What evidence on evidence-based management in healthcare?

This manuscript discusses the main findings gathered through a systematic literature review aimed at crystallizing the state of art about evidence-based management (EBMgt) in healthcare. The purpose of this paper is to narrow the main gaps in current understanding about the linkage between sources of evidence, categories of analysis and kinds of managerial decisions/management practices that different groups of decision-makers put in place. In fact, although EBMgt in healthcare has emerging as a fashionable research topic, little is still known about its actual implementation.

Using the Scopus database as main source of evidence, the authors carried out a systematic literature review on EBMgt in healthcare. Inclusion and exclusion criteria have been crystallized and applied. Only empirical journal articles and past reviews have been included to consider only well-mature and robust studies. A theoretical framework based on a “process” perspective has been designed on these building blocks: inputs (sources of evidence), processes/tools (analyses on the sources of evidence), outcomes (the kind of the decision) and target users (decision-makers).

Applying inclusion/exclusion criteria, 30 past studies were selected. Of them, ten studies were past literature reviews conducted between 2009 and 2014. Their main focus was discussing the previous definitions for EBMgt in healthcare, the main sources of evidence and their acceptance in hospitals. The remaining studies (n=20, 67 percent) were empirical; among them, the largest part (n=14, 70 percent) was informed by quantitative methodologies. The sources of evidence for EBMgt are: published studies, real world evidence and experts’ opinions. Evidence is analyzed through: literature reviews, data analysis of empirical studies, workshops with experts. Main kinds of decisions are: performance assessment of organization units, staff performance assessment, change management, organizational knowledge transfer and strategic planning.

This study offers original insights on EBMgt in healthcare by adding to what we know from previous studies a “process” perspective that connects sources of evidence, types of analysis, kinds of decisions and groups of decision-makers. The main findings are useful for academia as they consolidate what we know about EBMgt in healthcare and pave avenues for further research to consolidate this emerging discipline. They are also useful for practitioners, as hospital managers, who might be interested to design and implement EBMgt initiatives to improve hospital performance.