Evidence-Based Management

Looking Back and Forward

Thomas Rundall, PhDUniversity of California, Berkeley

2

Topics for Today’s Presentation

• Looking Back: The Emerging Field of EBMgt

– The Origins of the Modern Era

– Some Features of the Fields From Which EBMgt Is Emerging

• Practice

• Research

• Teaching

• Looking Forward: Encouraging Developments

• Increasing Institutionalization of EBMgt

• Four Recommendations

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

4

Best Available Scientific Evidence

Organizational Facts and

Characteristics

Managerial Expertise and

Judgement

Stakeholders’ Values and Concerns

Evidence-based Decision

Source: Center for Evidence-Based Management

5

Looking BackThe Emerging Field of EBMgt

6

The Origins of the Modern Era

Towards an Evidence Based Health Care Management

Runo AxelssonInternational Journal of HealthPlanning and Management, 1998

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 …

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 … 

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.”

Runo Axelsson, 1998

10

Yes, it’s quite a noise – but are we having any impact?

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

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

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

14

Looking Forward:Encouraging Developments in

Health Care Management

• Practice

• Research

• Teaching

• Institutional Development

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

16

Management Research inHealth 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

17

Management Teaching• 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)

18

Management Teaching

• “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 Decisions Toolbox is available to

support course projects:

http://www.ahrq.gov/policymakers/measurement/

decisiontoolbx/

index.html

19

Institutional Developmentof 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.

20

Institutional Developmentof 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

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

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

23

Thank You!