navigating the future: being and becoming a futurist daniel j. pesut phd aprn bc faan professor and...
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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
Future Pacing
• What concepts, tools, techniques are most useful?
• How can information be used?
• Why is information important?
• Why care about the information?
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.
Wonder
If a time traveler from 50 years in the future could give you the answer to
one question, what would it be?
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?
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?
Memory
What does the organization need to forget?
What must it always remember?
Imperatives
What are the most important strategic decisions we will have to make as an
organization?
Obstacles and Dangers
What will prevent us from succeeding?
What are the greatest risks and dangers?
Priorities
If you had the power to do one thing for the organization, what would it be, and
why?
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.
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
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.
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.
Crossing the Quality Chasm
A New Health System for the 21st Century- The Century of
Complexity
http://newton.nap.edu/books/0309072808/html/
Health Care PerformanceCharacteristics
• Safe
• Effective
• Patient- centered
• Timely
• Efficient
• Equitable
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.
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
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
Four Futures
• Possible
• Plausible
• Probable
• Preferred
“What the future holds for us depends on what we hold for the
future.”
Mikela and Philip Tarlow
Navigating the Future
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
Future Studies
The purpose of future studies is not to predict the future, but to envision desirable futures and avoid or prevent catastrophic ones.
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.
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.
Time and Time Spirits
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
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
Learning About the Future
World Future Society
http://www.wfs.org/
http://www.wfs.org/futuretimesmay07.htm
Reactions to Learning About the Future
• Patterns of Mind
• Patterns of Heart
• Patterns of Soul
Actively Monitor Trends and Forecasts
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.
Top Ten Forecasts
http://www.wfs.org/forecasts.htm
Trends and Consequences
• Personal
• Professional
• Organizational
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?
Discern Consequences of Trends
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?
Futures Wheel
A futures research method that draws out the consequences and expands the impact of an identified trend or event.
Futures Wheel
The search for consequences continues until three unanimously agreed-upon consequences have been developed.
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.
Global Health EconomyMap of the Decade
http://www.iftf.org/features/ghe_map.html
Future Health Scan
• Globalization• Cost containment and outcomes• Advanced personalized therapies• Information infrastructure advances• Human genome project• Predict-and-manage paradigm
Old ParadigmChronic Disease Management
Life ThreatLife Threat
Symptoms EmergeSymptoms Emerge
0
DiagnosisDiagnosis
SalvageSalvage
TreatmentTreatment
AgeAge
Inte
ns
ity
Inte
ns
ity
Source: Health Futures
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
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
• The future happens at the intersection of knowledge and services……
Influence Change With Emotional Intelligence
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.
Future Think : Integrated Levels
• Environment
• Behavior
• Capabilities
• Values and Beliefs
• Identity
• Mission
• Vision
• SpiritDilts, Robert : http://nlpu.com/Coach2Awakener.htm
Environment
• Constraints
• Opportunities
• Answers Where and When Questions?
Behavior
• Actions or Reactions in Environment
• Answers Questions of What?
Capabilities
• Abilities - Direct Actions; Map, Plan, Strategy.
• Answers the Question -- How?
Beliefs and Values
• Motivation
• Permission
• Support or Denial of Capabilities.
• Answers -- Why?
Identity
• Purpose
• Sense of Self
• Beliefs and Values
• Answers the Question -- Who?
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?
Vision and Truth
Desired State
Current Reality
Creative Tension
Spirit
• Faith
• Connectedness
• Community
• Mission
• Transmission
• Legacy
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.
Scenarios: The Back Side of Vision
Scenario Planning Resources: http://www.well.com/~mb/scenario/
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
Strategic Conversations
• How plausible does the scenario seem?
• What thoughts does it bring to mind?
• What feelings does it generate?
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?
Future Web Forums
http://www.wfs.org/inter.htm
http://weblogg-ed.com/2007/the-steep-unlearning-curve/
Global Health EconomyMap of the Decade
http://www.iftf.org/features/ghe_map.html
Future Forces Affecting Education 2006-2016
http://www.kwfdn.org/
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.
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.
Future Pacing
• What concepts, tools, techniques are most useful?
• How can information be used?
• Why is information important?
• Why care about the information?