Use of evidence-based management in healthcare administration decision-making

2017 ◽  
Vol 30 (3) ◽  
pp. 330-342 ◽  
Author(s):  
Ruiling Guo ◽  
Steven D. Berkshire ◽  
Lawrence V. Fulton ◽  
Patrick M. Hermanson
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Healthcare Management ◽  
Evidence Based ◽  
Healthcare Administration ◽  
Content Type ◽  
Study Results ◽  
Research Findings ◽  
Spearman’S Correlation ◽  
Healthcare Leaders

Purpose The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics. Design/methodology/approach A cross-sectional study was conducted among US healthcare leaders. Spearman’s correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0. Findings One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders’ values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous “use of EBMgt” response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman’s correlation indicated statistically significant relationships between healthcare leaders’ use of EBMgt and healthcare organization bed size (rs = 0.217, n = 152, p < 0.01), attitude towards EBMgt (rs = 0.517, n = 152, p < 0.01), and the number of organization employees (rs = 0.195, n = 152, p = 0.016). Originality/value This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.

An integrated approach to evaluate the risk of adverse events in hospital sector

2018 ◽  
Vol 56 (10) ◽  
pp. 2187-2224 ◽  
Author(s):  
Miguel Angel Ortiz-Barrios ◽  
Zulmeira Herrera-Fontalvo ◽  
Javier Rúa-Muñoz ◽  
Saimon Ojeda-Gutiérrez ◽  
Fabio De Felice ◽  
...  
Keyword(s):  
Decision Making ◽  
Adverse Events ◽  
High Performance ◽  
Decision Aids ◽  
Integrated Approach ◽  
Healthcare Management ◽  
Vikor Method ◽  
Hospital Sector ◽  
Content Type ◽  
Novel Approach

PurposeThe risk of adverse events in a hospital evaluation is an important process in healthcare management. It involves several technical, social, and economical aspects. The purpose of this paper is to propose an integrated approach to evaluate the risk of adverse events in the hospital sector.Design/methodology/approachThis paper aims to provide a decision-making framework to evaluate hospital service. Three well-known methods are applied. More specifically are proposed the following methods: analytic hierarchy process (AHP), a structured technique for organizing and analyzing complex decisions, based on mathematics and psychology developed by Thomas L. Saaty in the 1970s; decision-making trial and evaluation laboratory (DEMATEL) to construct interrelations between criteria/factors and VIKOR method, a commonly used multiple-criteria decision analysis technique for determining a compromise solution and improving the quality of decision making.FindingsThe example provided has demonstrated that the proposed approach is an effective and useful tool to assess the risk of adverse events in the hospital sector. The results could help the hospital identify its high performance level and take appropriate measures in advance to prevent adverse events. The authors can conclude that the promising results obtained in applying the AHP–DEMATEL–VIKOR method suggest that the hybrid method can be used to create decision aids that it simplifies the shared decision-making process.Originality/valueThis paper presents a novel approach based on the integration of AHP, DEMATEL and VIKOR methods. The final aim is to propose a robust methodology to overcome disadvantages associated with each method.

Evaluation of offending behaviour programme selection: the PNA

2019 ◽  
Vol 21 (4) ◽  
pp. 264-277
Author(s):  
Laura Ramsay ◽  
Jamie S. Walton ◽  
Gavin Frost ◽  
Chloe Rewaj ◽  
Gemma Westley ◽  
...  
Keyword(s):  
Decision Making ◽  
High Intensity ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Policy Makers ◽  
Content Type ◽  
Maximum Security ◽  
Research Findings ◽  
Probation Service ◽  
Offending Behaviour

Purpose The purpose of this paper is to outline the qualitative research findings of the effectiveness of Her Majesty’s Prison and Probation Service Programme Needs Assessment (PNA) in supporting decision making regarding selection onto high-intensity offending behaviour programmes. Design/methodology/approach Qualitative data analysis was used through the application of thematic analysis. Results were pooled using principles from meta-synthesis in order to draw conclusions as to whether the PNA was operating as designed. Findings Four overarching themes were identified, which have meaning in guiding decision making into, or out of high-intensity programmes. These were risk, need and responsivity, the importance of attitudes, motivation and formulation and planning. Research limitations/implications The majority of data were collected from category C prisons. Generalisability of findings to high-intensity programmes delivered in maximum security prisons and prisons for younger people aged 18–21 years is limited. The research team had prior knowledge of the PNA, whether through design or application. Procedures were put in place to minimise researcher biases. Practical implications Findings suggest that the PNA is effective in guiding clinical decision making. Practitioners and policy makers can be assured that the processes in place to select into high-intensity programmes are effective, and aligned with the What Works in reducing re-offending. Originality/value This is the first evaluation into the effectiveness of the PNA designed to support clinical decision making regarding participant selection onto accredited offending behaviour programmes. Implications for practice have been discussed.

