Evidence based management: Where does it come from?

1. Evidence based management: Where does it come from?

2. What field is this? • “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”

3. Medicine: Founding fathers David Sackett Gordon Guyatt McMaster University Medical School, Canada

4. How it all started

5. Problem I: too much information • 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

6. 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!)

7. Problem II: persistent convictions if you’re hyperventilating breathe into a bag

8. Problem III: jumping to conclusions 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

9. How 40,000 cardiologists can be wrong In the early1980s newly introduced anti-arrhythmic drugs were found to behighly successful at suppressing arrhythmias. Notuntil a RCT was performed was it realized that, althoughthese drugs suppressed arrhythmias, they actually increasedmortality. The CAST trial revealedExcess mortality of 56/1000. By the time the results of this trial were published, at least100,000 such patients had been taking these drugs.

10. David Sackett • Half of what you learn in medical school will be shown to be either dead wrong or out-of-date within 5 years of your graduation; the trouble is that nobody can tell you which half.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. • (Remember that your teachers are as full of bullshit as your parents)

11. Evidence-Based Practice 1991Medicine 1998Education 1999Social care 2000Nursing 2000Criminal justice ????Management?

13. Management: Founding Mother

14. Management: Founding Fathers Robert Sutton Jeffrey Pfeffer

15. Evidence based decision “Good managers use both individual managerialexpertise and the best available external evidence, and neither alone is enough. Without managerial expertise, practice risks becoming tyrannized by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual organization or team. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of organizations and employees.”

16. Evidence based decision Individual Managerial Expertise • Managerial skills and managerial judgment • Vital for determining whether the evidence applies to an individual organization (division, team) at all and, if so, how

17. 5-step approach EBMgt is a 5-step approach Formulate an answerable question (PICOC) Search for the best available evidence Critical appraise the quality of the found evidence Integrate the evidence with managerial expertise and organizational concerns and apply Monitor and evaluate the results