Evidence-based management

It's OK to be lucky when you're lucky, but it's not OK when the issues are critical. Too often, we manage by anecdote, which is OK when you can afford to be wrong, but when finances are tight, or the market is overregulated, or a lot is at stake, making mistakes is not an option. Evidence-based management depends on attention to three components: analytics, decision making, and problem solving. These are skills that should be required of everyone who assumes a management position, no matter how high or low one is on the totem pole. Understanding basic analytical techniques, knowing how to apply these techniques to making good decisions, and learning how to become a skilled problem solver ensure that, when we manage our businesses, we minimize the risk of mistakes and maximize the potential for positive outcomes.     

Evidence-based management reconsidered

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.     

Evidence-based management of schizophrenia

Antipsychotic medication is the foundation of care for patients who suffer from schizophrenia and other psychotic conditions. Newly diagnosed patients should be treated with atypical antipsychotics, of which the National Institute for Clinical Excellence guidelines recommend five. The quality of clinical evidence will ultimately establish the differences between available treatments.     

Evidence-based management of reproductive problems

Evidence-based medicine has become the catch-cry phrase of the 1990s. It is about using evidence from well-designed research and applying it to everyday practice. It would be a difficult task to appraise all the evidence from research without the help of well-prepared systematic reviews. This article examines some aspects of this approach.     

Evidence-based guidelines for early stroke management.

Stroke disease is the commonest neurological emergency encountered by the junior medical team. We have reviewed the literature to produce a series of substantiated guidelines to assist the admitting doctor in managing early stroke care optimally.     

Evidence-based healthcare management competency evaluation: alumni perceptions

An ongoing concern of healthcare educators is how well students are prepared for practice after they are graduated. Curriculum design and pedagogical methods are central components for developing healthcare management and leadership competencies. Various stakeholders have identified competency domains and typologies that outline the requisite skills and expertise to manage and lead healthcare organizations. This study analyzes survey data over a ten-year period from alumni one-year post graduation to compare self-reported assessment of competency development. Trends across two graduate professional programs tailored to different students of healthcare administration are compared. A total of 302 alumni responded to the survey. A factor analysis is performed to evaluate how the skills, knowledge, and abilities of graduates fit into identified competency domains. Fourteen competencies on the survey load into four factor domains: leadership, communication, business skills, and technology.     

循证医学在实验室设备管理中的应用

1 循证医学的概念和基本思想 循证医学是20世纪90年代引入临床医学领域的新概念,是近几年迅速兴起的一门新学科.它的出现使临床医学发生了巨大变化,逐步成为治疗疾病和医疗决策的最新思维方法和模式.不仅如此,循证医学在医疗卫生决策、医疗卫生管理等方面也得以广泛应用.循证医学的含义是指慎重、准确和明智地应用当前所能获得最好的研究依据,同时结合医生的个人专业技能和多年临床经验,考虑病人价值和愿望,将三者完美结合制定出病人治疗措施[1].循证医学要求在医疗实践中有证可循,循即是遵循、循例,证即是证据、证明;证据及其质量是循证医学的关键.     

Evidence-based guidelines for management of nursing home-acquired pneumonia

We convened a multidisciplinary, multispecialty panel to develop comprehensive evidence and consensus-based guidelines for managing nursing home-acquired pneumonia. The panel began with explicit criteria for process of care quality measures, performed a comprehensive review of the English-language literature, evaluated the quality of the evidence, and drafted a set of proposed guidelines. The panel reviewed the draft, an annotated bibliography, and data from a study of 30-day survival from nursing home-acquired pneumonia, and then participated in an all-day meeting in January 2001. Using a modified Delphi process, the panel refined the guidelines and developed a care pathway. The guidelines recommend a comprehensive approach, including immunization of staff and residents, and communication between nursing staff and the attending physician within 2 hours of symptom onset. Probable pneumonia was defined. An algorithm was delineated for assessing the patientamprsquos wishes for hospitalization and aggressive care, and deciding on hospitalization based on the severity of the illness as well as the capacity of the nursing home to provide acute care. The timing and extent of evaluation in a nursing home relative to the rapid initiation of antibiotics should depend on whether the patient has any unstable vital signs. An antibiotic covering Streptococcus pneumoniae, Haemophilus influenzae, common gram-negative rods, and Staphylococcus aureus should be given for 10 to 14 days, orally if the patient is able to take medications by mouth.     

循证医学与医院科研管理

随着循证医学数据库的不断增加,循证医学方法的应用,以及局域网的广泛使用,新疆医科大学第一附属医院各部门都将利用循证医学实现科研管理制度化、标准化、自动化、网络化.     

Evidence-based teaching: a course in health services management

This article traces the development of a course in health services management over 40 years and presents the course within a context of teaching evidence-based management. One emphasis of the course is on teaching through storytelling--students developing learning capability to listen to what each stakeholder has to say, and then figuring what to do about it. Students share evidence from the professor's own work experience, the student's own work experience, peer-reviewed published articles, and case studies.     

Evidence-based practice and the management of risk in nursing

This paper examines how nurses manage research evidence of risk in practice policy. Groups of specialist nurses were observed during the construction of consensus guidelines for three common nursing tasks. The process of interpreting and using research evidence included perceiving and prioritizing outcomes, evaluating their likely impact for patients and staff, and determining an acceptable balance of risk, cost and benefit for multiple contexts and stakeholder groups. The study illustrates some of the unarticulated rules of risk management in nursing, which were powerful mediators in the uptake and interpretation of research. The implications of these frames of reference are discussed in relation to the promotion of evidence-based nursing practice.     

Evidence-based guideline on the primary care management of asthma

This is an updated version of the first North of England Asthma Guideline (1,2) and summarizes the full guideline. (3) This paper presents all the recommendations within the guideline and, where these are new or substantially altered from the original version, it also presents a summary of the supporting evidence. The aims and methods of development (summarized in Box 1) of this guideline are unchanged from the original version, to which readers are directed for more detail. The research questions raised during the development of this guideline are shown in Box 2.     

Evidence-based guideline for the primary care management of stable angina

This is an updated version of the first North of England Stable Angina Guideline (1,2) and summarizes the full guideline. (3) This paper presents all the recommendations within the guideline; and where these are new or substantially altered from the original version, it also presents a summary of the supporting evidence. The aims and methods of development (summarized in Box 1) of this guideline are unchanged from the original version, to which readers are directed for more detail. The research questions raised during the development of this guideline are shown in Box 2.     

Evidence-based management: from theory to practice in health care

The rise of evidence-based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in the process. Though managers and policymakers have been quick to encourage clinicians to adopt an evidence-based approach, they have been slower to apply the same ideas to their own practice. Yet, there is evidence that the same problems (of the underuse of effective interventions and the overuse of ineffective ones) are as widespread in health care management as they are in clinical practice. Because there are important differences between the culture, research base, and decision-making processes of clinicians and managers, the ideas of evidence-based practice, while relevant, need to be translated for management rather than simply transferred. The experience of the Center for Health Management Research (CHMR) is used to explore how to bring managers and researchers together and promote the use of evidence in managerial decision-making. However, health care funders, health care organizations, research funders, and academic centers need wider and more concerted action to promote the development of evidence-based managerial practice.