"Management by walking around," in which senior leaders visit hospital front-lines to solicit ideas for improvement, can have a negative affect on staff if leaders don't act quickly on the problems they see, according to a study from Harvard School of Public Health and Harvard Business School.
MBWA, a management style widely used in manufacturing organizations, is intended to improve hospitals' safety climates and decrease medical errors. By "walking around," senior leaders and members of the hospital management team can ask front-line staff for their ideas to resolve issues and improve performance.
But in the first study to examine the factors and approaches associated with success of MBWA in hospitals, researchers found the management style can do more harm than good if it is not properly implemented by leaders.
In short: An unsuccessful MBWA program won't just lead to little to no improvement; it will actually hurt staff's perceptions of improvement.
The study tested the effectiveness of an 18-month MBWA-based program to improve patient safety. Researchers compared nurses' perception of improvement in 56 work areas in 20 hospitals that had implemented and completed the MBWA program with those of nurses in 138 work areas in 48 control hospitals.
Study authors found the MBWA program had a negative effect on nurses' perceptions of performance. Senior managers were found to allocate too much time analyzing which problems to solve rather than taking action, and this led to a negative effect on nurses' perception of improvement. Senior managers were only helpful on the frontlines if their presence enabled active problem solving, according to the study.
"MBWA can backfire if management fails to meet staff expectations raised by the program," Anita Tucker, associate professor of business administration at HBS, said in the news release. "When MBWA is successful, it's the action-taking that results from the program, rather than the mere physical presence of the senior managers, that positively impacts frontline staff performance."
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