Three perspectives on evidence-based management: rank, fit, variety

2018 ◽  
Vol 56 (10) ◽  
pp. 2085-2100 ◽  
Author(s):  
Peter F. Martelli ◽  
Tuna Cem Hayirli
Keyword(s):  
Decision Making ◽  
Science And Technology Studies ◽  
Management Decision ◽  
Evidence Based ◽  
Managerial Decision ◽  
Content Type ◽  
Rigorous Research ◽  
Central Notion ◽  
Management Decision Making ◽  
Cybernetic Theory

Purpose The debate on evidence-based management (EBMgt) has reached an impasse. The persistence of meaningful critiques highlights challenges embedded in the current frameworks. The field needs to consider new conceptual paths that appreciate these critiques, but move beyond them. The paper aims to discuss this issue. Design/methodology/approach This paper unpacks the concept of finding the “best available evidence,” which remains a central notion across definitions of EBMgt. For each element, it considers relevant theory and offers recommendations, concluding with a discussion of “bestness” as interpreted across three key dynamics – rank, fit, and variety. Findings The paper reinforces that EBMgt is a social technology, and draws on cybernetic theory to argue that the “best” evidence is produced not by rank or fit, but by variety. Through variety, EBMgt more readily captures the contextual, political, and relational aspects embedded in management decision making. Research limitations/implications While systematic reviews and empirical barriers remain important, more rigorous research evidence and larger catalogues of contingency factors are themselves insufficient to solve underlying sociopolitical concerns. Likewise, current critiques could benefit from theoretical bridges that not only reinforce learning and sensemaking in real organizations, but also build on the spirit of the project and progress made towards better managerial decision making. Originality/value The distinctive contribution of this paper is to offer a new lens on EBMgt drawing from cybernetic theory and science and technology studies. By proposing the theoretical frame of variety, it offers potential to resolve the impasse between those for and against EBMgt.

Decision-making experiences of public library CEOs

2015 ◽  
Vol 36 (8/9) ◽  
pp. 644-652 ◽  
Author(s):  
Cheryl Stenstrom
Keyword(s):  
Decision Making ◽  
Information Science ◽  
Public Library ◽  
Library And Information Science ◽  
Evidence Based ◽  
Interpersonal Influence ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Content Type ◽  
The Relationship

Purpose – The purpose of this paper is to explore and describe the decision-making practices of public library managers in the context of interpersonal influence and evidence-based information sources, and to investigate the relationship between models of evidence-based practice and interpersonal influence in the decision-making process of public library managers. Design/methodology/approach – Data were collected through short audio blog posts participants made about their everyday decisions and coded considering the facets of three existing evidence-based library and information practice (EBLIP) models as well as the facets of interpersonal influence. Findings – The findings show that public library CEOs decision-making behaviours reflect the use of a variety of practices from analytical to intuitive as is expected of managers in any sector; however, a stronger reliance on gathering objective information may be present than in other sectors. Seeking multiple sources of information and a tendency towards rationalism may indicate a more sophisticated approach to decision making, but be less indicative of the practices employed more broadly. A possible outcome of these tendencies may result in discordance with external partners and collaborators. Practical implications – The findings from this study may inform the work of associations, library and information science (LIS) educators, and library managers in developing strategic directions and instructional strategies within their organisations. It is also the first study to jointly examine models of interpersonal influence and evidence-based decision-making practices in any field. Originality/value – While the study of the decision-making practices of various groups is growing, little previous research has been conducted with public library managers, and none has been undertaken in Canada.

scholarly journals Adoption of the concept of person-centred care into discourse in Europe: a systematic literature review

2021 ◽  
Vol 35 (9) ◽  
pp. 265-280 ◽  
Author(s):  
Kristina Rosengren ◽  
Petra Brannefors ◽  
Eric Carlstrom
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Literature Review ◽  
Systematic Approach ◽  
Grey Literature ◽  
Quality Of Healthcare ◽  
Healthcare Systems ◽  
Evidence Based ◽  
Content Type ◽  
Healthcare Settings

PurposeThis study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).Design/methodology/approachA literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n = 139), Medline (n = 245), Scopus (n = 493) and Google (n = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.FindingsResults from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n = 481, 40.3%), Sweden (n = 231, 19.3%), the Netherlands (n = 80, 6.7%), Northern Ireland (n = 79, 6.6%) and Norway (n = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n = 999), as opposed to the Bismarck model, which was mostly supported by grey literature (n = 190).Practical implicationsAdoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.Social implicationsEvidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.Originality/valueOur findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.

