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Evidence-Based Management
Looking Back and Forward
Thomas Rundall, PhDUniversity of California, Berkeley
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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
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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
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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
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The Origins of the Modern Era
Towards an Evidence Based Health Care Management
Runo AxelssonInternational Journal of HealthPlanning and Management, 1998
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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 …
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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 …
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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
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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
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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
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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
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Looking Forward:Encouraging Developments in
Health Care Management
• Practice
• Research
• Teaching
• Institutional Development
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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
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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
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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)
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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
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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.
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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
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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
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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