Hungarian Association of ExecutivesEvidence-Based Management An introduction Hungarian Association of Executives October 26, Budapest
Hungarian Association of Executives Where does it come from? What is it? Why do we need it? How does it look like in practice? (An example)
Hungarian Association of ExecutivesEvidence based management: Where does it come from?
What field is this? Hungarian Association of Executives “there is a large research-user gap” “practitioners do not read academic journals” “the findings of research into what is an effective intervention are not being translated into actual practice” “academics not practitioners are driving the research agenda” “the relevance, quality and applicability of research is questionable” “practice is being driven more by fads and fashions than research” “many practices are doing more harm than good”
Medicine: Founding fathers Hungarian Association of Executives David Sackett Gordon Guyatt McMaster University Medical School, Canada
How it all started Hungarian Association of Executives
Problem I: too much information Hungarian Association of Executives More than 1 million articles in 40,000 medical journals per year (= 1995; now probably more than 2 million). For a specialist to keep up this means reading 25 articles every day (for a GP more than 100!) Most of the new insights and treatment methods don‟t reach the target group
Problem I: too much information Hungarian Association of Executives HRM: 1,350 articles in 2010 (ABI/INFORM). For an HR manager to keep up this means reading 3 to 4 articles every day (for a „general‟ manager more than 50!)
Problem II: persistent convictions Hungarian Association of Executives if you’re breathe into a bag hyperventilating
Problem II: persistent convictions Hungarian Association of Executiveselderly people who have give them a drug thatan irregular heartbeat are reduces themuch more likely to die of number of coronary disease irregular beats
How 40,000 cardiologists can be wrong Hungarian Association of Executives In the early 1980s newly introduced anti- arrhythmic drugs were found to be highly successful at suppressing arrhythmias. Not until a RCT was performed was it realized that, although these drugs suppressed arrhythmias, they actually increased mortality. The CAST trial revealed Excess mortality of 56/1000. By the time the results of this trial were published, at least 100,000 such patients had been taking these drugs.
Hungarian Association of ExecutivesDavid Sackett Half of what you learn in medical school will be shown to be either dead wrong or out-of-date within 5 years of your graduation; the trouble is that nobody can tell you which half. The most important thing to learn is how to learn on your own: search for the evidence! (Remember that your teachers are as full of bullshit as your parents)
Evidence-Based Practice Hungarian Association of Executives1991 Medicine1998 Education1999 Social care2000 Nursing2000 Criminal justice???? Management?
Hungarian Association of ExecutivesEvidence based management: What is it?
Definition Hungarian Association of ExecutivesEvidence-based management means making decisionsabout the management of employees, teams ororganizations through the conscientious, explicit andjudicious use of four sources of information:1. The best available scientific evidence2. Organizational facts, metrics and characteristics3. Stakeholders’ values and concerns4. Decision supports and practitioner expertise
Four sources Hungarian Association of Executives
Definition Hungarian Association of Executives When making an important decision, an evidence-based manager knows whether there is scientific evidence available to support this decision (and how „strong‟ the evidence is).
Hungarian Association of ExecutivesEvidence-based management: Why do we need it?
Four sources Hungarian Association of Executives
Hungarian Association of ExecutivesTrust me: 20 years of management experience!
Errors and Biases of Human Judgment Hungarian Association of Executives
Errors and Biases of Human Judgment Hungarian Association of Executives Seeing order in randomness Mental corner cutting Misinterpretation of incomplete data Halo effect False consensus effect Attribution error Confirmation bias Group think Authority bias Self serving bias Small numbers fallacy Sunk cost fallacy In-group bias Cognitive dissonance reduction Recall bias Anchoring bias Inaccurate covariation detection Distortions due to plausibility
Hungarian Association of Executives“I’ve been studying intuition for 45 years, and I’m no betterthan when I started. I make extreme predictions. I’m over-confident. I fall for every one of the biases.”
Errors and Biases of Human Judgment Hungarian Association of Executives Doctors and managers hold many erroneous beliefs, not because they are ignorant or stupid, butbecause they seem to be the most sensible conclusion consistent with their own professional experience!
