Postgraduate Course

Evidence based management:Where does it come from?

Postgraduate Course

“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?

Postgraduate Course

McMaster University Medical School, Canada

Medicine: Founding fathers

David Sackett Gordon Guyatt

Postgraduate Course

How it all started

Postgraduate Course

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

Postgraduate Course

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!)

Postgraduate Course

Problem II: persistent convictions

if you’re hyperventilating breathe into a bag

Postgraduate Course

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

Postgraduate Course

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.

Postgraduate Course

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shown to be either dead wrong or out-of-date within 5 years of your graduation; the trouble is that nobody can tell you which half.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)

Postgraduate Course

Evidence-Based Practice

1991Medicine

1998Education

1999Social care

2000Nursing

2000Criminal justice

????Management?

Postgraduate Course

Postgraduate Course

Management: Founding Mother

Postgraduate Course

Jeffrey Pfeffer Robert Sutton

Management: Founding Fathers

Postgraduate Course

“Good managers use both individual managerial expertise 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.”

Evidence based decision

Postgraduate Course

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

Evidence based decision

Postgraduate Course

5-step approach

EBMgt is a 5-step approach

1. Formulate an answerable question (PICOC)

2. Search for the best available evidence

3. Critical appraise the quality of the found evidence

4. Integrate the evidence with managerial expertise and organizational concerns and apply

5. Monitor and evaluate the results