navigating the future: being and becoming a futurist

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

dpesut@iupui.edu

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?