Evidence-Based Management: Looking Back and Forward

Center for Evidence-Based Management
Center for Evidence-Based ManagementCenter for Evidence-Based Management
Evidence-Based Management
Looking Back and Forward
Thomas Rundall, PhD
University of California, Berkeley
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 Recommendations
2
What is Evidence-Based Management?
Evidence-based management means making decisions about
the management of employees, teams or organizations
through conscientious, explicit and judicious use of four
sources of information
1. The best available scientific evidence
2. The best available organizational evidence
3. The best available experiential evidence
4. Organizational values and stakeholder’s concerns
3
BestAvailable
Scientific Evidence
Organizational Facts
and Characteristics
Managerial Expertise
and Judgement
Stakeholders’Values
and Concerns
Evidence-based
Decision
Source: Center for Evidence-Based Management4
Looking Back
The Emerging Field of EBMgt
5
The Origins of the Modern Era
Towards an Evidence Based Health Care
Management
RunoAxelsson
InternationalJournal of Health
Planning and Management, 1998
6
Management theory and research is not useful
to managers
“During the past 10 years organizational theory has
become more and more esoteric and largely dissociated
from the problems of management.At the same time,
organizational research seems to have come to a scientific
dead end, where nothing can be proved or disproved any
longer. Knowledge about organizations has reduced to a
question of culture, language and symbols …
7
The research efforts have been limited to understanding
different aspects of organizational life, rather than trying
to explain and predict the consequences of managerial
action …With this orientation, the results from
organizational research have become less and less
relevant for practical management …
8
It is difficult to escape the feeling of resignation in this
research on organizations.The research seems to have
become an end in itself and has very little relevance for
practical management. Instead the field has been left
wide open for consultants and different charlatans to
influence managers with their fashionable models of
organization and management.”
RunoAxelsson, 1998
9
Yes, it’s quite a noise – but are we having any impact?
10
Some Features of the Fields from
Which EBMgt Is Emerging
• Emerging from the field of management practice
– in which there is no universally accepted certification
to enter the profession
– there has been little collaboration with researchers
– in which research has been sparingly used; there is a
gap between what we know and what we do in many
management areas
11
Some Features of the Fields from
Which EBMgt Is Emerging
• Emerging from the field of management research
– that lacks broad agreement on fundamental issues such
as whether the field should be advancing prescriptive
advice to improve organizational performance or non-
prescriptive understandings of life within organizations
– that lacks structures, processes and incentives to produce
and disseminate actionable management findings
12
Some Features of the Fields from
Which EBMgt Is Emerging
• Emerging from a field of management teaching in
which there is little emphasis on the steps required
to practice EBMgt or the skills necessary to apply
research evidence to managerial decisions
13
Looking Forward:
Encouraging Developments in Health
Care Management
• Practice
• Research
• Teaching
• Institutional Development
14
Management Practice in
Health 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 of
Accountable Care Organizations
15
Management Research in
Health Services
• Greater emphasis by funding agencies and
research 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 practice
16
ManagementTeaching
• Suggestions for how to incorporate EBMgt in curricula are
available
– Rousseau, D.M. & McCarthy S., Educating Managers From an Evidence-Based
Perspective,Academy of Management Learning and Education, 2007
– Rundall,T., Refocusing Future Faculty on Evidence-based Health Services
Management 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
ManagementTeaching
• “Model” course syllabi available on-line: e.g. Denise
Rousseau’s course Evidence Based Management,
http://www.heinz.cmu.edu/Courses/397syl.pdf
• The Informed DecisionsToolbox is available to support
course projects:
http://www.ahrq.gov/policymakers/measurement/decisionto
olbx/index.html
18
Institutional Development
of EBMgt
• Growing literature developing the concepts, practices and
examples 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
Institutional Development
of EBMgt
• Communities of practice, e.g. the Evidence-Based Management
Collaborative at Carnegie Mellon University:
http://wpweb2.tepper.cmu.edu/rlang/ebm_conf/index.html
• Centers dedicated to promoting evidence-based practice, e.g. the Center
for Evidence-Based Management in Amsterdam: http://www.cebma.org
• Web-based Blogs and other related sites, e.g. Evidence-based
Managament (Pfeffer & Sutton), Stanford University:
http://blog.stanford.edu/node/145
20
Four Recommendations to Further
Institutionalize EBMgt
1. Curriculum Development: embed EBMgt in
a. Introduction to Health Services Management (and Policy)
b. Specialty courses such as strategic planning, human resource
management, financial management, and quality and patient safety
(Faculty Forum recommendations?)
c. Capstone projects
2. Expand EBMgt communities of practice
21
Four Recommendations to Further
Institutionalize EBMgt
3. Create and disseminate a comprehensive vision of an
evidence-based approach to management in health care
organizations
a. Strategic Dimension: external demands for performance accountability
b. Structural Dimension: accountability structure for knowledge transfer
c. Cultural Dimension: questioning organizational culture
d. Technical Dimension: participation in management research
4. Create a National Evidence-based HealthCare Management
Center, including a repository of management research
similar to the Cochran Collaboration
22
ThankYou!
23
1 of 23

