EVIDENCE IN MANAGEMENT DECISIONS:
ADVANCING KNOWLEDGE UTILISATION IN HEALTHCARE MANAGEMENT
Research Context
What is the Problem?
In this time of change in the English NHS,
improving quality and productivity depends
increasingly on using evidence in
commissioning decisions.
Making decisions on the basis of sound evidence can lead to
better health service outcomes. Yet, we know very little about
how commissioning decisions actually become evidence
based.
Research Methods
Research Questions
1. What kind of evidence and how is it utilised in
practice for commissioning decisions?
2. What factors influence evidence utilisation?
3. How does evidence utilisation differ in different
decision making contexts?
In-depth qualitative case studies in 4 local health
economies in England based on:
a) Observations (N=80),
b) Documentary analysis,
c) Semi-structured interviews (N=50).
Also, a national survey is currently in progress.
● ● ●
“When you use evidence for
clinical decisions it’s easy and
Emerging Findings:
straightforward...
(Yet) evidence
Using Evidence for Redesigning and
of processes (also) needs to be
Commissioning Services
thought of very carefully...”
(Consultant Diabetologist)
● ● ●
 There appears to be necessity for using
not only clinical evidence, but also nonclinical evidence (e.g. narratives of good
practice, and contracting models)
Lessons Learnt
Who is organising this Research?
Warwick Business School and Warwick Medical
School conduct this research in collaboration.
Funding comes from the NIHR through its SDO
(Service Delivery Organisation) programme.
Project team
Prof. Jacky Swan
1
Prof. Aileen Clarke
Dr Davide Nicolini
 Importance of utilisation timing. For
example, evidence of commissioning
models may be needed well in advance.
 Co-production of decisions can be
challenging when multiple
parties/organisations are involved. There
may be limits to intensive collaboration.
 Taken-for-granted ‘decisions’ (e.g.
direction of travel) can become
roadblocks to evidence-based
commissioning.
 Value plurality of evidence (from both
authoritative bodies and local
commissioning knowledge) in a forward
looking manner
 Question the most fundamental
decisions and the (multiple kinds of)
evidence behind it.
1
2
Dr John Powell
Prof. Harry Scarbrough
Claudia Roginski
1
3
Dr Emmanouil Gkeredakis
Dr Sian Taylor-Phillips
Dawn Coton
 Think proactively of what coproduction is needed and how it is going
to be organised for the long-run
2
1
2
1
1 Warwick Business School
2 Warwick Medical School
3 Coventry Teaching PCT
Website:
www.warwick.ac.uk/go/
emd