Evidence-based Management: Translating Research into Practice Annual Meeting of AcademyHealth 2004

1. Evidence-based Management:Translating Research into Practice Annual Meeting of AcademyHealth2004

2. How Managerial Decisions Are Typically Made in Health Service Organizations

3. Think of the last time your organization (or subunit) faced a managerial problem, such as: • relatively high rates of medical errors across the organization • workforce supply shortage • poor hospital-physician relations • adoption of new technology • declining market share What decision did your organization’s managers make? How did they make this decision?

4. Do nothing Copy what other organizations have done Use intuition and experience of leader(s) Seek expert consultation Seek leadership team consensus Examine relevant cases Model and forecast Review relevant piece of management research Conduct study to assess alternatives Apply evidence-based decision making Top Ten Approaches to Managerial Decision Making

5. The “Usual” Approaches to Managerial Decision Making Often Produce Ineffective Actions • Overuse • Underuse • Misuse

7. Can Health Management Research: • Improve financial performance? • Improve quality of care and patient outcomes? • Improve consumer/patient access to care?

8. The Key Principles of Evidence-Based Management

9. Evidence-based management is part of a larger movement to strengthen evidence-based decision making in health service organizations. Evidence-based decision making is defined as: “the systematic application of the best available evidence to the evaluation of options and to decision making in clinical, management, and policy settings.”

10. What is evidence-based management? At the core of evidence-based management is the notion that health managers should incorporate into their decision making evidence from well conducted management research, thereby minimizing the problems of overuse, underuse, and misuse of organizational problem solving strategies and operational procedures.

11. Evidence-based management is the integration of: • Managerial expertise • Organizational mission and values • The best available evidence into the decision-making process.

12. Managerial expertise = The manager’s cumulated experience, education, and managerial skills

13. Organizational mission and values = The core values and beliefs promoted by the organization’s leaders and internalized by its managerial and clinical staff.

14. Best available evidence = The methodologically strongest research available at the time a decision must be made.

15. What types of evidence can be incorporated in evidence-based management? • Meta-analyses • Systematic reviews • Evaluations using experimental designs • Evaluations using quasi-experimental designs • Observational studies • Expert committee assessments • Personal experience

16. The evidence, by itself, does not make the decision for you, but it can increase your understanding of the expected effects of managerial decisions. The full integration of these three components into managerial decisions enhances the opportunity for improving organizational performance on the criteria most highly valued by the organization.

17. Some Ways EBM Has Improved Organizational Performance in Health Service Organizations

18. Complement - not replace - the many other forms of data and knowledge that go into making decisions; Help managers and policy makers evaluate the feasibility and potential impact of their options. Make it easier to explain where decisions came from; Help in negotiations between interest groups and competing arguments; Increase confidence that managers are making the best investments possible. In conclusion, management research evidence can

19. What are the Characteristics of a Health Service Organization that Facilitate Evidence-Based Management?Imagine being a manager in an organization with high performing evidence-based management support…

20. Chief Knowledge Management Officer Training in evidence-based management(e.g. locating and using research syntheses) Management Journal Club Evidence Assessment Teams Management Research Seminars Use of Management “Dashboards”’ Ongoing Management Research Projects … Some characteristics of organizations that practice evidence-based management

21. What can managers do to better prepare their organization to practice EBM? • Start by working with colleagues to complete an assessment of the organization’s ability to: • Acquire evidence • Assess evidence • Adapt its format • Apply it in decisions

22. Even if you’re on the right track,you’ll get run over if youjust sit there. Will Rogers