Evidence-Based Management An introduction
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Evidence-Based ManagementAn introduction
Hungarian Association of ExecutivesOctober 26, Budapest
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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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Evidence based management:
Where does it come from?
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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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How it all started
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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
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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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Evidence based management:
What is it?
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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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Four sources
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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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Evidence-based management:Why do we need it?
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Four sources
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Trust me: 20 years of management experience!
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Errors and Biases of Human Judgment
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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
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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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FADS
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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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Evidence based management:
How does it look like in practice?
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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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1. Formulate a focused question
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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
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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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2. Finding the best available evidence
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Where do we search?
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Hands on instruction
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3. Critical appraisal of studies
Making sense of evidence
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Best available evidence?
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Research designs
What is the BEST car?
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Which design for which question?
Research designs
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Explanation
Which design for which question?
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Best research design?
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Best available?
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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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Step 4: Turning evidence into practice
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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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Evidence-based practice:
Focuses on the decision making process
Uses research findings to increase the likelihood of a positive outcome