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 information1. The best available scientific evidence2. The best available organizational evidence3. The best available experiential evidence4. 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 ina. 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 accountabilityb. Structural Dimension: accountability structure for knowledge transferc. Cultural Dimension: questioning organizational cultured. 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!