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Article
Publication date: 25 May 2012

Vishwanath V. Baba and Farimah HakemZadeh

The purpose of this paper is to integrate existing body of knowledge on evidence‐based management, develop a theory of evidence, and propose a model of evidence‐based

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Abstract

Purpose

The purpose of this paper is to integrate existing body of knowledge on evidence‐based management, develop a theory of evidence, and propose a model of evidence‐based decision making.

Design/methodology/approach

Following a literature review, the paper takes a conceptual approach toward developing a theory of evidence and a process model of decision making. Formal research propositions amplify both theory and model.

Findings

The paper suggests that decision making is at the heart of management practice. It underscores the importance of both research and experiential evidence for making professionally sound managerial decisions. It argues that the strength of evidence is a function of its rigor and relevance manifested by methodological fit, relevance to the context, transparency of its findings, replicability of the evidence, and the degree of consensus within the decision community. A multi‐stage mixed level model of evidence‐based decision making is proposed with suggestions for future research.

Practical implications

An explicit, formal, and systematic collaboration at the global level among the producers of evidence and its users akin to the Cochrane Collaboration will ensure sound evidence, contribute to decision quality, and enable professionalization of management practice.

Originality/value

The unique value contribution of this paper comes from a critical review of the evidence‐based management literature, the articulation of a formal theory of evidence, and the development of a model for decision making driven by the theory of evidence.

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Book part
Publication date: 7 October 2011

Melanie Kazman Kohn, Whitney Berta, Ann Langley and David Davis

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of…

Abstract

The relatively recent attention that evidence-based decision making has received in health care management has been at least in part due to the profound influence of evidence-based medicine. The result has been several comparisons in the literature between the use of evidence in health care management decisions and the use of evidence in medical decision making. Direct comparison, however, may be problematic, given the differences between medicine and management as they relate to (1) the nature of evidence that is brought to bear on decision making; (2) the maturity of empirical research in each field (in particular, studies that have substantiated whether or not and how evidence-based decision making is enacted); and (3) the context within which evidence-based decisions are made. By simultaneously reviewing evidence-based medicine and management, this chapter aims to inform future theorizing and empirical research on evidence-based decision making in health care settings.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

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Article
Publication date: 13 November 2017

Renée J. Mitchell and Stuart Lewis

The purpose of this paper is to argue that police research has reached a level of acceptance such that executive management has an ethical obligation to their communities…

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1445

Abstract

Purpose

The purpose of this paper is to argue that police research has reached a level of acceptance such that executive management has an ethical obligation to their communities to use evidence-based practices.

Design/methodology/approach

Using an Evidence-Based Medicine (EBM) framework the authors apply an ethical-based decision-making model to policing decisions. EBM does not allow physicians to ignore research when giving guidance to patients. The authors compare the two professional approaches to decision making and argue policing has reached a level of research that if ignored, just like medicine, should be considered unethical. Police interventions can potentially be harmful. Rather than do no harm, the authors argue that police managers should implement practices that are the least harmful based on the current research.

Findings

The authors found policing has a substantial amount of research showing what works, what does not, and what looks promising to allow police executives to make decisions based on evidence rather than tradition, culture, or best practice. There is a deep enough fund of knowledge to enable law enforcement leadership to evaluate policies on how well the policies and procedures they enforce prevent crime with a minimum of harm to the communities they are sworn to protect and serve.

Originality/value

Policing has yet to view community interventions as potentially harmful. Realigning police ethics from a lying, cheating, stealing, lens to a “doing the least harm” lens can alter the practitioner’s view of why evidence-based policing is important. Viewing executive decision from an evidence-based ethical platform is the future of evaluating police executive decisions.

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International Journal of Emergency Services, vol. 6 no. 3
Type: Research Article
ISSN: 2047-0894

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Article
Publication date: 1 October 1999

Nigel Ford, Dave Miller, Alan O’rourke, Jane Ralph, Edward Turnock and Andrew Booth

The emergence of evidence‐based medicine has implications for the use and development of information retrieval systems which are not restricted to the area of medicine. …

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925

Abstract

The emergence of evidence‐based medicine has implications for the use and development of information retrieval systems which are not restricted to the area of medicine. ‘Evidence‐based’ practice emphasises the retrieval and application of high quality knowledge in order to solve real‐world problems. However, information seeking to support such evidence‐based approaches to decision making and problem solving makes demands on retrieval systems which they are not well suited at present to satisfy. A number of approaches have been developed in the field of medicine that seek to address these limitations. The extent to which such approaches may be applied to other areas is discussed, as are their limitations.

Details

Journal of Documentation, vol. 55 no. 4
Type: Research Article
ISSN: 0022-0418

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Article
Publication date: 14 November 2008

Marco Isetta

The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to…

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2368

Abstract

Purpose

The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to identify the emergence of the term EBP in the professional literature to establish an empirical foundation for discussion. The understanding of and relevance to healthcare practitioners in a large South West London hospital are assessed and their views related to the perspective of library and information professionals to assess implications for practice.

Design/methodology/approach

An extensive literature search was carried out and the data generated used to produce a growth curve for the literature. A survey of health care professionals using e‐mail and follow‐up interviews was undertaken at the case hospital.

Findings

Between 1998 and 2004 the number of papers appearing to discuss the theme increased four‐fold. The first recorded reference was in 1991. The EBP model had strong official and political support in the field. On the user sample there is evidence of resistance to the orthodoxy.

Practical implications

The EBP model – variously adopted by several healthcare agencies – has placed information management at the centre of the care process. In spite of this, there are few definite implications for the role of library and information professionals, since the world of information and the UK NHS itself are continually in a state of flux, and the current EBP dominance may neither strengthen nor safeguard it.

