Navigating the Future with Nursing Foresight€¢Discuss the concepts of nursing foresight and...
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Navigating the Future with Nursing Foresight Daniel J Pesut PhD RN PMHCNS-BC FAAN Professor of Nursing Population Health and Systems Cooperative Unit Director of the Katharine Densford International Center for Nursing Leadership Katherine R. and C. Walton Lillehei Chair in Nursing Leadership University of Minnesota School of Nursing 308 Harvard St. SE 4-185 Weaver-Densford Hall Minneapolis, MN 55455 [email protected] Office Phone number: 612-626-9443 © 2017 All Rights Reserved
Transcript of Navigating the Future with Nursing Foresight€¢Discuss the concepts of nursing foresight and...
Navigating the Future with Nursing
ForesightDaniel J Pesut PhD RN PMHCNS-BC FAAN
Professor of Nursing Population Health and Systems Cooperative Unit
Director of the Katharine Densford International Center for Nursing
Leadership
Katherine R. and C. Walton Lillehei Chair in Nursing Leadership
University of Minnesota School of Nursing
308 Harvard St. SE
4-185 Weaver-Densford Hall
Minneapolis, MN 55455
Office Phone number: 612-626-9443
© 2017 All Rights Reserved
Objectives
• Discuss the concepts of nursing foresight and anticipatory
leadership.
• Identify emerging health care trends and scenario
consequences for nursing practice, education and
research.
• Identify selected references and resources to explore and
advance knowledge, insight, understanding and futures
literacy.
Definition of Nursing
“Nursing is the protection, and optimization of health and
abilities, prevention of illness and injury, facilitation of
healing, alleviation of suffering through the diagnosis and
treatment of human response, and advocacy in the care of
individuals, families, groups, communities and populations.”
American Nurses Association (2015). Scope and Standards of Practice 3rd Edition, Nursebooks.org, Silver
Springs, Maryland. Page 1.
Future Blind vs Foresight
Future Blind vs Foresight
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.
Crucial Questions About the Future
• Why do we act in ways that
hurt our future?
• Why should we care about the
next forty years?
• How much responsibility do
we have to future
generations?
• From which aspects of reality
can we gain meaning and
purpose?
Tough, A. (1991). Crucial questions about the future. University Press of America. Lanham MD.
Crucial Questions About the Future
Tough, A. (1991). Crucial questions about the future. University Press of America. Lanham MD.
• How can we achieve a satisfactory
future?
• What will our actual future turn out
to be?
• How can each person contribute?
• Why is it worth trying?
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.
http://millennium-project.org/
State of the Future Index
Nursing Foresight
Nursing foresight is the ability to foresee and the act of
forecasting what will happen or be needed in the future in
light of emergent health care trends that have
consequences for population and planetary health, as well
as the profession’s purpose, definition, professional scope,
and standards of practice.
Generations of Nursing Process
• 1950-1970 Problems to Process
• 1970-1990 Diagnoses and Reasoning
• 1990-2010 Outcome Specification/Testing
• 2010-2030 Knowledge Modeling
• 2030-2050 Prescriptive Nursing
• 2050-2070 Predictive Nursing
Pesut, D., & Herman, J. (1998). OPT: Transformation of nursing process for contemporary nursing practice. Nursing Outlook, 46(1), 29-36.
Pesut, D. J. (2006). 21st Century Nursing Knowledge Work: Reasoning into the Future. In C. Weaver, C. W. Delaney, P. Weber, & R. Carr (Eds). Nursing and
Informatics for the 21stCentury: An International Look at Practice, Trends and the Future. (pp. 13-23). Chicago, IL: Health Care Information and Management
Systems Society, (HIMSS).
Think ~Pair~ Share
• I used to think……
• Now I think……
Futures Literacy Skills
• Awareness
• Discovery
• Choice
Miller, Riel. (2007). Futures literacy: A hybrid strategic scenario method. Futures, 39(4), 341-362
Becoming Future Literate
• Know your personal orientation toward time
• Consider the value of foresight thinking to support
anticipatory leadership.
• Learn about the future.
• Actively monitor industry trends, forecasts, disruptions.
• Discern logical consequences of trends using futures
thinking tools and techniques.
Pesut, D. (2000). Looking forward: Being and becoming a futurist. Nurses Taking the Lead.
Personal Qualities of Effective Leadership. Pennsylvania, PA: WB Saunders Company, 39-65.
Becoming Future Literate
• Appreciate the use of vision-based scenarios.
• Stimulate strategic conversations about espoused
visions looking backwards from the future.
• Navigate change efforts through the use of
Appreciation, Influence and Control (AIC).
• Build a leadership legacy through creating the
future.
