Evidence-Based Management
Looking Back and Forward
Thomas Rundall, PhD
University of California, Berkeley
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
Managerial Expertise
and Judgement
Evidence-based
Decision
Organizational Facts
and Characteristics
Stakeholders’ Values
and Concerns
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Source: Center for Evidence-Based Management
Looking Back
The Emerging Field of EBMgt
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The Origins of the Modern Era
Towards an Evidence Based Health Care
Management
Runo Axelsson
International Journal of Health
Planning 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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Yes, it’s quite a noise – but are we having any impact?
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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 nonprescriptive 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 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
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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/decisionto
olbx/index.html
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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.
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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
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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
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Thank You!
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