The Effectiveness of Management‐By‐Walking‐Around: A Randomized Field Study

Abstract

Management-By-Walking-Around (MBWA) is a widely adopted technique in hospitals that involves senior managers directly observing frontline work. However, few studies have rigorously examined its impact on organizational outcomes. This paper examines an improvement program based on MBWA in which senior managers observe frontline employees, solicit ideas about improvement opportunities, and work with staff to resolve the issues. We randomly selected 19 hospitals to implement the 18-month long MBWA-based improvement program; 56 work areas participated. We find that the program, on average, had a negative impact on performance. To explain this surprising finding, we use mixed methods to examine the impact of the work area's problem solving approach.Results suggest that prioritizing easy-to-solve problems was associated with improved performance.We believe this was because it resulted in greater action taking. A different approach was characterized by prioritizing high value problems, which was not successful in our study. We also find that assigning to senior managers responsibility for ensuring that identified problems get resolved resulted in better performance. Overall, our study suggests that senior managers' physical presence on their organizations' frontlines was not helpful unless it enabled active problem solving.

Healthcare operations management: a structured literature review

“…In this technique, managers keep a watch over frontline employees and resolve their problems right on their workstations. In this respect, Tucker and Singer (2015) found that mere physical presence of senior managers on organisation's frontlines did not help until it enabled real problem-solving. A major drawback of using this method of managerial control is that if managers are not able to resolve undertaken issues, then it negatively impacts the psyche of frontline employees (Tucker and Singer 2015).…”

“…In this respect, Tucker and Singer (2015) found that mere physical presence of senior managers on organisation's frontlines did not help until it enabled real problem-solving. A major drawback of using this method of managerial control is that if managers are not able to resolve undertaken issues, then it negatively impacts the psyche of frontline employees (Tucker and Singer 2015). Research methodologies used in papers selected in the domain of frontline employees are based on empirical and qualitative techniques.…”

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“…Studies have shown that focusing on easy-to-solve problems, rather than entrenched issues, is most associated with improved performance as it results in greater action on the part of management. 26 in staff can be particularly important given the difficult and sometimes dangerous environmental conditions in which many rangers/scouts operate.…”

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“…Two experimental controlled studies, one in the US Veterans Health Administration55 and the other in the private sector,62 find that safety climate and perceived improvement in performance decline in randomly selected intervention units compared to control units and hospitals. The third experimental study, in which safety rounds were implemented as part of a general improvement programme, shows some improvement in organisational climate relative to control hospitals, but no improvement or a relative decline in multiple other measures 46 63.…”