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Evidence-Based Management: Looking Back and Forward

  • 1. Evidence-Based Management Looking Back and Forward Thomas Rundall, PhD University of California, Berkeley
  • 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 Recommendations 2
  • 3. What is Evidence-Based Management? Evidence-based management means making decisions about the management of employees, teams or organizations through conscientious, explicit and judicious use of four sources of information 1. The best available scientific evidence 2. The best available organizational evidence 3. The best available experiential evidence 4. Organizational values and stakeholder’s concerns 3
  • 4. BestAvailable Scientific Evidence Organizational Facts and Characteristics Managerial Expertise and Judgement Stakeholders’Values and Concerns Evidence-based Decision Source: Center for Evidence-Based Management4
  • 5. Looking Back The Emerging Field of EBMgt 5
  • 6. The Origins of the Modern Era Towards an Evidence Based Health Care Management RunoAxelsson InternationalJournal of Health Planning and Management, 1998 6
  • 7. Management theory and research is not useful to managers “During the past 10 years organizational theory has become more and more esoteric and largely dissociated from the problems of management.At the same time, organizational research seems to have come to a scientific dead end, where nothing can be proved or disproved any longer. Knowledge about organizations has reduced to a question of culture, language and symbols … 7
  • 8. The research efforts have been limited to understanding different aspects of organizational life, rather than trying to explain and predict the consequences of managerial action …With this orientation, the results from organizational research have become less and less relevant for practical management … 8
  • 9. It is difficult to escape the feeling of resignation in this research on organizations.The research seems to have become an end in itself and has very little relevance for practical management. Instead the field has been left wide open for consultants and different charlatans to influence managers with their fashionable models of organization and management.” RunoAxelsson, 1998 9
  • 10. Yes, it’s quite a noise – but are we having any impact? 10
  • 11. Some Features of the Fields from Which EBMgt Is Emerging • Emerging from the field of management practice – in which there is no universally accepted certification to enter the profession – there has been little collaboration with researchers – in which research has been sparingly used; there is a gap between what we know and what we do in many management areas 11
  • 12. Some Features of the Fields from Which EBMgt Is Emerging • Emerging from the field of management research – that lacks broad agreement on fundamental issues such as whether the field should be advancing prescriptive advice to improve organizational performance or non- prescriptive understandings of life within organizations – that lacks structures, processes and incentives to produce and disseminate actionable management findings 12
  • 13. Some Features of the Fields from Which EBMgt Is Emerging • Emerging from a field of management teaching in which there is little emphasis on the steps required to practice EBMgt or the skills necessary to apply research evidence to managerial decisions 13
  • 14. Looking Forward: Encouraging Developments in Health Care Management • Practice • Research • Teaching • Institutional Development 14
  • 15. Management Practice in Health 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 of Accountable Care Organizations 15
  • 16. Management Research in Health Services • Greater emphasis by funding agencies and research 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 practice 16
  • 17. ManagementTeaching • Suggestions for how to incorporate EBMgt in curricula are available – Rousseau, D.M. & McCarthy S., Educating Managers From an Evidence-Based Perspective,Academy of Management Learning and Education, 2007 – Rundall,T., Refocusing Future Faculty on Evidence-based Health Services Management 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. ManagementTeaching • “Model” course syllabi available on-line: e.g. Denise Rousseau’s course Evidence Based Management, http://www.heinz.cmu.edu/Courses/397syl.pdf • The Informed DecisionsToolbox is available to support course projects: http://www.ahrq.gov/policymakers/measurement/decisionto olbx/index.html 18
  • 19. Institutional Development of EBMgt • Growing literature developing the concepts, practices and examples 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. Institutional Development of EBMgt • Communities of practice, e.g. the Evidence-Based Management Collaborative at Carnegie Mellon University: http://wpweb2.tepper.cmu.edu/rlang/ebm_conf/index.html • Centers dedicated to promoting evidence-based practice, e.g. the Center for Evidence-Based Management in Amsterdam: http://www.cebma.org • Web-based Blogs and other related sites, e.g. Evidence-based Managament (Pfeffer & Sutton), Stanford University: http://blog.stanford.edu/node/145 20
  • 21. Four Recommendations to Further Institutionalize EBMgt 1. Curriculum Development: embed EBMgt in a. Introduction to Health Services Management (and Policy) b. Specialty courses such as strategic planning, human resource management, financial management, and quality and patient safety (Faculty Forum recommendations?) c. Capstone projects 2. Expand EBMgt communities of practice 21
  • 22. Four Recommendations to Further Institutionalize EBMgt 3. Create and disseminate a comprehensive vision of an evidence-based approach to management in health care organizations a. Strategic Dimension: external demands for performance accountability b. Structural Dimension: accountability structure for knowledge transfer c. Cultural Dimension: questioning organizational culture d. Technical Dimension: participation in management research 4. Create a National Evidence-based HealthCare Management Center, including a repository of management research similar to the Cochran Collaboration 22