I know what you are all thinking...Evidence-Based Management? Seriously? Well, yes, seriously. This is a heads up, my friends. Evidence-Based Medicine may be to blame for this movement, however the culture is moving this way. People want evidence. Patients want proof. Comparisons and proven results is the current trend.
Jeffrey Pfeffer and Robert Sutton, in their Harvard Business Review article "Evidence-Based Management" (2006) compare the model to evidence-based medicine. Briefly-for those new to the business, evidence-based medicine is defined as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." In this article it is reported that only 15% of physician decision making is evidence based with the remainder of physician decision making based on "obsolete knowledge gained in school."
So...if evidence-based medicine is modeled to use current best evident in making decisions, how does this relate to management? For some of us, this concept is not going to feel like an old comfortable pair of Levi's 501's. The reason for this is evidence-based management requires the executive to set aside wisdom and experience and substitute and engage in an ever-evolving experiment. As the authors state, "treat the organization like an unfinished prototype and encourage trial programs, piolot studies, and experiementation--and reward learning from these activities, even when something new fails--your organization will begin to develop its own evidence base." Essentially, if you adopt this management style your practice will continually create new knowledge, unique to your practice.
Ironically, the authors consider caution when using benchmarking data. I believe benchmarking is a great tool but not the rule. Why? Every practice is different. Every practice has dynamics that couldn't possibly be duplicated exactly across the board and this makes a difference on how decisions are made. It is virtually impossible to emulate a best practice in its entirety, however you can borrow the ideas and see if they "fit". Among the last 6 points of moving your business towards evidence-based management that intrigued me and challenged the authors the most was "adopting a neutral stance toward ideologies and theories". Management and neutral stance? Yes, well, this is where it gets "personal" for some of us, because this posits giving up what we, as medical management executives believe is the right way to do things just because in some instances we know there is only one right way. Remember...your practice is an ever-evolving experiment. There is nothing mundane about management except you know every day will be different and evolving. There is much to gain from the "collective brilliance" and I truly embrace this concept. Efficiencies and best practices are gained through those seemingly small steps every day. I have learned the most by stepping back and learning from the collective brilliance of my staff or physicians.
The authors likened managers to physicians who face one decision after another in that we couldn't possible make the right choice every time. Hippocrates put it this way: "Life is short, the art long, opportunity fleeting, experiement treacherous, judgment difficult."
Bibliography:
Pfeffer, J. and Sutton, R. (2006) "Evidence-Based Management." Harvard Business Review (online version).