Management-by-Walking-Around programs may do more harm than good

Management-By-Walking-Around, a widely adopted technique in hospitals in which senior managers visit the frontlines of their organizations to solicit improvement ideas and resolve issues, has the potential to do more harm than good, according to a new study by researchers from Harvard School of Public Health (HSPH) and Harvard Business School (HBS). In contrast to evidence that suggests MBWA-type programs improve the safety climate in hospitals, this study finds the effectiveness of these programs depends on how they are approached.

“Our research cautions managers against adopting practices just because evidence suggests they are effective in one or a few hospitals. Managers really need to understand what makes practices effective in order to replicate their success,” said co-author Sara Singer, associate professor in the Department of Health Policy and Management at HSPH.

The paper appeared online March 31, 2014 in Production and Operations Management.

To improve the quality of care and decrease medical errors, many hospitals in the U.S. and U.K. have adopted MBWA, a program that has also been used widely in manufacturing organizations. However, previous studies had not looked closely at the factors and approaches associated with the success of MBWA in hospitals.

Singer and co-author Anita Tucker, associate professor of business administration at HBS, did a randomized controlled study to test the effectiveness of an 18-month MBWA-based program to improve patient safety.