title: Evidence-based management reconsidered.
abstract: Reports of medical mistakes have splashed across newspapers and magazines in the United States. At the same time, instances of overuse, underuse, and misuse of management tactics and strategies receive far less attention. The sense of urgency associated with improving the quality of medical care does not exist with respect to improving the quality of management decision making. A more evidence-based approach would improve the competence of the decision-makers and their motivation to use more scientific methods when making a decision. The authors of this article consider a study of 68 U.S. health services managers that found a low level of evidence-based management behaviors. From the findings, four strategies are suggested to increase health systems managers' use of research evidence to improve decision making: focusing evidence-based decision making on strategically important issues, developing committees and other structures to diffuse management research throughout the organization, building a management culture that values research, and training managers in the competencies required to apply research evidence to health services management decisions. To aid the manager in understanding and applying an evidenced-based approach to decision making, the article provides practical tools, techniques, and resources for immediate use.
authors.affiliation: New York University's Wagner Graduate School of Public Service, New York City, NY, USA.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Kovner
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Rundall
mesh_terms: D003659:Decision Making, Organizational; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000193:education*; D006270:Health Facility Administrators / Q000193:education* / Q000592:standards; D006298:Health Services Administration / Q000592:standards*; D006801:Humans; D015279:Organizational Culture; D011361:Professional Competence; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration*; D012109:Research Support as Topic; D013192:Staff Development; D014481:United States