navigating the future: being and becoming a futurist daniel j. pesut phd aprn bc faan professor and...
TRANSCRIPT
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Navigating the Future:Being and Becoming
a Futurist
Daniel J. Pesut PhD APRN BC FAAN
Professor and Associate Dean for Graduate Programs
Indiana University School of Nursing
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Future Pacing
• What concepts, tools, techniques are most useful?
• How can information be used?
• Why is information important?
• Why care about the information?
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Foresight
“Images of the future are the blue prints that we use in constructing our lives”
Cornish, E. (1977). The study of the future. Bethesda, MD: World Future Society.
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Wonder
If a time traveler from 50 years in the future could give you the answer to
one question, what would it be?
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Pride
If you were looking back 10 years from now and telling the tale of the
organization’s greatest success, what would the story be and why?
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Shame
If you were looking back 10 years from now and telling the tale of the
organization’s greatest failure, what would the story be and why?
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Memory
What does the organization need to forget?
What must it always remember?
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Imperatives
What are the most important strategic decisions we will have to make as an
organization?
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Obstacles and Dangers
What will prevent us from succeeding?
What are the greatest risks and dangers?
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Priorities
If you had the power to do one thing for the organization, what would it be, and
why?
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Objectives
• Discuss eight strategies that help to navigate future trends and issues in health care.
• Discuss futures thinking tools that help discern consequences of identified future health care trends.
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Foresight ~ Future Blind
Knowledge ~ Research
Learning ~ Education
Service ~ Practice
Kelso, Scott & Engstrom, D. (2006) The complementary nature. Bradford Books, MIT Press, Boston, MA. http://www.thecomplementarynature.com/TCN_Glossary.php
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Future Blind
• Lost and trapped in yesterday’s decisions, choices and consequences –become risk aversive
• Betrayed by expectations -must negotiate the expectations of youth with the experience of life
Hudson, Frederic (1999). The Adult Years: Mastering the art of self-renewal. Jossey-Bass: San Francisco.
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Future Blind
• Social systems once protective are destabilizing
• Overwhelmed with information and decisions• Bewildered by change, complexity and
discontinuities• Develop discourse of regret versus hope
Hudson, Frederic (1999). The Adult Years: Mastering the art of self-renewal. Jossey-Bass: San Francisco.
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Crossing the Quality Chasm
A New Health System for the 21st Century- The Century of
Complexity
http://newton.nap.edu/books/0309072808/html/
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Health Care PerformanceCharacteristics
• Safe
• Effective
• Patient- centered
• Timely
• Efficient
• Equitable
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A 21st Century Health Care System
• Evidenced based, planned care
• Reorganization of practices
• Systematic attention to patient information needs and behavioral change
• Ready access to clinical expertise
• Supportive information systems
Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Institute of Medicine, National Academy Press, Washington, D.C.
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Redesign Challenges
• Redesign care processes
• Effective use of information technologies
• Manage clinical knowledge and skills
• Develop effective teams
• Coordinate across conditions, services, settings, time
• Use of outcome measures for improvement and accountability
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USA AHA Workforce Keys
• Foster meaningful work– Patients, staff needs, meaning
• Improve workplace partnerships– Value, voice, rewards
• Broaden base of health care workers– Attract and retain a diverse work force
• Collaborate and build societal support– Institutional and public policy reform
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Four Futures
• Possible
• Plausible
• Probable
• Preferred
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“What the future holds for us depends on what we hold for the
future.”
Mikela and Philip Tarlow
Navigating the Future
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Glo
bal
R
enai
ssan
ce
Sus
tain
able
S
ocie
ty
The New
Econom
y
Failures of
Success
Fortress World
Co
llapse
into
Ch
aos
Business-As-Usual
Problems
Successes
Alternative Alternative FuturesFutures
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Future Studies
The purpose of future studies is not to predict the future, but to envision desirable futures and avoid or prevent catastrophic ones.
