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The health care
sector is entrusted to promote, protect and support, to whatever extent
possible, 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. For
example, what constitutes a healthy organization, and how does that
affect the health care services it provides? If leaders and staff
ignore entrenched problems within health care organizations - such as
institutional racism, in which employees feel that they have been
discriminated against and this is not addressed - the wounds fester.
This kind of unhealthy organization is bound to have ripple effects out
into the world it serves.
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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 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.
Attendance was supposed to
be "voluntary," though I
overheard the manager of the clinic and our workshop respond to a
person who got sick and asked permission not to come to the gathering
say, by telephone, "But you are not in the Reanimation! Gennadiy
Zakharovich said, that everybody who is not in the reanimation should
come!"
With great concern
participants listened to our
facilitators' introduction, though it was after encouraging speech of
the Chief of the Clinic, and started to work, to analyze their past.
Their faces became more alive, but, I should say, there were very few
words on the 'wall'. 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 time lines on the walls.
As the event went on, the
energy changed and enthusiasm developed as we looked toward the future
possibilities for the clinic
Sergey Sparin. 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."
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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 with these organizational needs structural demands. 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.
The value of future search in health care:
- Represents a chance for consumers of health care,
including people
often stripped of their dignity, to be in dialogue with people in
charge of large health care systems and organizations.
- Provides a forum to launch innovative actions that
address the
underlying systemic factors that affect the health of people and
communities.
- Fosters essential but previously unlikely
partnerships to create more humane systems that promote holistic
healing.
- Brings together stakeholders from medicine, managed
care,
foundations, insurance companies, education, faith, community,
government, and families.
- Overcomes turf issues in health care that block
people and
organizations from taking steps toward unity and respect. An example is
the longstanding mistrust between academic medical centers and
communities of color that prevents the two from collaborating to
prevent youth violence.
- Enables deeply divisive issues such as institutional
racism to be addressed in constructive ways.
- Intensifies the growing urgency to include citizens
in all phases of health care programs, policies, services, and systems.
- Clarifies the importance of viewing health within an
interconnected
ecological context that honors social connectedness and the quality of
human relationships as one of the most important determinants of health
status.
- Enables health care to rise above traditional models
based on
morbidity, mortality, risk, and deficits. Instead, it taps into the
strengths, resources, resiliency, and capacity of people and
organizations to become healthy in mind, body, and spirit.
- Because children and families represent our future,
the extent to
which we have systems and policies that honor and promote their health
will, in effect, determine how successful we are at becoming a more
just, more peaceful, and less violent society. Future search can help
us implement this.
- Bring together diverse people to envision a community
where
children are healthy and thriving, and where families are loving and
affirming, helping them realize how much they have in common. Future
search in the health sector brings alive the biological reality that
human beings are 99.9 % genetically alike.
- Paves the way for health care that is culturally and
ethnically
sensitive and proficient. Future search honors and respects the
uniqueness of cultures and the potential for diversity to enrich a
person's health. The rapidly changing demographic diversity of the
United States is fertile ground for future searches.
- Illuminates the deeper meaning of access to health
care. People are
gifted with intuition. They intuitively know when they call a medical
office to what extent they are honored and welcomed. When you feel like
you are imposing on the very people you count on to help you, the
motivation to engage with the systems disappears. Consumers of health
care intuitively sense whether an organization has got its act together.
- Brings out the necessity for having healthy employees
in order to
strengthen the health care's productivity. Healthy employees depend on
an organization that honors diversity and the unique creativity and
gifts that each person brings to that organizations.
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