Time Perspectives
• Past-negative
• Past-positive
• Present fatalistic
• Present hedonistic
• Future
• Transcendental future
• The time paradox survey
Zimbardo, Philip (2010). The secret powers of time RSA Animate –
Time Consciousness Knowledge Orientation Learning Mode Action Focus Performance
Right Now
(this moment)Awareness Data Instinctual
Data
(input)
Feedback
(awareness)
Present
(very short)Physical Sentience Information Single-Loop
Procedural
(procedure)
Efficiency
(know what)
Expanded Present
(short)Self-Reflective Knowledge Double-Loop
Functional
(engineer)
Effectiveness
(know how)
Medium to Long
(past to future)Communal Meaning Communal
Managing
(context)
Productivity
(know why)
Long Term
(far past and future)Pattern Philosophy Duetero
Integrating
(systems)
Optimization
(create why)
Very Long
(distant past to future)Ethical Wisdom Generative
Renewing
(purpose and values)
Integrity
(care why)
Timeless
(inter-generational)Universal Union Synergistic
Union
(co-creating)
Sustainability
(greater good)
Anticipatory Leadership Literacies
• Awareness
• Authenticity
• Audacity
• Adaptability
• Action
Ratcliffe, J., & Ratcliffe, L. (2015). Anticipatory Leadership and Strategic Foresight: Five ‘Linked Literacies’.
Journal of Futures Studies, 20(1), 1-18.
Leaders Make the Future• A maker instinct – ability to activate, build, and connect with others to
remake organizations.
• Clarity – ability to see through complexity and distill the essence of issues in complex situations.
• Dilemma Flipping- ability to turn dilemmas into polarities that need to be managed versus problems that need to be solved. (Perhaps recognize the complementary nature and competing values of issues).
• Immersive learning – jump into experience to learn from a first person perspective.
• Bio-empathy – ability to see things from natures point of view and to understand, respect and learn from natures patterns.
Johansen, Bob (2012). Leaders make the future: Ten new leadership skills for an uncertain world,
Berrett-Kohler, San Francisco, CA.
Leaders Make the Future• Constructive de-polarization – calm tense situations and positively
engage people even when differences are apparent.
• Quiet transparency – be open and authentic without undue self-promotion.
• Rapid proto-typing- create versions of innovations realizing that future success depends on early failures.
• Smart- mob organization – create, engage and link purposeful business and social networks.
• Commons creating – seed, nurture, grow shared assets that benefit others and allow competition at other levels in a system.
Johansen, Bob (2012). Leaders make the future: Ten new leadership skills for an uncertain world,
Berrett-Kohler, San Francisco, CA.
Future Studies
The purpose of future
studies is not to predict
the future, but to
envision desirable
futures and avoid or
prevent catastrophic
ones.
http://www.wfs.org/
https://www.wfsf.org/about-us
If a time traveler from 25
years in the future could
give you the answer to one
question, what would it be?
Wonder
Pride
If you were looking back
10 years from now and
telling the tale of the
organizations/
professions 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 or nursing
professions greatest
failure, what would the
story be and why?
Memory
What does the organization
or profession need to
forget?
What must the organization
or profession always
remember?
Imperatives
What are the most
important strategic
decisions the
organization or
profession must make
today in order to realize
a desired future?
Obstacles and Dangers
What will prevent the
organization or
profession from
succeeding?
What are the greatest
risks and dangers?
Priorities
If you had the power to
do one thing for the
organization or
profession what would it
be, and why?
Navigating the Future with Nursing
Foresight
Wonder
Pride
Shame
Memory
Imperatives
Obstacles and Dangers
Priorities
1-2-4- all
Progressive, Rapid Cycle Conversation
http://www.liberatingstructures.com/1-1-2-4-all/
“Future studies is the art and science of
taking responsibility for the long term
consequences of our decisions and our
actions of today.”
Gidley, Jennifer. ( 2017). The Future : A Very Short
Introduction, Oxford University Press, UK.
Reactions to Learning About the Future
• Patterns of Mind
• Patterns of Heart
• Patterns of Soul
• Alignment
– Values
– Beliefs
– Action
Rogers, M. (2012). 15. Student responses to learning about futures. World Yearbook of Education 1998: Futures Education, 203.
“The future happens at the intersection of
knowledge and services… and if you
have the knowledge you can provide the
service.”
- Daniel J Pesut
Actively Monitor Trends, Forecasts,
Disruptions
“If your organization is more frog than
bat, perhaps you need to change it?”
Deering A., Dilts, R., & Russell, J. (2002). Alpha leadership: Tools for business leaders
who want more from life. John Wiley, NY.
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.
Trends, Consequences, Disruptions
Personal
Professional
Organizational
Social
Planetary
Future Today Institute
The National Center for Healthcare
Leadership
• The US will become part of a global system focusing on wellness and preventive care worldwide.
• Patients will receive care from “virtual” centers of excellence around the world.
• Deeper understanding of the human genome will create exciting new forms of drugs that will prevent disease from developing. Treatment will evolve from disease management to prevention or minimization.
• As the “baby boomers” become senior citizens around 2020 the issue of rising costs, resource allocation and priorities will be exacerbated.
The National Center for Healthcare
Leadership
• Fueled by access to information through the World Wide Web,
people will take more self-management of their personal health
decisions and demand that the system treat them as customers
rather than users.
• Most Americans will receive care from specialized centers for
chronic diseases (cancers, women’s health, heart etc.)
