Research suggests a strong association between evidence-based management and improved effectiveness and efficiency in health service provision. The ability to identify and use evidence to guide management practice has been accepted as a core competency for healthcare managers. However, studies in the UK, Canada and the USA have shown that managers make little use of evidence-based approaches to decision making. This recently completed study collected quantitative and qualitative data from members of the Australian College of Health Service Executives (ACHSE) in Victoria, Australia. It clarifies what constitutes evidence in the view of healthcare managers and confirms whether evidence was commonly and effectively sourced, appraised and used. A number of key factors that influence the practice of evidence- based decision making in health management have been identified. The project concludes that the responsibility of improving the practice of evidence- based decision making among healthcare managers is shared by managers, their healthcare organisations, professional bodies, educators and researchers. Recommendations to improve the practice are also made.