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A Framework for Management
The rise of evidence-based clinical practice was
prompted in part by the existence of unexplained wide variations in
practice patterns, by the slow application of new therapies of known
effectiveness, and by the persistent use of technologies that were
known to be ineffective. The problems of overuse, underuse and misuse
are found also in managerial practice in health care organizations in
the way that decisions about organizing, structuring, delivering, or
financing health services are made.
1 Perhaps not yet as well
understood, these decisions also influence, directly or indirectly,
clinical effectiveness.
Abundant evidence reveals a research practice gap in health care policy
and management. This section describes the basic principles of what is now
called evidence-based management and the research needed to support it.
In addition we look at an integral part of that work: working collaboratively
with the client—managers and other leaders—to design relevant studies and
then to translate and present the results in an effective manner.
This section draws heavily on the work of Walshe, Randall, Alexsson,
Kovner, Elton, and Billings. 1,
2, 3
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