scholarly journals Quandaries of Autonomy and Empowerment in Evidence-Based Nursing Care

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marita Nordhaug
Keyword(s):  
Decision Making ◽  
Nursing Care ◽  
Patient Empowerment ◽  
Professional Autonomy ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Autonomous Choice ◽  
Patient’S Autonomy ◽  
Research Findings ◽  
Evidence Based Nursing

Empowerment and evidence-based practice represent two influential principles in nursing care: that decision-making should be based upon the patient’s autonomous choice, and the most up-to-date research findings, respectively. In this article, patient empowerment is taken to imply a transfer of control and power from the nurse to the patient through communication and care and acknowledging the patient’s perspectives and values. Empowerment-based nursing may thus be central to enhancing a patient’s autonomy. Evidence-based nursing combines up-to-date research findings, the nurse’s clinical expertise and the patient’s preferences. This article concerns some of the potential conflicts these principles may give rise to in everyday deliberations in nursing care. It is argued that patient empowerment and autonomy potentially both have paternalistic connotations. It is also questioned whether an increased emphasis on patient empowerment and autonomy may lead to a risk of diminished professional autonomy.

Evidence based practice among healthcare providers: a cross-sectional study

2019 ◽  
Vol 32 (5) ◽  
pp. 867-878
Author(s):  
Khalil Kalavani ◽  
Rafat Mohebbifar ◽  
Sima Rafiei
Keyword(s):  
Health Workforce ◽  
Positive Attitude ◽  
Evidence Based Practice ◽  
Service Providers ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Content Type ◽  
Knowledge And Skills ◽  
Study Results ◽  
Self Administered Questionnaire

Purpose Nowadays health systems in most of the countries are trying to build their healthcare provision system based on scientific knowledge based evidence. Evidence-based practice (EBP) is a crucial factor for quality improvement focusing on compliance with clinical standards. The purpose of this paper is to assess evidence-based knowledge and skills among healthcare providers in Qazvin hospitals in 2016. Design/methodology/approach This was a descriptive study conducted among 300 health professionals working in hospitals affiliated by Qazvin University of Medical Sciences in 2016. A self-administered questionnaire was used to gather data on health providers’ attitude, knowledge and skill regarding EBP. Descriptive statistics and multiple linear regressions were used to analyze data using SPSS 16 software. Findings A total of 254 participants (84.6 percent) completed the questionnaire in which their attitude, knowledge and skill toward EBP were assessed at a low level. Study results indicated that among different occupational groups, physicians and those with greater awareness toward EBP terminology had a more positive attitude compared with others. Furthermore, a higher level of knowledge and skill toward EBP was associated with being a physician and having a positive attitude toward the issue. Practical implications Given the importance of EBP and due to insufficient knowledge of healthcare providers about the issue, it is necessary to hold appropriate educational courses to empower health workforce in implementing EBP principles. Originality/value The authors applied a self-administered questionnaire to assess health workforce knowledge and skills toward EBP. The results obtaining from the analysis not only highlights weaknesses related to service providers’ knowledge and capabilities to implement EBP but also reveals facilities required for realization of the subject in hospital settings.

Establishing a health economics and value unit at the Children’s Cancer Hospital–Egypt: Introducing a practical approach for evidence-based decision making.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18859-e18859
Author(s):  
Ranin Soliman ◽  
Nourhan Tarek ◽  
Sandra Samir ◽  
Shimaa Okail ◽  
Wael Eweida ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Economics ◽  
Childhood Cancer ◽  
Resource Use ◽  
Real World ◽  
Healthcare Management ◽  
Evidence Based ◽  
Real World Evidence ◽  
Oncology Center ◽  
Evidence Based Decision Making