Errors and Biases of Human Judgment Hungarian Association of Executives stress & lifestyle peptic ulcer
Oct 2005 Peptic ulcer – an infectious disease!This years Nobel Prize in Physiology or Medicine goes to Barry Marshall and RobinWarren, who with tenacity and a prepared mind challenged prevailing dogmas. Byusing technologies generally available (fibre endoscopy, silver staining ofhistological sections and culture techniques for microaerophilic bacteria), theymade an irrefutable case that the bacterium Helicobacter pylori is causing disease.By culturing the bacteria they made them amenable to scientific study. In 1982, when this bacterium was discovered by Marshall and Warren, stress and lifestyle were considered the major causes of peptic ulcer disease. It is nowfirmly established that Helicobacter pyloricauses more then 90% of duodenal ulcers.The link between Helicobacter pyloriinfection and peptic ulcer disease has beenestablished through studies of humanvolunteers, antibiotic treatment studies andepidemiological studies.
Beliefs vs Evidence Hungarian Association of Executives“What gets us into trouble is not what wedont know,its what we know for sure that just isnt so.” Mark Twain
True or false? Hungarian Association of Executives1. Incompetent people benefit more from feedback than highly competent people.2. Task conflict improves work group performance while relational conflict harms it.3. Encouraging employees to participate in decision making is more effective for improving organizational performance than setting performance goals.
How evidence-based are we? Hungarian Association of ExecutivesHR Professionals beliefs about effective human resource practices: correspondencebetween research and practice, (Rynes et al, 2002, Sanders et al 2008) 959 (US) + 626 (Dutch) HR professionals 35 statements, based on an extensive body of evidence true / false / uncertain On average: 35% - 57% correct
Evidence-based? Hungarian Association of Executives Competence management Excellent care Total Quality Management Flexible workspace / The New World of Work Knowledge Management Investors in People, Great Place To Work Balanced Score Card / INK Lean / Six Sigma / TOC
Evidence-based approach Hungarian Association of Executives How „new‟ is this question or problem? Is there evidence from scientific research that can help us find the most effective approach? How „strong‟ is this evidence? Is the evidence applicable to my situation?
Hungarian Association of Executives Evidence based management:How does it look like in practice?
The 5 steps of EBP Hungarian Association of Executives1. Formulate a focused question (Ask)2. Search for the best available evidence (Acquire)3. Critically appraise the evidence (Appraise)4. Integrate the evidence with your managerial expertise and organisational concerns and apply (Apply)5. Monitor the outcome (Assess)
Hungarian Association of Executives1. Formulate a focused question
Asking the right question? Hungarian Association of Executives Does team-building work? Does the introduction of self-steering teams work? Does management development improve the performance of managers? Does employee participation prevent resistance to change? Is 360 degree feedback effective?
Focused question? Hungarian Association of Executives Does team-building work? What is a „team‟? What kind of team? In what contexts/ settings? What counts as „team-building‟? What does „work‟ mean? What outcomes are relevant? Over what time periods?
Answerable question: PICOC Hungarian Association of ExecutivesP = PopulationI = Intervention or success factorC = ComparisonO = OutcomeC = Context
Focused question: PICOC Hungarian Association of ExecutivesP = PopulationI = Intervention or successfactorC = Comparison Employee productivity? Job satisfaction?O = Outcome Return on investment? Market share?C = Context Organizational commitment?
Hungarian Association of Executives2. Finding the best available evidence
Where do we search? Hungarian Association of Executives
Hands on instruction Hungarian Association of Executives
Hungarian Association of Executives3. Critical appraisal of studies Making sense of evidence
Hungarian Association of ExecutivesBest available evidence?
Research designs Hungarian Association of Executives What is the BEST car?
Research designs Hungarian Association of ExecutivesWhich design for which question?
Which design for which question? Hungarian Association of ExecutivesExplanation
Hungarian Association of ExecutivesBest research design?
Best available? Hungarian Association of Executives
What is evidence? Hungarian Association of Executives Evidence is not the same as „proof‟ or „hard facts‟ Evidence can be - so strong that no one doubts its correctness, or - so weak that it is hardly convincing at all
Hungarian Association of ExecutivesStep 4: Turning evidence into practice
Applicable / Feasible? Hungarian Association of Executives organizational facts and characteristics cultural aspects stakeholders‟ values and concerns political aspects financial aspects /cost-effectiveness / ROI priorities change readiness / resistance to change implementation capacity timing
Hungarian Association of Executives Evidence-based practice: Focuses on the decision making process Uses research findings to increase the likelihood of a positive outcome