Hungarian Association of Executives Evidence-Based Management An introduction Hungarian Association of Executives October 26, Budapest.
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Hungarian Association of Executives
Evidence-Based Management
An introduction
Hungarian Association of Executives
October 26, Budapest
Hungarian Association of Executives
Where does it come from?
What is it?
Why do we need it?
How does it look like in practice?
(An example)
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“there is a large research-user gap”
“practitioners do not read academic journals”
“the findings of research into what is an effective intervention
are not being translated into actual practice”
“academics not practitioners are driving the research agenda”
“the relevance, quality and applicability of research is
questionable”
“practice is being driven more by fads and fashions than
research”
“many practices are doing more harm than good”
What field is this?
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McMaster University Medical School, Canada
Medicine: Founding fathers
David Sackett Gordon Guyatt
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More than 1 million articles in 40,000 medical journals per
year (= 1995; now probably more than 2 million). For a
specialist to keep up this means reading 25 articles every
day (for a GP more than 100!)
Most of the new insights and treatment
methods don’t reach the target group
Problem I: too much information
Hungarian Association of Executives
Problem I: too much information
HRM: 1,350 articles in 2010 (ABI/INFORM). For an HR
manager to keep up this means reading 3 to 4 articles
every day (for a ‘general’ manager more than 50!)
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Problem II: persistent convictions
if you’re hyperventilating
breathe into a bag
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elderly people who have an irregular heartbeat are much more likely to die of
coronary disease
give them a drug that reduces the number of
irregular beats
Problem II: persistent convictions
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How 40,000 cardiologists can be wrong
In the early 1980s newly introduced anti-arrhythmic drugs were found to be highly successful at suppressing arrhythmias.
Not until a RCT was performed was it realized that, although these drugs suppressed arrhythmias, they actually increased mortality.
The CAST trial revealed Excess mortality of 56/1000.
By the time the results of this trial were published, at least 100,000 such patients had been taking these drugs.
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David Sackett
Half of what you learn in medical school will be
shown to be either dead wrong or out-of-date
within 5 years of your graduation; the trouble is that
nobody can tell you which half.
The most important thing to learn is how to learn
on your own: search for the evidence!
(Remember that your teachers are as full of bullshit
as your parents)
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Evidence-Based Practice
1991Medicine
1998Education
1999Social care
2000Nursing
2000Criminal justice
????Management?
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Definition
Evidence-based management means making decisions
about the management of employees, teams or
organizations through the conscientious, explicit and
judicious use of four sources of information:
1. The best available scientific evidence
2. Organizational facts, metrics and characteristics
3. Stakeholders’ values and concerns
4. Decision supports and practitioner expertise
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Definition
When making an important decision,
an evidence-based manager knows
whether there is scientific evidence
available to support this decision
(and how ‘strong’ the evidence is).
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Seeing order in randomness Mental corner cutting Misinterpretation of incomplete data Halo effect False consensus effect Attribution error Group think Self serving bias Sunk cost fallacy Cognitive dissonance reduction
Confirmation bias Authority bias Small numbers fallacy In-group bias Recall bias Anchoring bias Inaccurate covariation detection Distortions due to plausibility
Errors and Biases of Human Judgment
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“I’ve been studying intuition for 45 years, and I’m no better than when I started. I make extreme predictions. I’m over-confident. I fall for every one of the biases.”
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Errors and Biases of Human Judgment
Doctors and managers hold many erroneous beliefs,
not because they are ignorant or stupid, but because
they seem to be the most sensible conclusion
consistent with their own professional experience!
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Errors and Biases of Human Judgment
stress & lifestyle peptic ulcer
Peptic ulcer – an infectious disease!
This year's Nobel Prize in Physiology or Medicine goes to Barry Marshall and Robin Warren, who with tenacity and a prepared mind challenged prevailing dogmas. By using technologies generally available (fibre endoscopy, silver staining of histological sections and culture techniques for microaerophilic bacteria), they made an irrefutable case that the bacterium Helicobacter pylori is causing disease. By culturing the bacteria they made them amenable to scientific study.
In 1982, when this bacterium was discovered by Marshall and Warren, stress and lifestyle were considered the major causes of peptic ulcer disease. It is now
firmly established that Helicobacter pylori causes more then 90% of duodenal ulcers. The link between Helicobacter pylori infection and peptic ulcer disease has been established through studies of human volunteers, antibiotic treatment studies and epidemiological studies.
Oct 2005
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Beliefs vs Evidence
“What gets us into trouble is not what we
don't know,
it's what we know for sure that just isn't so.”
Mark Twain
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1. Incompetent people benefit more from feedback than
highly competent people.
2. Task conflict improves work group performance while
relational conflict harms it.
3. Encouraging employees to participate in decision
making is more effective for improving organizational
performance than setting performance goals.
True or false?
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How evidence-based are we?
959 (US) + 626 (Dutch) HR professionals
35 statements, based on an extensive body of
evidence
true / false / uncertain
On average: 35% - 57% correct
HR Professionals' beliefs about effective human resource practices: correspondence between research and practice, (Rynes et al, 2002, Sanders et al 2008)
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Evidence-based?
Competence management
Excellent care
Total Quality Management
Flexible workspace / The New World of Work
Knowledge Management
Investors in People, Great Place To Work
Balanced Score Card / INK
Lean / Six Sigma / TOC
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How ‘new’ is this question or problem?
Is there evidence from scientific research that
can help us find the most effective approach?
How ‘strong’ is this evidence?
Is the evidence applicable to my situation?
Evidence-based approach
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The 5 steps of EBP
1. Formulate a focused question (Ask)
2. Search for the best available evidence (Acquire)
3. Critically appraise the evidence (Appraise)
4. Integrate the evidence with your managerial
expertise and organisational concerns and apply
(Apply)
5. Monitor the outcome (Assess)
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Asking the right question?
Does team-building work?
Does the introduction of self-steering teams work?
Does management development improve the performance
of managers?
Does employee participation prevent resistance to change?
Is 360 degree feedback effective?
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What is a ‘team’?
What kind of team?
In what contexts/ settings?
What counts as ‘team-building’?
What does ‘work’ mean?
What outcomes are relevant?
Over what time periods?
Focused question?
Does team-building work?
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P = Population
I = Intervention or success factor
C = Comparison
O = Outcome
C = Context
Answerable question: PICOC
Hungarian Association of Executives
P = Population
I = Intervention or successfactor
C = Comparison
O = Outcome
C = Context
Focused question: PICOC
Employee productivity?
Job satisfaction?
Return on investment?
Market share?
Organizational commitment?
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Evidence is not the same as ‘proof’ or ‘hard facts’
Evidence can be
- so strong that no one doubts its correctness, or
- so weak that it is hardly convincing at all
What is evidence?
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Applicable / Feasible?
organizational facts and characteristics
cultural aspects
stakeholders’ values and concerns
political aspects
financial aspects /cost-effectiveness / ROI
priorities
change readiness / resistance to change
implementation capacity
timing
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