Futures Literacy in Health Care:
The Managed Outcomes Project
Paul Forte1, Riel Miller2, Tom Bowen1
1The Balance of Care Group
www.balanceofcare.com
2UNESCO
1st International Conference on Anticipation, Trento 5-7 November 2015
The FP-7 ‘Managed Outcomes’ Project
www.managedoutcomes.eu
• Effect of organisation and management of care
processes on patient health outcomes for:
•
•
•
•
type 2 diabetes
acute stroke care
dementia
hip osteoarthritis
• Case study comparison of health networks and patient
outcomes (EQ-5D)
• Finland, Netherlands, Spain, Greece, Germany, England
• Scenarios to address existing and future health needs
1st International Conference on Anticipation, Trento 5-7 November 2015
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‘Futures Literacy’ methodology
• Aims to deepen understanding of current procedures and
how these might be affected by assumptions about the
future
• Level 1 – Catalytic Awareness
– Where are the trends going?
• Level 2 – Imaginative Discovery
– Breaking out of current assumptions
– Unconstrained futures
• Level 3 – Strategic Choice
– What changes can be made now given the above?
1st International Conference on Anticipation, Trento 5-7 November 2015
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Why scenarios?
• Highlight important relationships between
process and outcomes
• Combinations which optimise various elements
and perspectives including delivery channels
• Insights from model elements and FL
perspectives
• Stories about the future; insights for the present
1st International Conference on
Anticipation. Trento 5-7 November 2015
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Futures Literacy and Managed Outcomes
• Why use it?
– Better suited to our timescales, resources and
available expertise than a ‘Delphi’ process
– Advantages of an ‘action research’ approach
• Who was it for?
– Participants from the case instance location working
in the same clinical domain, but across different
organisations
– Clinical and non-clinical backgrounds
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Scenario workshop format
•
•
•
•
•
Systematic
Facilitated by Managed Outcome researchers
Involved wide-ranging local expertise
Time and resource constrained
Format:
– Relevant Managed Outcomes case study introduction
– Level 1: Catalytic Awareness (group discussion)
– Level 2: Imaginative Discovery (group discussion)
– Level 3: Strategic Choice (plenary)
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Futures workshops: the challenge
Stroke
Hips
Diabetes
Dementia
England
Yes
Yes
Yes
Yes
Finland
Yes
Yes
No
Yes
Greece
Yes
Yes
Yes
Yes
Netherlands
Yes
Yes
Yes
No
Spain
Yes
Yes
Yes
Yes
In some case studies workshops were held separately; at locations where
more than one case study took place there were some joint workshops with
case-specific streams.
Most workshops ran for half or full days depending on availability of participants.
Training, development of materials and delivery – 6 month timescale.
1st International Conference on Anticipation, Trento 5-7 November 2015
Stroke scenarios
• Rapid access to specialist stroke team
- prioritise this over thrombolysis and related processes
- distance issue becomes less important
• High prevention/awareness strategy (minimise
stroke)
- reduced incidence
- increased thrombolysis
1st International Conference on Anticipation, Trento 5-7 November 2015
1st International Conference on Anticipation, Trento 5-7 November 2015
Some follow-up data
Time from admission to CT Scan
No of patients admitted
250
200
150
2010-11
2011-12
100
50
0
<=1
1-3
3-24
>24
NK
Hours from admission to CT Scan
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Type 2 diabetes scenarios
– Low cost
• maintain patients as long as possible in early
stage of the condition
– Prevention
• active management of patients at all stages
including pre-diagnosis
– ‘Zero complications’
• no ‘excess risk’ for stroke, amputation, sight
problems
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Useful experience gained
• Clarity of the workshop objectives:
– pre-workshop meetings to clearly define workshop
objectives and outcomes?
• Importance of relating the FL approach to participants
who have a predominantly operational rather than policy
focus
• Increased importance of facilitation in ‘short workshops’
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Conclusions
• Valid and useful methodology which was easy to apply
and enthusiastically received by participants
• Had an ‘instant’ effect for those taking part as well as
providing material for enriching the development of the
Managed Outcomes scenarios
• Efficient of project time and resources available
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The views of participants
• ‘We rarely have time as a group to sit down and do this
kind of thinking – very helpful to know what colleagues
think of these issues’
• ‘Good to meet other people working on the same field
but with different approach – an opportunity to develop
links for future collaboration’
• ‘We are all looking forward to meeting in a few months
to review the final figures (never seen my team so
animated with facts and figures!)’
• ‘A useful day and good to take a breather from the frontline’
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