Originality/value

The bibliometric study provides a baseline. The study of healthcare professionals is a case study to add to knowledge of practice.

Details

Aslib Proceedings, vol. 60 no. 6
Type: Research Article
ISSN: 0001-253X

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Article
Publication date: 1 December 2000

Ljuba Bacharova, Svatopluk Hlavacka and Viera Rusnakova

This study reports the findings of the first survey of the knowledge and needs for training in evidence based medicine (EBM) of health‐care workers in Slovakia. This study…

Abstract

This study reports the findings of the first survey of the knowledge and needs for training in evidence based medicine (EBM) of health‐care workers in Slovakia. This study was primarily qualitative and based on a triangular approach, which included: analysis of the situation in pre‐ and postgraduate education in Slovakia aimed at estimating needs in EBM and critical appraisal skills (CAS) training; analysis of questionnaires distributed in a sample of medical doctors and university educated public health workers undergoing postgraduate training; and focus group discussions. The findings revealed a real gap in knowledge in EBM and CAS in Slovakia and identified several areas as the focus for intervention. The results showed also some important behavioural and cultural aspects, including low individual responsibility for education; tendency to delegate responsibility to authorities (experts, top management, Ministry of Health); and persistence of the state paternalistic type of education. Concludes that managers planning to implement EBM in Slovakia should therefore consider a broader behavioural and cultural context for change, not just introduction of a training EBM module.

Details

Journal of Management in Medicine, vol. 14 no. 5/6
Type: Research Article
ISSN: 0268-9235

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Abstract

Details

Empirical Nursing
Type: Book
ISBN: 978-1-78743-814-9

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Article
Publication date: 1 September 2003

Wally R. Smith

The concept of evidence‐based medicine, or medical practice based on up‐to‐date research about the best available diagnoses and treatments, has been well accepted into…

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1779

Abstract

The concept of evidence‐based medicine, or medical practice based on up‐to‐date research about the best available diagnoses and treatments, has been well accepted into mainstream medicine. In contrast, evidence‐based quality improvement, culminating in evidence‐based dissemination or implementation of the latest research, is far from a reality. One of the many reasons for this failure is that all responsible for dissemination and implementation do not understand or apply relevant theories from the social and educational sciences. Rather, many popular approaches to quality improvement have been chosen empirically, unguided by theory. Sometimes these choices have resulted in failure and/or unintended consequences. The purpose of this review is to categorize and explain various theories relevant to quality improvement interventions. Each reviewed theory is connected with approaches the theory suggests would be successful. The review discusses how knowledge of improvement theory can drive not only the choice of techniques to employ but also the choice of contexts for employment. The review offers a critique of some theories and their associated approaches.

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Clinical Governance: An International Journal, vol. 8 no. 3
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 1 July 2018

Saligrama Agnihothri and Raghav Agnihothri

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Abstract

Purpose

The purpose of this paper is to develop a framework for the application of evidence-based management to chronic disease healthcare.

Design/methodology/approach

Chronic healthcare is specially characterized by recursive patient-physician interactions in which evidence-based medicine (EBM) is applied. However, implementing evidence-based solutions to improve healthcare quality requires managers to effect changes in many different areas: organizational structure, procedures, technology and in physician/provider behaviors. To complicate matters further, they must achieve these changes using the tools of resource allocation or incentives. The literature contains many systematic reviews evaluating the question of physician and patient behavior under various types and structures of incentives. Similarly, systematic reviews have also been done regarding specific changes to the healthcare process and their effectiveness in improving patient outcomes. Yet, these reviews uniformly lament a lack of appropriate data from well-organized studies on the question of “Why?” solutions may work in one instance while not in another. The authors present a new theoretical framework that aids in answering this question.

Findings

This paper presents a new theoretical framework (Influence Model of Chronic Healthcare) that identifies: the critical areas in which managers can effect changes that improve patient outcomes; the influence these areas can have on each other, as well as on patient and physician behavior; and the mechanisms by which these influences are exerted. For each, the authors draw upon, and present the evidence in the literature. Ultimately, the authors recognize that this is a complex question that has not yet been fully researched. The contribution of this model is twofold: first, the authors hope to focus future research efforts, and second, provide a useful heuristic to managers who must make decisions with only the lesser-quality evidence the literature contains today.

Originality/value

This model can be used by managers as a heuristic either ex ante or ex post to determine the effectiveness of their decisions and strategies in improving healthcare quality. In addition, it can be used to analyze why actions or decisions taken achieved a given outcome, and how best to proceed to effect further improvements on patient outcomes. Last, the model serves to focus attention on specific questions for further research.

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Article
Publication date: 1 July 1999

Alan Cowling, Karin Newman and Susie Leigh

This paper focuses on the practice of evidence‐based healthcare by doctors, nurses, midwives and the professions allied to medicine in four NHS Trusts in and around…

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3580

Abstract

This paper focuses on the practice of evidence‐based healthcare by doctors, nurses, midwives and the professions allied to medicine in four NHS Trusts in and around London. This qualitative study, based on interviews and self‐efficiency ratings uncovered the extent of evidence based practice between different groups and between acute and community Trusts, the perceived obstacles to the adoption and implementation of EBHC, and throws light on the knowledge, skills and attitudes required for such practice. Five clusters of competencies were identified – personal attributes, interpersonal, self‐management, information management and technical knowledge skills – and these form the basis of a competency framework of measurable criteria to assess proficiency as well as staff training needs which it is hoped will enable NHS Trusts to devise strategies to meet the requirements and challenges of clinical governance from April 1999.

Details

International Journal of Health Care Quality Assurance, vol. 12 no. 4
Type: Research Article
ISSN: 0952-6862

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