• Standard diagnostic health will largely be electronic, with people
conducting their own “doctor visits” from home through miniature
data collection and monitoring devices.
Future Work Force: Vital Skills
Sense making
Social intelligence
Novel and adaptive thinking
Cross cultural competency
Computational thinking
New media literacy
Transdisciplinarity
Design mindset
Cognitive load management
Virtual collaboration
Health Care TrendsHealth Hyper Efficiency✓ Empathetic Health Interfaces,
✓ Predictive Psycho-history
✓ Unhealthy Surveillance
The Personalized Health Movement✓ Augmented Nutrition
✓ The Device Divide
✓ Multicultural Misalignment
✓ Medical Genealogy
✓ Neuroinfluence Mapping
✓ Natural Medicine
✓ Healthy Real Estate
✓ The Over Quantified Self
✓ Micro Health Rewards
Digital Peer to Peer Health Care✓ Care Hacking
✓ Accelerated Trial Sourcing
✓ Virtual Counseling
Future Health Scan
• Globalization
• Cost containment and outcomes
• Advanced personalized therapies
• Information infrastructure advances
• Human genome project
• Predict-and-manage paradigm
Personal Health Systems
Foresight Project
http://www.phsforesight.eu/comment
The Surprising Power of Liberating Structures
Navigating the Future with Nursing Foresight
25/10 Crowd SourcingRapidly generate and sift a group’s most powerful actionable ideas
On index cards, each participant writes:
• What is one significant future trend you believe is likely to transform the profession of nursing or your organization in the next 10 years?
• No namesWrite legibly
25/10 CrowdsourcingRapidly generate and sift a group’s
most powerful actionable ideas
• Pass cards around while milling
• 5 rounds: stop & rate the card in
hand
• Rate each card: 1 = ho-hum to 5 =
fabulous, “I’m in!”
• Decide* before looking at other
scores Put rating on the back of
the card
Final Steps Rapidly generate and sift a group’s
most powerful actionable ideas
• Add all the scores* after the last round
• Call out the score on your card (max score 25)
• Post high-to-low scoring ideas on a wall tapestry
• Cards will be collected and trends ranked
* If you have more than 5 scores, add them together, divide by the total number of scores, then multiply by 5
High
Low
Discern Consequences of Trends
Flaring A Six Step Forecasting Method
Webb, A. (2016). The Signals are Talking: Why Today's
Fringe is Tomorrow's Mainstream. Public Affairs.
The Five Whats of Trends• 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?
Becoming a Trend CuratorBe curious always asking why, investing in learning and improving knowledge
through investigation and questions.
Be observant learn to see small details in stories and life that others may
Ignore or fail to recognize as significant.
Be fickle move from one idea to the next without becoming fixated or over
Analyzing each idea in the moment.
Be thoughtful take time to develop a meaningful point of view and consider
Alternative viewpoints without bias.
Be elegant seek beautiful ways to describe ideas that bring together disparate
Concepts in simple and understandable ways.
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.
Past Present Future Wheels
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.
This Photo by Unknown Author is licensed under CC BY-SA
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.
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?
The Future• Knowledge
– Genetics
– Informatics
– Artificial Intelligence
– Alternative RX
– Gaming
– Aging
– Biotechnology
• Services
“What the future holds for us
depends on what we hold for the
future.”
Tarlow, Mikela. (1998). Navigating the Future: A Personal Guide to
Achieving Success in the New Millennium. McGraw-Hill/Contemporary.
You as a “Power-Full” Leader
Smith, William (2009). The creative power: Transforming ourselves, our organizations and our world. Routledge, New York,
Ideals
Goals
Values
Influence
Appreciation
Control
The Whole
Others
Self
PURPOSE
RELATIONS POWER
Smith, William (2009). The creative power: Transforming ourselves, our organizations and our world.
Routledge, New York, New York ISBN 0-415-39360-4 see www.odii.com
The New Leadership Literacies
✓ Look backward from the future
✓ Voluntary fear engagement
✓ Leadership for shape-shifting organizations
✓ Being there when you are not there
✓ Create and sustain positive energy
Foresight ~Insight~ Action
Pledge to Future Generations
Tough, Allen. (1993). Making a Pledge to Future Generations, Futures, 25,90-92 https://doi.org/10.1016/0016-3287(93)90120-
I
Think ~Pair~ Share
✓ What concept, idea, did you find interesting and /or useful?
✓ How can the knowledge be used ?
✓ Why is the knowledge important?
✓ Why care about the knowledge or information?
Navigating the Future with
Nursing Foresight Daniel J Pesut PhD RN PMHCNS-BC FAAN
Professor of Nursing Population Health and Systems Cooperative Unit
Director of the Katharine Densford International Center for Nursing
Leadership
Katherine R. and C. Walton Lillehei Chair in Nursing Leadership
University of Minnesota School of Nursing
308 Harvard St. SE
4-185 Weaver-Densford Hall
Minneapolis, MN 55455
Office Phone number: 612-626-9443
© 2017 All Rights Reserved
