Healthcare and Medicine Reference
With the statistician's help, Jack has begun doing systematic reviews
that allow him to find articles providing an overview of the latest research.
He has also begun taking courses in management that emphasize an objec-
tive, competency-based approach. Like all fields, there seems to be a good
deal of extraneous and incorrect theory in the management literature.
There is also a great deal of cheerleading, or what Jack considers to be fairly
innocuous homilies. For example, an article on developing team work
ends, “Making teams requires recognizing that it is our nature to belong—
that we want to be part of something larger than ourselves. Thriving in
teams requires acknowledging the essential humanness of each member. It
all begins with choice and voice” ( Axelrod, 2002 , p. 12). Jack could not
find a shred of evidence that anything in the article had been proven and
decided the article consisted of statements made that sounded good but
had no support and could have been completely wrong.
In another example from the management literature, the reasons
given for low morale in organizations were that “Rumor, negativity, gos-
sip, and quiet character assassination kill organizations, kill productivity,
kill morale and crush the spirit” ( Schuler, 2004 , p. 2). While that may be
true, the author failed to offer data to support this statement and failed to
provide best evidence about how to rectify low morale. Like so many
articles he has read, Jack finds that these articles just add to his confusion
and lack of direction.
With the help of several instructors and a friend with a good research
background, he has been able to separate the evidence that provides best
practices from platitudes that seem overly general and prescriptive. What
he failed to realize was that it takes time and practice to apply best evi-
dence and that not all workers enjoy such an objective, results-oriented
approach to management. Several of his workers argued that the process
of helping patients had become too rational and objective and that the
fun they used to have was gone. Others said that the use of best evidence
didn't individualize them and that they felt like cogs in a machine. And
yet others complained that what they did in practice was very subjective.
Bottom line expectations failed to consider that some patients, while not
seeming better on objective measures, really were better.
Jack thinks these are all good concerns and has begun meeting with
workers individually and as a group to respond to their concerns. But the
effort to institute best evidence has begun to have a positive impact on
the overall performance of the unit and is self-reinforcing. Additionally,
Jack is feeling much more comfortable about his supervisory skills and
has begun to realize that one must provide humane, supportive manage-
ment that reinforces positive behavior, helps change negative behavior,
and melds various personalities into a cohesive working unit. And much
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