Wellbeing specialist Dr Bridget Juniper considers evidence-based management and the role it can play in developing an effective employee wellbeing strategy.
Increasingly, we hear that HR and management academics use the term "evidence-based management" in their various pronouncements on workforce research and best practice. They commend business leaders to embrace this approach and apply it to the big decisions they take about their organisations.
Put simply, evidence-based management has evolved from evidence-based medicine. This latter concept has its roots in 19th century philosophy. It describes "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" (Sackett et al, 1996). The approach integrates individual clinical expertise and blends this with the best available external clinical evidence. It is not "cookbook" medicine. Rather, it calls for a bottom-up approach that integrates the best science with patient choice and preference.
Applying this way of thinking to organisations was championed by Jeffrey Pfeffer and Robert Sutton in the Harvard Business Review in 2006. The authors argued that the tendency of senior managers to rely on unfounded promises, half-truths and dubious knowledge sources was the same if not worse than that shown by their medical counterparts. They called for management teams to challenge their assumptions and relentlessly seek out logic and evidence to support their decisions. The theory is sound.
Lack of evidence
How this approach is manifested in wider parts of the organisation is beyond the remit of this column. What can be commented on, however, is the dismal lack of evidence that underpins employee wellbeing programmes. In the majority of cases, a "cookbook" type approach is used, where managers blindly follow a formulaic recipe without studiously checking the evidence and holding their various advisers and vendors to account on the promises that they make. Ingredients in the recipe often involve the usual suspects such as employee assistance programmes, health insurance and health screening services. Other components may include subsidies to stress awareness, fitness clubs, cycle-to-work schemes and perhaps a series of seminars promoting healthy lifestyles. All are made available in the vain belief that they will enhance employee wellbeing and boost productivity.
When Dame Carol Black and Dr Steve Boorman were commissioned by the Government to report on the health of the UK working population and the health and wellbeing of NHS staff respectively, they issued calls for evidence to help build their case. The response was underwhelming; there existed only a paltry amount of robust evidence that made the empirical case for enhancing employee wellbeing. Even the PricewaterhouseCoopers (PwC) report Building the case for wellness, specifically commissioned by Black to spell out the evidence and link this to practical examples of UK businesses, was less than convincing. In fact, PwC observed, there was no clear business case showing the wellness programmes that they had studied had a direct financial return or effects on tangible business benefits.
If organisations take the time to collect views on how people consider their work to impact on their wellbeing, they will be rewarded with some rich insights."
Why is there this stark lack of evidence? Cynics might say that it is simply because the link between performance and employee wellbeing does not exist. Others might contend it is because employers do not have the time and resources to develop an empirical base at the outset, and it is therefore not feasible to track changes over time to evidence the impact of programmes.
Importance of planning
I have empathy with both viewpoints. In my experience of working with organisations, I find that their existing employee wellbeing programmes may be flawed in two key ways. First, programme design is not relevant to the workforce for whom it is intended and the link between wellbeing and performance therefore remains unproven. Second, managers tasked with developing a programme are inclined to jump straight to delivery without first amassing the necessary data on which to inform choice and content. These two shortcomings are inextricably linked with the likely consequence that programmes are doomed from the start and compelling evidence to make the business case is left unverified.
Two of the most important numbers that any organisation will look at are employee costs and productivity. There are real benefits to be reaped from evidence-based employee wellbeing programmes but, for the majority, this concept is consigned to the "too hard to deal with" bin. Wellbeing isn't just about gym memberships or healthy options in the canteen. It isn't just about putting into place healthcare measures to support the small numbers of staff who become ill. Instead, employee wellbeing programmes should embrace all factors within a workplace that may impair health and wellness, which can range from job design, the physical workplace and how people are managed. If employers took the time to examine these dimensions at the start and then feed their findings into the overall wellbeing mix, they would have more success. However, there is an inexplicable stubbornness to focus only on the symptoms of ill health and avoid taking full stock of the situation. It is rather like trying to improve the performance of your car without first looking under the bonnet.
Of course, there are exceptions to the rule and pockets of good practice do exist. The size of the prize is huge for those who take the time to get underneath the skin of a workforce to establish empirically how wellbeing is impairing performance. In our experience, employees are only too willing to contribute to the evidence base. If organisations take the time to collect views on how people consider their work to impact on their wellbeing, they will be rewarded with some rich insights. Some of these may confirm what is already suspected to be the case. Other findings may be more counter-intuitive and therefore more important. Facing up to hard facts about employee wellbeing will help managers and their teams to perform better. If these principles are adopted, next time there is a call for evidence, we will be better placed to respond.
Dr Bridget Juniper is head of Work and Well-Being Ltd, which specialises in the measurement of employee wellbeing. She has conducted award-winning research on employee wellbeing at Cranfield University. She publishes regularly in scholarly journals and frequently presents to academic and corporate audiences.
Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS (1996). "Evidence based medicine: What it is and what it isn't". British Medical Journal, 312, 71-72.