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Becoming A Futurist
• Pay attention to time and time-spirits.
• Learn about the future.
• Understand people’s reactions to learning about the future.
• Actively monitor industry trends and forecasts.
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Becoming a Futurist
• Discern logical consequences of trends using futures thinking tools and techniques.
• Use emotional intelligence in change efforts.
• Create vision-based scenarios.
• Stimulate strategic conversations about espoused visions.
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Time and Time Spirits
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Domains of Work
SharedMeaning
Creating valuein the present
Adding valuefor the future
Sustainingvalues
Quality indaily work
Processmanagement &
improvement
Process/systemdesign
Innovation & transformingwork
Strategicdevelopmentof physical &
intellectual capital
Strategic intent asdirection
Strategic intent asviability
Corporate citizenship& stewardship
Meeting present needswithout compromising
future generations
Keith McCandless, 1998Adapted from Hoebecke &
BIOSS
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Time Span Responsibilities
Creating valuein the present
Adding valuefor the future
Sustainingvalues
Quality indaily work
Processmanagement &
improvement
Process/systemdesign
Innovation & transformingwork
Strategicdevelopmentof physical &
intellectual capital
Strategic intent asdirection
Strategic intent asviability
Corporate citizenship& stewardship
Meeting present needswithout compromising
future generations
Keith McCandless, 1998Adapted from Hoebecke &
BIOSS
20-50 Years
10-20 Years
5-10 Years
2-5 Years
1-2 Years
3 Months-1 Year
1 Day-3 MonthsMastering the directtouch & feel of worktasks & patient care
Improving step-by-stepdiscrete processes
Connecting & finetuning parts of a system
Modeling & mappingalternative ideas/
practices
Imagining & creatingnew rules & fields of
knowledge
Weaving social, political,economic, global
intelligence
Sensing/perceiving theinterconnectedness of
all things & envisioningnew forms oforganization
50+ Years
Core Work Capabilities
Engaging Stakeholders in Each Domain
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Learning About the Future
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World Future Society
http://www.wfs.org/
http://www.wfs.org/futuretimesmay07.htm
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Reactions to Learning About the Future
• Patterns of Mind
• Patterns of Heart
• Patterns of Soul
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Actively Monitor Trends and Forecasts
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Scanning
Scanning involves searching information resources, consciously (active) or not (passive), for a particular kind (directed) of information which is then subjected to special attention.
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Top Ten Forecasts
http://www.wfs.org/forecasts.htm
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Trends and Consequences
• Personal
• Professional
• Organizational
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Future Trends
• On a sheet of paper write what you believe to be the top 7 trends
• Share your trends with a colleague
• Colleagues – must mark off the trend they believe least likely to happen
• Share with one more colleague and they must mark off the trend they believe least likely to happen
• One more time repeat the sharing and marking off
• What trends are left?
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Discern Consequences of Trends
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Trend
• What does this really mean?
• What does this really mean?
• What does this really mean?
• What does this really mean?
• What does this really mean?
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Futures Wheel
A futures research method that draws out the consequences and expands the impact of an identified trend or event.
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Futures Wheel
The search for consequences continues until three unanimously agreed-upon consequences have been developed.
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Cross-Impact Analysis• A futures method
technique used to make judgments about relationships among identified trend consequences.
• A matrix is developed with the identified trends.
• Judgments are made about the positive and negative impact of the trends in relation to one another.
