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Evidence-Based Management Practice and Leadership


Interorganizational communication and networks. Theory for Managing Communication ... Mass communication theory. Speech pathology theories. Network theory and ... – PowerPoint PPT presentation

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Title: Evidence-Based Management Practice and Leadership

Evidence-Based Management Practice and Leadership
  • L. Michele Issel, PhD, RN
  • UIC, SPH
  • MCH Leadership Conf
  • April 2002

Objectives of Session
  • Appreciate the breadth and depth of scientific
    knowledge applicable to management practice
  • Be able to list three theories that can be used
    in management practice
  • List at least two sources of obtaining current
    management knowledge
  • Make a commitment to own growth in the area of
    practicing science-based management and leadership

  • Science and theory for practice of leadership and
  • Practice needs to be based on science
  • Can integrate management and organizational
    science and theory into practice
  • All applicable to MCH
  • Tomorrow will not be like today or yesterday

Evidence Based Practice
  • Management is a practice, and research identifies
    most effective actions under what conditions

No need to fly (only) by the seat of your pants
  • Use the available technology and instruments

What is Evidence Based?
  • Consistent and judicious use of the best evidence
    when making decisions regarding delivery of
    treatment or interventions.
  • In management, intentional actions are

Isnt Evidence Evident? Well
  • Latest research reports
  • May or may not be sound, rigorous research
  • May or may not have results consistent with past
  • Own practice experiences
  • Human recall is notoriously biased
  • Unknown if same results can happen with other
  • Existing practice guidelines
  • May be based on outdated data and on habits

Evidence Quadrants

Many Studies
Ideal, strongest evidence
Ambiguous evidence
High Quality (Rigor)
Low Quality
Barely of interest
Strongly suggestive
Single Study
Quality Continuum

Randomized, double blind clinical trial with
large sample size
Quasi-experimental, small sample
Quasi-experimental, large sample
Descriptive anecdotal
Quality of Study (Rigor)
References on Assessing Study Quality
  • Brown, S. (1991). Nursing Research, 40352-355.
  • Easy to use tool to assess the quality of a
  • Moher, D. et al (1995). Controlled Clinical
    Trials, 16 62-73.
  • Review of 25 tools to assess study quality.

Steps to Establish the Evidence for a Practice
  • Evidence Review
  • I. Define Problem
  • II. Locate Studies
  • III. Evaluate Studies
  • IV. Determine Strength of Evidence
  • Evidence-Based Practice (EBP)
  • V. Develop Guidelines
  • VI. Change Practice

Evidence in Organizational Science
  • Look for meta-analyses and literature synthesis
  • ABI INFORM as the library database
  • Look for body of work by one scholar
  • Accumulation across several studies
  • Look for work done in variety of organizations
  • Accumulation of knowledge across settings

First, Aim for Leadership
  • Flexibility and responsiveness
  • Innovation of approaches and solutions
  • Trail blaze into new risky territory
  • Embrace change
  • See opportunities, the full half

Leadership how?
  • Self-awareness
  • With passion, enthusiasm
  • With intelligence
  • With knowledge
  • With confidence
  • With intent

Leadership Management
  • Strategy focused
  • Set mission
  • Context awareness
  • Encouragement
  • Operations focus
  • Follow mission
  • Content awareness
  • Control

Managing What ?
  • People
  • Ideas
  • Processes
  • Images and Perceptions
  • Communication
  • Time

Managing People
  • Motivation
  • Conflict
  • Ethics
  • Legal parameters
  • Professionalism

The 3 As
  • Autonomy
  • Authority
  • Accountability
  • Responsibility

Theory for Managing People
  • Motivation theories
  • Whistle blowing theories
  • Mentoring theories
  • Role theory

Motivation Theory and Science (from Mitchells
  • Efficacy, expectancy goals
  • Self-regulation, control, switching, habits
  • Emotions, affect, mood
  • Needs (hygiene factors), dispositional
  • Task design
  • Justice, rewards, reinforcement
  • Influence, culture

Evidence for People Management
  • High motivation work environments have these
    characteristics (Jeff Pfeffer)
  • Employment stability
  • Participation in decision making
  • Performance reward
  • Train employees
  • Open book management

Evidence-Based People Management
  • To have a high motivation work environment
  • Keep employees
  • Involve staff in decision making
  • Reward performance
  • Invest in training employees
  • Give feedback to employees

Managing Ideas
  • Innovations
  • Knowledge
  • Ideologies
  • Learning
  • Creativity

Theory for Managing Ideas
  • Diffusion of innovation theory
  • Organizational learning theory
  • Theories of creativity
  • Knowledge-based vs. knowledge-generating

Evidence for Idea Management
  • Management of Innovation.
  • Approximately 50 of innovators come from middle
    management or front-line staff
  • Innovators used comprehensive planning as a mode
    of analysis leading to innovation
  • Brinis (2001) Am Review Pub Admin.

