Evidence-based management: a literature review

Abstract

This paper presents a review of evidence-based management (EBM), exploring whether management activities within healthcare have been, or can be, subject to the same scientific framework as clinical practice. The evidence-based approach was initially examined, noting the hierarchy of evidence ranging from randomized control trials to clinical anecdote. The literature varied in its degree of criticism of this approach; the most common concern referring to the assumed superiority of positivism. However, evidence-based practice was generally accepted as the best way forward. Stewart (1998) offered the only detailed exposition of EBM, outlining a necessary 'attitude of mind' both for EBM and for the creation of a research culture. However, the term 'clinical effectiveness' emerged as a possible replacement buzz-word for EBM (McClarey 1998). The term appears to encompass the sentiments of the evidence-based approach, but with a concomitant concern for economic factors. In this paper the author has examined the divide between those who viewed EBM as an activity for managers to make their own practice accountable and those who believed it to be a facilitative practice to help clinicians with evidence-based practice. Most papers acknowledged the limited research base for management activities within the health service and offered some explanation such as government policy constraints and lack of time. Nevertheless, the overall emphasis is that ideally there should be a management culture firmly based in evidence.

Positivism: A Concept Analysis

“…Young [11] wondered if health care management had been or even could be studied using evidence-based practice (EBP). Young learned positivism played a role in criticism as the opposed and favored approach to EBP.…”

Evidence-based nursing management: Challenges and facilitators

“…Other barriers include such factors as organizational culture, organizational values, the effect of different styles of management, lack of a clear description for success criteria [10] . Among other factors complicating the implementation of EBMgt are unfavorable working conditions, poor working methods, the negative attitudes of managers and colleagues, and personal beliefs [21] .…”

“…An evidence-oriented leadership and communities of practice for knowledge sharing are necessary to build an evidence-based culture [6] . Among other factors facilitating research utilization in the field of management are the presence of a research culture in the organization, personal beliefs, good working organization, and effective self-discipline [21] .…”

The PICO strategy for the research question construction and evidence search

“…As the EBM precepts were incorporated into other disciplines, it started to be called Evidence-Based Practice (EBP) (2) . The EBP previews methodologies and processes in order to identify evidence of whether a certain treatment or diagnosis is effective, strategies to evaluate the quality of studies and mechanisms to implement it in care.…”