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Congres Evidence-Based Zorglogistiek , 13 oktober 2011. Evidence-Based Management What is it? Why do we need it? How does it look like in practice?. Postgraduate Course. Evidence based management: What is it?. Definition. - PowerPoint PPT Presentation
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Congres Evidence-Based Zorglogistiek, 13 oktober 2011
Evidence-Based Management
What is it?Why do we need it?
How does it look like in practice?
1. Evidence based management:What is it?
Postgraduate Course
Postgraduate Course
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. Practitioner expertise and judgment
Postgraduate Course
Four sources
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?Postgraduate Course
McMaster University Medical School, Canada
Medicine: Founding fathers
David Sackett Gordon Guyatt
Postgraduate Course
Management: Founding MotherPostgraduate Course
Jeffrey Pfeffer Robert Sutton
Management: Founding FathersPostgraduate Course
2. Evidence-based management:Why do we need it?
Postgraduate Course
EBMgt: some basic assumptionsPostgraduate Course
Research produced by management scholars could be useful to organizations
Drawing on available evidence (including research produced by academics) is likely to improve decisions
Organizations do not appear to be strongly aware of nor use research findings
EBMgt is a potentially useful way of thinking about how we can incorporate research evidence into decision-making
Reason 1:Errors and Biases of Human
Judgment
Postgraduate Course
Seeing order in randomness
Mental corner cutting
Misinterpretation of incomplete data
Halo effect
False consensus effect
Reinterpreting evidence
Group think
Postgraduate Course
Errors and Biases of Human Judgment
Confirmation bias
Authority bias
In-group bias
Recall bias
Anchoring bias
Inaccurate covariation detection
Distortions due to plausibility
Seeing order in randomness Mental corner cutting
Misinterpretation of incomplete data
Halo effect
False consensus effect
Reinterpreting evidence
Group think
Postgraduate Course
Errors and Biases of Human Judgment
Confirmation bias
Authority bias
In-group bias
Recall bias
Anchoring bias
Inaccurate covariation detection
Distortions due to plausibility
We are predisposed to see order, pattern and causal relations in the world.
Patternicity: The tendency to find meaningful patterns in both meaningful and meaningless noise.
Postgraduate Course
Seeing order in randomness
We are patern seeking primates: association learning
Postgraduate Course
Seeing order in randomness
Postgraduate Course
Points of impact of V-1 bombs in London
Postgraduate Course
Points of impact of V-1 bombs in London
A Type I error or a false positive, is believing a pattern is real when it is not (finding a non existent pattern)
A Type II error or a false negative, is not believing a pattern is real when it is (not recognizing a real pattern)
Postgraduate Course
Errors and Biases of Human Judgment
Dr. Michael Shermer (Director of the Skeptics Society)
A Type I error or a false positive: believe that the rustle in the grass is a dangerous predator when it is just the wind (low cost)
Postgraduate Course
Errors and Biases of Human Judgment
A Type II error or a false negative: believe that the rustle in the grass is just the wind when it is a dangerous predator (high cost)
Postgraduate Course
Errors and Biases of Human Judgment
Pattern detection problem
Assessing the difference between a Type I and Type II error is highly problematic (especially in split second ‘life and death’ situations), so the default position is to assume all patterns are real.
Postgraduate Course
Errors and Biases of Human Judgment
Postgraduate Course
Errors and Biases of Human Judgment
Jennifer Whitson, University of Texas Austin, corporate environments
Postgraduate Course
Errors and Biases of Human Judgment
Erroneous beliefs plaque both experienced professionals and less informed laypeople alike.
stress peptic ulcer
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
Postgraduate Course
Errors and Biases of Human Judgment
Doctors, teachers, lawyers 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 the available evidence.
They hold such beliefs because they seem to be the irresistible products of their own professional experience.
They are the products, not of irrationality, but of flawed rationality
Seeing order in randomness
Mental corner cutting
Misinterpretation of incomplete data
Halo effect
False consensus effect
Reinterpreting evidence
Group think
Postgraduate Course
Errors and Biases of Human Judgment
Confirmation bias
Authority bias
In-group bias
Recall bias
Anchoring bias
Inaccurate covariation detection
Distortions due to plausibility
Postgraduate Course
Group think: management fads
The nearly-forgotten fads:
Scientific Management/Taylorism Business Process Reengineering Management by results Excellence Total Quality Management Learning Organizations Knowledge Management
Postgraduate Course
Group think: management fads
The fads that haven’t been forgotten (yet):
Talent management Management development Executive coaching Emotional intelligence Employee engagement Knowledge management Myers Briggs Type Indicator Belbin Team Roles
Postgraduate Course
Group think: management fads
“And there we see the power of any big managerial idea (or fad). It may be smart, like quality, or stupid, like conglomeration. Either way, if everybody's doing it, the pressure to do it too is immense. If it turns out to be smart, great. If it turns out to be stupid, well, you were in good company and most likely ended up no worse off than your competitors. Your company's board consists mostly of CEOs who were probably doing it at their companies. How mad can they get?
Postgraduate Course
Group think: management fads
The true value of conventional management wisdom is not that it's wise or dumb, but that it's conventional. It makes one of the hardest jobs in the world, managing an organization, a little easier. By following it, managers everywhere see a way to drag their sorry behinds through another quarter without getting fired. And isn't that, really, what it's all about?”
(Colvin, 2004, Fortune)
Postgraduate Course
So?
Managers seem to be extremely good at generating ideas, theories, and explanations that have the ring of plausibility. They may be relatively deficient, however, in evaluating and testing those ideas once they are formed.
This requires that we think critically about experience, question our assumptions, and challenge what we think we know
(Show me the evidence!)