Evidence-Based Idea Management
  • Managing Innovation.
  • Listen to and seek ideas from middle management
    or front-line staff
  • Use comprehensive planning as starting point
    leading to innovation

Managing Processes
  • Decision making
  • Change
  • Career advancement
  • Group work and interactions
  • Tasks (use of interventions, job performance)
  • Attention

Theory for Managing Processes
  • Participation in decision making theories
  • Theories of organizational change
  • Work group perspectives
  • Autonomous
  • Work group effectiveness
  • Career advancement
  • Mentoring
  • Organizational constraints (glass ceiling)

Evidence for Process Management
  • Decision making.
  • Participation of staff in decision making about
    strategy, operations, and marketing is related to
    more effective organizations
  • Participation of staff in decision making is
    better patient outcomes
  • Anderson Issel

Evidence-Based Process Management
  • Managing decision processes
  • Involve staff in identifying the issues, seeking
    solutions and choosing solutions
  • Involve staff in decision making that affects the
    organization, not just their job

Managing Images and Perception
  • Symbols and rituals
  • Marketing principles
  • Sense making and meaning making
  • Personal culture
  • Organizational culture

Theory for Managing Perceptions
  • Organizational climate and culture
  • Typologies
  • Diversity in meanings
  • Organizational cognition theories
  • Learning organizations
  • Sense-making
  • Weicks social organizing

Evidence for Perception Management
  • Weicks work on attention and interpretations in
    high velocity environments
  • When things are happening fast, people miss
    information and make assumptions
  • People in organizations retrospectively make
    sense of the past events
  • People in organizations create the future they
    are planning for

Evidence-Based Perception Management
  • Managing perceptions
  • Seek lots of diverse information to understand
    what is going on
  • Defer to expertise that exists across/up-down the
  • Look for information that disconfirms your ideas

Managing Communication
  • Interpersonal dialogues
  • Modes and medium of communication
  • Mass communications
  • Interorganizational communication and networks

Theory for Managing Communication
  • Interpersonal communication theory
  • Theory of language
  • Mass communication theory
  • Speech pathology theories
  • Network theory and science
  • Individual level
  • Organizational level

Communication and Networks
  • Boundary Spanning
  • Density and Homophily
  • Network Characteristics and Effects
  • Boundary spanners gather information
  • Strength of weak ties

Communication Mode
  • Daft and Engles Media Richness
  • Medial richness is the degree to which a cues are
    given that can be used to interpret the message
  • Media richness increases understanding
  • Face to face communication is richest media

Evidence for Communication Management
  • Baltes et al. (2002) did a meta-analysis of 22
    studies about computer mediated communication
    versus face to face communication.
  • Computer use is associated with
  • more negative work outcomes
  • decrease group effectiveness
  • increased time to decision
  • decreased satisfaction

Evidence-Based Communication Management
  • Managing communication
  • Be selective about when use computer versus
    in-person communication
  • Match the mode of communication with the need for
    rich information
  • Use the weak links in interpersonal and
    professional networks to gain new information

Managing Time
  • Personal time
  • Project time
  • Work time

Theory for Managing Time
  • Cue theory
  • Negotiation theory
  • Attention management
  • Multi-tasking

Evidence for Time Management
  • Stuhlmacher (1998) meta-analysis of effect of
    time pressure on negotiation in 23 studies
  • Greater time pressure was related to greater
    cooperative strategy being used, especially in
    single issue negotiations, when there is large
    incentive for cooperation, and parties can be
    flexible in meeting demands

Evidence-Based Time Management
  • Managing time
  • Anticipate effect of time frame on own actions
    and emotions and those of others
  • Anticipate the interaction of time frame with
    perceptions and responses

From Science to Practice
  • Changing ones own behavior requires
  • intention,
  • attention, and
  • skill

Learning Opportunities
  • Conferences
  • University courses and programs
  • Hired consultants
  • Mentors
  • Bookstores
  • Journal club
  • Listserves

Collaborate with Researchers
  • Stories with a lesson Share them to begin the
    search for explanations
  • Organization or program as a laboratory for
    testing management and leadership approaches

Where to get the latest management science
  • Journals
  • Harvard Business Review
  • MITs Sloan Management Review
  • J of Public Health Management and Practice
  • Healthcare Management Review
  • J of Nursing Administration

Who to read? Almost anyone
  • Managing Processes
  • Warren Bennis
  • Managing Perceptions
  • Karl Weick
  • Managing Communications
  • Fishers Getting to Yes

NY Times Business Best Seller From March 17 list
  • Leading Quietly by Badaracco
  • 4 yr study showing that great leadership is
    generally conducted in careful, thoughtful, small
    and practical efforts.

NY Times Business Best Sellers From April 14 List
  • Primal Leadership by Coleman , Boyatzis McKee
  • putting emotional intelligence to work
  • Who moved my cheese? By Johnson
  • techniques for dealing with workplace change

Your turn to participate
  • What aspects of my work are managerial and what
    aspects are leadership?
  • What questions do I have about management and
    leadership? (curiosity)
  • Where can I look for answers to those questions?

Your turn to participate
  • Take a moment and write
  • Two things you intend to do based on this
  • Two things you learned that you dont want to

Make a commitment
  • By next year, I will have a science based answer
    to at least one of my management practice

Sound Bytes
  • Remember small is big small changes have big
  • Managing happens, regardless of being planned
  • Fads of science become fads in practice change
    is perpetual

Thank You
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