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Global Health EconomyMap of the Decade
http://www.iftf.org/features/ghe_map.html
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Future Health Scan
• Globalization• Cost containment and outcomes• Advanced personalized therapies• Information infrastructure advances• Human genome project• Predict-and-manage paradigm
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Old ParadigmChronic Disease Management
Life ThreatLife Threat
Symptoms EmergeSymptoms Emerge
0
DiagnosisDiagnosis
SalvageSalvage
TreatmentTreatment
AgeAge
Inte
ns
ity
Inte
ns
ity
Source: Health Futures
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Diabetes - The Harvest Scenario
Life ThreatLife Threat
Symptoms EmergeSymptoms Emerge
0
InsulinInsulindependencedependence
DialysisDialysis
DiagnosisDiagnosis
TimeTime
Ac
uit
yA
cu
ity
CataractCataractremoval/removal/new lensesnew lenses
AmputationAmputationof limbsof limbs
CardiacCardiacSurgerySurgery
Source: Health Futures
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Diabetes - The Prediction & Management Scenario
Life ThreatLife Threat
Symptoms EmergeSymptoms Emerge
0 TimeTime
Ac
uit
yA
cu
ity
Biosensors/regulationBiosensors/regulationArtificial pancreasArtificial pancreasIslet cell transplantationIslet cell transplantationImmunotherapyImmunotherapySerum marker testingSerum marker testing
GeneticGeneticscreeningscreening
Source: Health Futures
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• The future happens at the intersection of knowledge and services……
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Influence Change With Emotional Intelligence
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Emotional Intelligence
• “The ability to sense, understand and effectively apply the power and acumen of emotions as a source of human energy, information, connection and influence”
Cooper, Robert & Sawaf, Ayman. (1997). Executive EQ: Emotional intelligence in leadership & organizations: Grosset/Putnam: New York.
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Future Think : Integrated Levels
• Environment
• Behavior
• Capabilities
• Values and Beliefs
• Identity
• Mission
• Vision
• SpiritDilts, Robert : http://nlpu.com/Coach2Awakener.htm
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Environment
• Constraints
• Opportunities
• Answers Where and When Questions?
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Behavior
• Actions or Reactions in Environment
• Answers Questions of What?
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Capabilities
• Abilities - Direct Actions; Map, Plan, Strategy.
• Answers the Question -- How?
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Beliefs and Values
• Motivation
• Permission
• Support or Denial of Capabilities.
• Answers -- Why?
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Identity
• Purpose
• Sense of Self
• Beliefs and Values
• Answers the Question -- Who?
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Mission
• What is my mission?
• What roles do I create for myself or are attributed to me by others?
• How do these roles support or impede my personal or professional aspirations?
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Vision and Truth
Desired State
Current Reality
Creative Tension
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Spirit
• Faith
• Connectedness
• Community
• Mission
• Transmission
• Legacy
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Create Vision Based Scenarios
A scenario is a method for telling a story about the future. It can be based on reliable or speculative data.
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Scenarios: The Back Side of Vision
Scenario Planning Resources: http://www.well.com/~mb/scenario/
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Canadian 2020 Nursing Scenarios
• Technology eclipses care
• Control manage and measure
• Return to care
• The transformation
Toward 2020: Visions for Nursing Toward 2020: Visions for Nursing
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Strategic Conversations
• How plausible does the scenario seem?
• What thoughts does it bring to mind?
• What feelings does it generate?
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Strategic Conversations
• What are the implications for society, healthcare and nursing?
• If parts of the scenario are desirable what actions need to be taken to increase the chances of it happening?
• If parts are undesirable what actions need to be taken to prevent them form happening?
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Future Web Forums
http://www.wfs.org/inter.htm
http://weblogg-ed.com/2007/the-steep-unlearning-curve/
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Global Health EconomyMap of the Decade
http://www.iftf.org/features/ghe_map.html
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Future Forces Affecting Education 2006-2016
http://www.kwfdn.org/
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Being and Becoming a Futurist
• Pay attention to time and time-spirits.
• Learn about the future.
• Understand people’s reactions to learning about the future.
• Actively monitor industry trends and forecasts.
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Being and Becoming a Futurist
• Discern logical consequences of trends using futures thinking tools and techniques.
• Use emotional intelligence in change efforts.
• Create vision-based scenarios.
• Stimulate strategic conversations about espoused visions.
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Future Pacing
• What concepts, tools, techniques are most useful?
• How can information be used?
• Why is information important?
• Why care about the information?