15
  16. 16. Management Research inHealth Services• Greater emphasis by funding agencies andresearch community on implementation,evaluation and translational research• Journals extending their reach to practitioners– Plain language summaries of research findings– Practitioner responses to articles• Increasing case studies of EBMgt in practice16
  17. 17. ManagementTeaching• Suggestions for how to incorporate EBMgt in curricula areavailable– Rousseau, D.M. & McCarthy S., Educating Managers From an Evidence-BasedPerspective,Academy of Management Learning and Education, 2007– Rundall,T., Refocusing Future Faculty on Evidence-based Health ServicesManagement Research, Journal of Health Administration Education, 2004• Courses are being added to management curricula– 25% of core MBA courses use EBMgt in some form (Charlier and Brown,Academy of Management, 2011)17
  18. 18. ManagementTeaching• “Model” course syllabi available on-line: e.g. DeniseRousseau’s course Evidence Based Management,http://www.heinz.cmu.edu/Courses/397syl.pdf• The Informed DecisionsToolbox is available to supportcourse projects:http://www.ahrq.gov/policymakers/measurement/decisiontoolbx/index.html18
  19. 19. Institutional Developmentof EBMgt• Growing literature developing the concepts, practices andexamples of use of EBMgt– Rousseau (Ed.),The Oxford Handbook of Evidence-Based Management.Oxford University Press, 2012– Kovner, Fine & D’Aquila (Eds.) Evidence-based Management in Healthcare,2009• Increasing consensus on definition, key concepts, steps,techniques, etc.19
  20. 20. Institutional Developmentof EBMgt• Communities of practice, e.g. the Evidence-Based ManagementCollaborative at Carnegie Mellon University:http://wpweb2.tepper.cmu.edu/rlang/ebm_conf/index.html• Centers dedicated to promoting evidence-based practice, e.g. the Centerfor Evidence-Based Management in Amsterdam: http://www.cebma.org• Web-based Blogs and other related sites, e.g. Evidence-basedManagament (Pfeffer & Sutton), Stanford University:http://blog.stanford.edu/node/14520
  21. 21. Four Recommendations to FurtherInstitutionalize EBMgt1. Curriculum Development: embed EBMgt ina. Introduction to Health Services Management (and Policy)b. Specialty courses such as strategic planning, human resourcemanagement, financial management, and quality and patient safety(Faculty Forum recommendations?)c. Capstone projects2. Expand EBMgt communities of practice21
  22. 22. Four Recommendations to FurtherInstitutionalize EBMgt3. Create and disseminate a comprehensive vision of anevidence-based approach to management in health careorganizationsa. Strategic Dimension: external demands for performance accountabilityb. Structural Dimension: accountability structure for knowledge transferc. Cultural Dimension: questioning organizational cultured. Technical Dimension: participation in management research4. Create a National Evidence-based HealthCare ManagementCenter, including a repository of management researchsimilar to the Cochran Collaboration22
  23. 23. ThankYou!23