The Promise of Evidence-Based Management

More and more, healthcare providers are committing to evidenced-based clinical practice as a rational way to deliver care. Rather than make decisions anecdotally, clinicians find that the addition of research provides statistical evidence for their decisions, and thus should result in better, more consistent care. But, what about management decisions? Shouldn't evidence also be sought by hospital executives before making strategic decisions that will affect their organizations? Do not these decisions also affect the quality and safety of patient care? And if so, what is preventing executives from using such evidence before making these decisions? This issue of Frontiers explores these questions from both the research and practitioner points of view. In the feature article, "Evidence-Based Management Reconsidered," Anthony Kovner, PhD (professor of health policy and management at New York University), and Thomas Rundall, PhD (professor of organized health systems at University of California-Berkeley), make the case for why evidence-based health services management (EBHSM) can and should be used. Kovner and Rundall suggest that EBHSM can be applied to core business transactions, as well as to operational and strategic management, and they elaborate on a five-step process for making that happen. Acknowledging that there is little use of the EBHSM approach in the field today, the authors recommend strategies to facilitate greater use of this model.

The three commentaries explore the issues raised in the above articles. All of the authors agree that evidence-based management is an idea whose time has come. From all the "evidence," it has become clear that more often than not clinical errors occur as a result of a system failure-management-type decisions made without the proper knowledge and information. So, what will it take to get EBHSM implemented throughout healthcare? Hopefully, some of the ideas and strategies presented in this issue will get us closer to that goal.