e18859 Background: Health Economics is a multi-disciplinary practice that recently gained recognition in healthcare management systems. Value-based healthcare (VBHC) focuses on improving patient outcomes while using fewer healthcare resources. Integrating the principles of health economics and VBHC are essential to better inform decision-making based on evidence, especially in resource-limited settings, that need ultimate efficiency in managing resources. Egypt has the highest second estimated number of incident childhood cancer cases in the Eastern Mediterranean Region (EMR), based on GLOBOCAN 2020. Thus, childhood cancer in Egypt is an urging priority due to the large number of patients, limited resources, and poor outcomes. There is a need to optimize resource use and promote value in care delivery for childhood cancer care in Egypt, based on real-world evidence. Methods: This work aims to highlight the role of establishing a health economics and value (HEV) unit at the Children’s Cancer Hospital 57357 –Egypt (CCHE), to improve care and outcomes for children with cancer efficiently. CCHE is a not-for profit pediatric oncology center, treating around 50–60% of childhood cancers across Egypt free of charge. Results: The HEV unit was established in 2017 as a sub-function of the upper management at the hospital. The core mission of the unit is to translate health economics and VBHC concepts into practice to promote evidence-based decision-making, through applying the following functions and activities: monitoring trends in childhood cancer survival, resource use, and costs; applying health economic evaluation tools such as cost-effectiveness analysis (CEA) and multi-criteria decision analysis (MCDA); applying time-driven activity based costing (TDABC); implementing VBHC on a disease- and a hospital-level; monitoring costs and benchmarking. Some of these functions/activities reflect on operational processes such as integrating the CEA tools within the hospital procedures to maximize value of money spent; and restructuring hospital-wide cost centers for accurate costs reporting. Capacity building is also an important pillar in the unit’s framework, where the unit team conducts internal and external training sessions and workshops to spread the knowledge about health economics, VBHC, and evidence-based healthcare. Conclusions: The HEV unit at CCHE presents a unique model of applying health economics and value-based healthcare at a micro level in a pediatric oncology center in Egypt. This is a novel approach for healthcare management in Egypt and making informed decisions based on real-world evidence.

The role of finance in the sales and operations planning process: a multiple case study

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marcelo Seeling ◽  
Tobias Kreuter ◽  
Luiz Felipe Scavarda ◽  
Antonio Márcio Tavares Thomé ◽  
Bernd Hellingrath
Keyword(s):  
Latin American ◽  
Multiple Case Study ◽  
Evidence Based ◽  
Operations Planning ◽  
Content Type ◽  
Study Results ◽  
Multiple Case ◽  
Pharmaceutical Industries

PurposeThis paper aims to offer evidence-based findings on the under-researched role of finance in the sales and operations planning (S&OP) process, aiming to guide academics and practitioners towards successful S&OP implementations.Design/methodology/approachThe research builds upon a multiple case study, embracing five Latin American subsidiaries of four global manufacturing corporations from the consumer goods, chemical and pharmaceutical industries. Following an exploratory approach, the case study results are analysed in within- and cross-case analyses.FindingsThe research findings are synthesised into a framework, demonstrating relevant benefits from the engagement of finance along the S&OP process and the implications of its interactions with traditional S&OP functions as sales, marketing and operations. The paper shows how finance adds value in supporting the process, enabling decisions on costs, margins, capital expenditures and return on investments. Finance strengthens S&OP when assessing demand- and supply-related risks and facilitates comparing the functional business areas' plans to budget. While finance participation is highlighted as necessary for supporting successful S&OP implementations, it also receives valuable inputs in return, characterising a two-way communication role that benefits the entire organisation.Originality/valueThis is the first research paper focusing on empirically exploring the role of finance within S&OP, going beyond initial insights from practice and academia. It provides practitioners and scholars with an in-depth, evidence-based view of finance's integration along the S&OP process.

Silo busting makes good business sense

2020 ◽  
Vol 19 (4) ◽  
pp. 151-156
Author(s):  
Linda D. Henman
Keyword(s):  
Decision Making ◽  
Personal Development ◽  
Design Methodology ◽  
New Economy ◽  
Barriers To Success ◽  
Development Working ◽  
Content Type ◽  
Real People ◽  
Working Together ◽  
Research Findings

Purpose The purpose of this study is to help these leaders position themselves for the new economy, to help them see what the author has seen. As the author’s clients emerged from the global economic turmoil that began in 2008, they indicated they had learned numerous lessons – the most important one: when leaders make good decisions, little else matters. When they refuse to make decisions, or show a pattern of making bad ones, nothing else matters. Helping these leaders position themselves for the new economy, the author could see what others did not. Design/methodology/approach Something was standing in their way – usually the unwillingness or inability to demand cohesion and teamwork. In many cases, they thought they needed more – more education, more experience, more time or more data. They did not realize they had enough of these, but they did lack the confidence, courage and optimism to make the changes that many would resist. Findings Through this work together, the most successful leaders realized they could no longer push growth. Instead, they had to remove barriers to success and usually these barriers were of their own making. They needed to understand how to leverage their strengths, remove their silo-building behaviors and replace them with silo-busting decisions. Originality/value These compelling stories and surprising research findings in this paper focus on real people, who actively sought professional improvement and personal development. Working together, the author and others mapped out their journeys, identified the key roadblocks they faced, recognized the wrong turns they had taken and unlocked their decision-making potential – all the while navigating an increasingly uncertain world and, in some cases, more than doubling the size of their companies.

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