Future Search in Healthcare
The health care sector is entrusted to promote, protect and support the health and well-being of the children, families and others that it serves. This is a huge challenge with the many factors competing within the health care system today. These include: demands for profitability, staffing and labor issues, professional contracting, coordination of services, treatment costs, public perceptions, bureaucratic dynamics, social and cultural issues such as racism, income and citizenship status, patient demands, legal realities and business and market dynamics to name a long partial list. Facing these issues raises huge organizational questions.
Novosibirski, Russia. The Chief of the Medsanchast (Clinic & Hospital) in Novosibirski, Russia – Gennadiy Zakharovich Rot – said to me: “Strategic planning workshop? How can I invite people for a meeting when I don’t know myself, what we will be facing in the coming year, since, by the order of governor of the region, we will be kicked out of the obligatory medical insurance system as a non-government clinic?” I answered him, “Well, this is really the right time to gather all collective: administration, chiefs of the departments, senior doctors, doctors, medical sisters and nurses, to work on a common plan, so that the people in this facility can effectively respond to developing circumstances, so that they will know how to develop mutual plans and to work together.” And we did gather! It was a big innovation for Gennadiy Zakharovich, who made the decision to use this “modern” method with his collective in such difficult conditions. The faces of people, who gathered in the room, was not the kind I would have thought boded well for a successful Future Search. They were as white as their hospital gowns, the faces of people who had worked the full week, coming together on Friday, to face more work on Saturday and Sunday.
With great concern, participants listened to our facilitators’ introduction, and started to work, to analyze their past. Their faces became more alive, but, I should say, there were very few words on the timeline. The reports of analyses of the past were also short, though, it was a pleasant surprise, that they could say anything at all from the small amount of material on the timelines on the walls. As the meeting went on, the energy changed and enthusiasm developed as we looked toward the future possibilities for the clinic. The Chief of the Surgical Department said of his experience at the Future Search, “I would say that at first I has a negative attitude toward this conference . . . it seemed to me, that I know how we have lived, how we live now and the perspective is so unpleasant, that I was discouraged about what we could discuss. It seemed like anything different was impossible. But, it turned out that everything is not so, that everything is just the opposite . . . it was very pleasant to work in the collective, in the collective of associates, with people, who have good will . . . It was valuable to get beyond the past and present and focus on the future – here we have the possibility of very interesting projects.”
How Future Search Can Help Healthcare Systems
It is important that health care organizations, along with their programs and services, be driven by, and implement, healthy guiding principles. One public health organization, for instance organized itself around family-centered care, community-wide leadership, resiliency, outreach, and cultural and linguistic competence. Their ability to effectively implement this greatly increased the health of the community it served.
Whatever principles an organization chooses, it is important to make those principles come alive the organization. You can’t do it on the outside, if you don’t do it on the inside. Future search provides a tool coherent in its principles and practice. It supports solutions and action which builds on the core principles of inclusion and collaboration. It produces effective commitment to action based on the discovered values, skills and knowledge commonly shared within an organization. Often an organization spends 80% of its time focusing on the 20% of the things it disagrees about. Future search is effective at shifting the dynamic so that organizations can act from their common center.
Some ways Future Search has helped Healthcare Systems
- Providing a chance for consumers of health care to be in dialogue with people in charge of large health care systems and organizations.
- Providing a forum to launch innovative actions to address the underlying factors that affect the health of people and communities.
- Fostering essential but previously unlikely partnerships to create more humane systems that promote healing.
- Bringing together stakeholders from medicine, managed care, foundations, insurance companies, education, faith, community, government, and families to discover common ground.
- Enabling stakeholders to tap into the strengths, resources, resiliency, and capacity of people in the healthcare system.
