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Evidence-Based Management Practice and Leadership

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Title: Evidence-Based Management Practice and Leadership


1
Evidence-Based Management Practice and Leadership
  • L. Michele Issel, PhD, RN
  • UIC, SPH
  • MCH Leadership Conf
  • April 2002

2
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

3
Premises
  • Science and theory for practice of leadership and
    management
  • 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

4
Evidence Based Practice
  • Management is a practice, and research identifies
    most effective actions under what conditions

5
No need to fly (only) by the seat of your pants
  • Use the available technology and instruments

6
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
    interventions.

7
Isnt Evidence Evident? Well
  • Latest research reports
  • May or may not be sound, rigorous research
  • May or may not have results consistent with past
    studies
  • Own practice experiences
  • Human recall is notoriously biased
  • Unknown if same results can happen with other
    practitioners
  • Existing practice guidelines
  • May be based on outdated data and on habits

8
Evidence Quadrants

Many Studies
Ideal, strongest evidence
Ambiguous evidence
High Quality (Rigor)
Low Quality
Barely of interest
Strongly suggestive
Single Study
9
Quality Continuum

Randomized, double blind clinical trial with
large sample size
Quasi-experimental, small sample
Quasi-experimental, large sample
Descriptive anecdotal
High
Low
Quality of Study (Rigor)
10
References on Assessing Study Quality
  • Brown, S. (1991). Nursing Research, 40352-355.
  • Easy to use tool to assess the quality of a
    study.
  • Moher, D. et al (1995). Controlled Clinical
    Trials, 16 62-73.
  • Review of 25 tools to assess study quality.

11
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

12
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

13
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

14
Leadership how?
  • Self-awareness
  • With passion, enthusiasm
  • With intelligence
  • With knowledge
  • With confidence
  • With intent

15
Leadership Management
  • Strategy focused
  • Set mission
  • Context awareness
  • Encouragement
  • Operations focus
  • Follow mission
  • Content awareness
  • Control

16
Managing What ?
  • People
  • Ideas
  • Processes
  • Images and Perceptions
  • Communication
  • Time

17
Managing People
  • Motivation
  • Conflict
  • Ethics
  • Legal parameters
  • Professionalism

18
The 3 As
  • Autonomy
  • Authority
  • Accountability
  • Responsibility

19
Theory for Managing People
  • Motivation theories
  • Whistle blowing theories
  • Mentoring theories
  • Role theory

20
Motivation Theory and Science (from Mitchells
summary)
  • Efficacy, expectancy goals
  • Self-regulation, control, switching, habits
  • Emotions, affect, mood
  • Needs (hygiene factors), dispositional
  • Task design
  • Justice, rewards, reinforcement
  • Influence, culture

21
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

22
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

23
Managing Ideas
  • Innovations
  • Knowledge
  • Ideologies
  • Learning
  • Creativity

24
Theory for Managing Ideas
  • Diffusion of innovation theory
  • Organizational learning theory
  • Theories of creativity
  • Knowledge-based vs. knowledge-generating
    organization

25
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.

26
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

27
Managing Processes
  • Decision making
  • Change
  • Career advancement
  • Group work and interactions
  • Tasks (use of interventions, job performance)
  • Attention

28
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)

29
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

30
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

31
Managing Images and Perception
  • Symbols and rituals
  • Marketing principles
  • Sense making and meaning making
  • Personal culture
  • Organizational culture

32
Theory for Managing Perceptions
  • Organizational climate and culture
  • Typologies
  • Diversity in meanings
  • Organizational cognition theories
  • Learning organizations
  • Sense-making
  • Weicks social organizing

33
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

34
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
    organization
  • Look for information that disconfirms your ideas

35
Managing Communication
  • Interpersonal dialogues
  • Modes and medium of communication
  • Mass communications
  • Interorganizational communication and networks

36
Theory for Managing Communication
  • Interpersonal communication theory
  • Theory of language
  • Mass communication theory
  • Speech pathology theories
  • Network theory and science
  • Individual level
  • Organizational level

37
Communication and Networks
  • Boundary Spanning
  • Density and Homophily
  • Network Characteristics and Effects
  • Boundary spanners gather information
  • Strength of weak ties

38
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

39
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

40
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

41
Managing Time
  • Personal time
  • Project time
  • Work time

42
Theory for Managing Time
  • Cue theory
  • Negotiation theory
  • Attention management
  • Multi-tasking

43
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

44
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

45
From Science to Practice
  • Changing ones own behavior requires
  • intention,
  • attention, and
  • skill

46
Learning Opportunities
  • Conferences
  • University courses and programs
  • Hired consultants
  • Mentors
  • Bookstores
  • Journal club
  • Listserves

47
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

48
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

49
Who to read? Almost anyone
  • Managing Processes
  • Warren Bennis
  • Managing Perceptions
  • Karl Weick
  • Managing Communications
  • Fishers Getting to Yes

50
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.

51
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

52
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?

53
Your turn to participate
  • Take a moment and write
  • Two things you intend to do based on this
    presentation
  • Two things you learned that you dont want to
    forget

54
Make a commitment
  • By next year, I will have a science based answer
    to at least one of my management practice
    questions.

55
Sound Bytes
  • Remember small is big small changes have big
    effects
  • Managing happens, regardless of being planned
  • Fads of science become fads in practice change
    is perpetual

56
Thank You
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