![]() If an organization is open-minded to change, and if the people within it believe that there is an opportunity to improve by employing newer and more contemporary techniques, then exploring evidence-based management will likely be beneficial. In a jury, people put aside their biases, prejudices, and preconceived ideas in favor of information, data, and evidence to come to a decision that will result in a just outcome. He cites the jury system as a prime example of an evidence-based management model. Mr Cohen explains that this concept employs practical applications such as process mapping, cause and effect analysis, and critical thinking, but perhaps more importantly, it forces organizations to ask themselves practical questions such as, “Is what we are doing working for us and continuing to result in improvements?” and “Do the majority of our decisions result in positive outcomes?” In healthcare, evidence-based management is defined as, “the systematic application of the best available evidence to the evaluation of managerial strategies for improving the performance of health services organizations.” 1 After all, that’s why we’re doing this.” What is Evidence-Based Management? “While no system is perfect, the use of evidence in the form of data and statistics can significantly increase the probability that the decisions you make will result in a positive outcome. “Way too often we depend on traditions, emotions, politics, or anecdotes to make critically important business and management decisions, which we’re going to stand accountable for in the future,” he says. By employing evidence-based management techniques, organizations can validate their findings and use them to inform positive changes. Rather, practice managers and others in the healthcare field should seek out what is and is not working. Relying on the excuse of, “this is how it’s always been done,” no longer cuts it, he explains. Cohen, Director, Analytics and Business Intelligence, Doctors Management, Knoxville, TN, a healthcare consulting firm. In turn, the decision sciences highlight the need to consider the role of expertise and judgment when interpreting research evidence, the role of preferences and values when applying it to specific decisions, and the practical limits imposed by the uncertainty inherent in each.Just because an organization is used to doing things a certain way, it does not mean it is the best way, according to Frank D. Using these models as exemplars, we argue that attempts to apply research evidence directly to practice or policy without consideration of expert judgement or preferences and values reflect fundamental misconceptions about the theory of rational decision making that can impede implementation. Applying this theory to medical care, clinical decision-making models clearly demonstrate that rational decisions require not only a range of relevant evidence, but also expertise to inform judgments regarding the credibility of estimates and to assess fit-to-context, and stakeholder preferences and values to weigh trade-offs among competing outcomes. In contrast, other conceptualisations of EBM are rooted in expected utility theory, which defines rational decisions as choices that are expected to result in the greatest benefit. However, some proponents argue that ‘uptake’ of research evidence should be direct and universal, for example through wide-scale implementation of ‘evidence-based practices’. Advocates for EBM all seek to use research evidence to optimise clinical care. Tracing the historical development of evidence-informed policy to its roots in evidence-based medicine (EBM), we distinguish between two understandings of how research evidence may be applied. Many of the resources developed to promote the use of evidence in policy aspire to an ideal of rational decision making, yet their basis in the decision sciences is often unclear.
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