Postgraduate Course
Errors and Biases of Human Judgment
Reason 2:
De ‘buitenwereld’ wordt steeds kritischer
Postgraduate Course
Postgraduate Course
Probleem 2: kritische geluiden
“Managers maken Nederland ziek ... Steeds meer vakmensen (zoals docenten, verpleegkundigen, artsen) hebben het gevoel dat ze worden aangestuurd door managers die van het vak geen verstand hebben maar wel de dienst uitmaken.”
Ad Verbrugge
Postgraduate Course
“Of het nu gaat om een ziekenhuis of een dropfabriek, te veel managers hebben de pretentie dat ze alles kunnen managen zonder ook maar te letten op de inhoud van het werk. Het zijn figuren die als een vlo van de ene "uitdaging" naar de andere springen, een spoor van verbittering en vernieling achter zich latend.”
Geert Mak
Probleem 2: kritische geluiden
Postgraduate Course
“Nog meer managers, nog meer reorganisaties, nog meer power point-presentaties, nog meer holle retoriek over topprestaties en topkwaliteit. De groeiende korst van nepfuncties die onze bedrijven, scholen en andere organisaties nutteloos belasten wordt almaar dikker .”
Dorien Pessers
Probleem 2: kritische geluiden
Postgraduate Course
Brede maatschappelijke ontwikkeling
Postgraduate Course
“Waar de overheid, de dokter, de pedagoog en
de manager vroeger een eenvoudig beroep op
hun autoriteit konden doen, zullen zij nu met
getallen en statistiek hun gelijk moeten
aantonen.”
Brede maatschappelijke ontwikkeling
Postgraduate Course
Evidence based medicine
Evidence based education
Evidence based criminology
Evidence based social welware
Evidence based management?
Brede maatschappelijke ontwikkeling
Evidence based management:How does it look like in practice?
Postgraduate Course
Postgraduate Course
Four sources
Postgraduate Course
JAMA, 1992
Postgraduate Course
Push vs Pull
Push: teaching (management) principles based upon a convergent body of research and telling students what to do.
Pull: teaching (managers) how to find, appraise and apply the outcome of research (evidence) by themselves
Postgraduate Course
The 5 steps of ‘pull’ EBP
1. Formulate an answerable question
2. Search for the best available evidence
3. Critically appraise the evidence
4. Integrate the evidence with your managerial expertise and organisational concerns and apply
5. Monitor the outcome
Postgraduate Course
The 5 steps of ‘pull’ EBP
1. Formulate an answerable question2. Search for the best available evidence
3. Critically appraise the evidence
4. Integrate the evidence with your managerial expertise and organisational concerns and apply
5. Monitor the outcome
Answerable questionPostgraduate Course
I am a consultant, my client a large health-care organization. The board of directors has plans for a merger with a smaller healthcare organization. However, it’s been said that the organizational culture differs widely between the two organizations. The board want’s to know if this can impede a successful outcome.
Postgraduate Course
P = Population or problem
I = Intervention or successfactor
C = Comparison
O = Outcome
C = Context
Answerable question: PICO(C)
Answerable question: PICOCPostgraduate Course
P: What kind of Population are we talking about? Middle managers, back-office employees, medical staff, clerical staff?
O: What kind of Outcome are we aiming for? Employee productivity, return on investment, profit margin, competitive position, innovation power, market share, customer satisfaction?
P/C: And how is the assumed cultural difference assessed? Is it the personal view of some managers or is it measured by a validated instrument?
Postgraduate Course
The 5 steps of ‘pull’ EBP
1. Formulate an answerable question
2. Search for the best available evidence3. Critically appraise the evidence
4. Integrate the evidence with your managerial expertise and organisational concerns and apply
5. Monitor the outcome
Where do we search?Postgraduate Course
How do we search?Postgraduate Course
Postgraduate Course
The 5 steps of ‘pull’ EBP
1. Formulate an answerable question
2. Search for the best available evidence
3. Critically appraise the evidence4. Integrate the evidence with your managerial
expertise and organisational concerns and apply
5. Monitor the outcome
Critical appraisal
How to read a research article?
Postgraduate Course
Critical appraisalPostgraduate Course
1. Study designs
2. Levels of evidence
3. Bias / confounding
4. Effect sizes
5. External validity
Postgraduate Course
Which study for which question?
Research designs
The “best” evidence depends on the question type !
Postgraduate Course
Levels of evidence
Postgraduate Course
The 5 steps of ‘pull’ EBP
1. Formulate an answerable question
2. Search for the best available evidence
3. Critically appraise the evidence
4. Integrate the evidence with your managerial expertise and organisational concerns and apply
5. Monitor the outcome
Postgraduate Course
1. Is your organization / division / population so different from those in the study that its results cannot apply?
2. How relevant is the study to what you are seeking to understand or decide?
3. What are your organization’s potential benefits and harms from the intervention?
4. Is the intervention feasible in your setting?
Organization concerns
Always ask yourself to what extent the evidence is applicable in your situation:
Postgraduate Course
The 5 steps of ‘pull’ EBP
1. Formulate an answerable question
2. Search for the best available evidence
3. Critically appraise the evidence
4. Integrate the evidence with your managerial expertise and organisational concerns and apply
5. Monitor the outcome
Postgraduate Course
Monitor the outcome
Uitkomst gemeten?
Voormeting?
Controlegroep?
Postgraduate Course
Do a trial!
Postgraduate Course
Monitor the outcome
Business Process Redesign?
Six Sigma?
Lean management?
Lean Six Sigma?
TOC/ Theory of Constraints?
Performance Management?
Of …..
Postgraduate Course
Vragen?
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