Evidence-Based Management A New Approach to Teaching the Practice of Management ACPE Annual Meeting, April 26 30, 2013, New York Tony Kovner, Michiel Bosman, Eric Barends
Feb 25, 2016
Evidence-Based ManagementA New Approach to Teaching the Practice of Management
ACPE Annual Meeting, April 26 30, 2013, New York
Tony Kovner, Michiel Bosman, Eric Barends
EBMgt: My Experiences
EBMgt as a Process
Why Don’t Managers use it?
Learning from Medicine
Contributions of Organizational Behavior
Experience in Teaching
The Politics of EBMgt
EBMgmt: Definition
“…the systematic, evidence-informed
practice of management, incorporating
scientific knowledge in the content and
process of making decisions.”
(Rousseau 2012)
EBMgt as a process
Framing the question behind the decision
Finding the sources of information
Assessing the accuracy of information
Assessing the applicability of information
Assessing the actionability of information
Determining if the information is adequate
(Hsu and others 2009)
Why don’t Managers use EBMgt?
Never heard of it. They are using it.
Cost now more probable than benefits in the future
Managers have to be persuaded and trained
The process doesn’t clearly lead to one-best way to intervene
Politics impacts interests
Learning from EB-Medicine
Interventions that achieve positive
predictable results
Hindrances that blocked implementation of
EBM same now for EBMgt
Financial as well as political impacts
Contributions of Organizational Behavior
Hiring Talent-relying on structured interviews
(Rousseau)
Challenging Performance goals impacting on
performance (Latham and Locke)
Managers who set a vision outperform other
managers (Kirkpattrick)
Teaching EBMgt
NYU / Wagner, Capstone course
Projects
Hourly nurse rounding process
Redesigning the nurses’ clinical ladder
Improving the supply distribution process
Identifying causes of emergency department waiting
The Politics of EBMgmt
Evidence is not sufficient to change people’s behavior
The quality of the argument and story-telling by persons presenting the evidence is what persuades stakeholders
How persuade the manager that this is in his own interest?
Michiel Bosman MD MMM FACPEMD, University of Amsterdam
MMM, CMU
Exec PhD (2015), OSU Spears School
Collaborator, Center for EBMgmt
Serial Entrepreneur
“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”
“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?
McMaster University Medical School, Canada
Medicine: Founding fathers
David Sackett Gordon Guyatt
How it all started
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 primary care physician more than 100!)
Problem: too much ‘evidence’
Problem: too much evidence
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!)
Problem: too many half truths
BTW: most of the research is seriously flawed or irrelevant for practice. And some claim so is most management advice.
The 5 steps of Evidence-Based Practice
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 professional expertise and apply (Apply)
5. Monitor the outcome (Assess)
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?
How evidence-based are managers?
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)
Evidence-Based Practice
1991 Medicine
1998 Education
1999 Social care, public policy
2000 Nursing
2005 Criminal justice
2010 Marketing
2013 Healthcare Management?
Evidence-Based Consulting
Close the research/practice gap
Professor + Consultant
EB Mgmt Workshops
Teach the 5 step EB Practice process
Answer business questions
CAT: Critically Appraised Topic
Closing the research/practice gap
Executive Doctorate in Management
University of Maryland College
Oklahoma State University
Development of tools to measure EB Mgmt Attitudes (EBMAS) and skills/competencies (Fresno)
Teaching Evidence Based Practice to managers
Evidence?
intuition, expertise, personal experience, collective experience,
organizational facts & data, best practices, benchmarking, outcome of scientific research
All managers base their decisions on ‘evidence’
BUT ...
Managers give little or no consideration to the
quality of the evidence they base their decisions on
SO ...
Teach managers how to find and and critically appraise
the evidence before they make their decision
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 professional expertise and apply (Apply)
5. Monitor the outcome (Assess)
0. Creating awareness Why do we need it?
Trust me, 20 years of management experience
Errors and Biases of Human Judgment
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 Outcome bias Authority bias Small numbers fallacy Recall bias Anchoring bias Inaccurate covariation detection
Errors and Biases of Human Judgment
1. Formulate a focused question
Asking the right question?
Does team-building work?
Does the introduction of self-steering teams work?
Does lean management improve the performance of
our hospital?
Is 360 degree feedback for doctors effective?
What is a ‘team’?
What kind of team?
In what contexts/ settings?
What counts as ‘team-building’?
What does ‘work’ mean?
Focused question?
Does team-building work?
P = Population
I = Intervention or success factor
C = Comparison
O = Outcome
C = Context
Answerable question: PICOC
P = Population
I = Intervention or successfactor
C = Comparison
O = Outcome
C = Context
Focused question: PICOC
Employee productivity?
Patient satisfaction?
Return on investment?
Market share?
Organizational commitment?
2. Finding the best available evidence
Best available experiential evidence
Best available internal evidence
Organizational values and stakeholders’
concerns
Best available external evidence
Evidence-based decision
Evidence-based decision
scientific
research
Scientific databases: management
ABI/INFORM
Business Source Elite
PubMed
PsycINFO
Web of Knowledge
ERIC
3. Critical appraisal of studies
Making sense of evidence
Critical appraisal
Construct validity (lean six sigma = value stream mapping, root cause analysis, goal setting, participative decision making)
Internal validity (does it work?)
External validity (will it also work for my employees / organization?)
Levels of internal validity
Best research design?
Best available
Critical appraisal
Step 4: Turning evidence into practice
Applicable?
organizational characteristics
cultural & political aspects
financial aspects /cost-effectiveness / ROI
priorities
change readiness / resistance to change
implementation capacity
timing
TEST?
CAT: Critically Appraised Topic
CAT-walk
Evidence-based practice:
If doctors can do it managers can do it!