Changing the Culture of Misuse of Alcohol and Drugs, Northern Ireland
Future Search helped the Addiction Services community of Belfast see themselves as a system with different approaches and priorities, but with common goals. Northern Ireland has a fragmented public administration. Years of conflict and political vacuum put non-governmental organizations in charge of public services like education, housing, and tourism, far from political control. As a result of the Future Search they organized to create coordinated plans that are now really helping the people they serve.
There are 11 states in the United States where Home Birth is illegal and some women have faced serious backlash. At the same time, the rate of women wanting birth-setting choice is on the rise, with more women and their partners seeing it as a critical part of the birth experience. A multidisciplinary group of leaders planned a Future Search, called the Home Birth Summit, and brought together consumers, midwives, physicians, hospital administrators, legislators and public health for a groundbreaking meeting to support women’s choice and ensure safety. In three intense days of dialogue and discovery, they unpacked assumptions they held about each other and reached agreement on 9 Common Ground propositions. They meet every two years and continue reaching new levels of collaboration. US Congresswomen Royball – Allard Less than a month after the Future Search, Congresswoman Lucille Roybal-Allard (CA-34) recognized the recent Home Birth Consensus Summit held in Virginia. For more see homebirthsummit.org.
» MAINE EARLY CHILDHOOD INITIATIVE FUTURE SEARCH
Our goal was to discover our common ground for the future of Maine’s children and to initiate action. We built upon the work of the Task Force on Early Childhood, chaired by First Lady Karen Baldacci. 75 stakeholders attended the Future Search from many sectors: parents, guardians, families; children and youth; state, local and federal government; investors (business, philanthropy, health insurance); education (primary-graduate); early care and education providers; health care providers; community organizations, leaders, clergy and advocates. They were able to create and strengthen partnerships across departments, programs, systems and other boundaries. They developed new cross-cultural strategies and got a long-term commitment to dignifying and humanizing the life of their statewide community. By writing Future Search into the MCH Grant, Maine started a process of systematically incorporating Future Search principles and process into the ways it views the early childhood population.
» Functional Assessment in Job Injuries in Southern Ontario Province, Canada
A research team from McMaster University organized a meeting to address challenges with conducting, using and assessing Functional Assessments (FA). The research team had just finished a two-year study documenting FA by following 70 injured workers. The researchers believed that through Future Search a more effective and evidence-based approach to FA could be created to assist all stakeholder groups, including injured workers, healthcare representatives, employers, health care representatives, labour groups and the Workplace Safety Insurance Board. After the Future Search, one participant said, ” I think the format was excellent in terms of allowing everyone to see the various perspectives and goals the different stakeholders have and how, despite the diversity, we can become a venue for change by consolidating these resources.”
University Health Center, Quebec, Canada
Seventy-two partners of a large University Health Center got together in a Future Search to clarify their mission and address these issues: relations between the health network and the community, services offered, relations with patients and their family, management philosophy and the role of one of the three newly-merged hospitals. They created multi-partner task forces. A year later, 175 enthusiastic persons attended a one-day Review Meeting to continue coordination of these major projects.
Reproductive Health in Northern Nigeria, Africa
Future Search, sponsored by David and Lucille Packard Foundation, brought diverse stakeholders into the room to establish a comprehensive plan for reproductive health in Northern Nigeria. A year and one-half later, a second Future Search was held to build on the initial effort, include more people, and broaden the impact of the work. The American Public Health Association selected a paper by Mike A. Egboh on this Future Search to be presented at the association annual meeting. The paper is entitled: “Reaching common ground on Reproductive Health services in Islamic communities: Impact of Future Search methodology in northern Nigeria”
Lakeland Regional Health System, Berrien County, Michigan
A large group of physicians, nurses, patients, hospital administrators and community leaders assembled for the purpose of improving ‘the patient experience” in their local healthcare organization. Lakeland Regional Health System (LRHS) is a recently integrated system of hospitals, nursing homes and outpatient facilities, located in Southwest Michigan. Using Future Search as part of their strategic and facility planning effort, Lakeland improved patient satisfaction by delivering more convenient and effective patient-centered care.