Futures Literacy in Health Care: The Managed Outcomes Project Paul Forte 1, Riel Miller 2, Tom Bowen...
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Transcript of Futures Literacy in Health Care: The Managed Outcomes Project Paul Forte 1, Riel Miller 2, Tom Bowen...
Futures Literacy in Health Care:The Managed Outcomes Project
Paul Forte1, Riel Miller2, Tom Bowen1
1The Balance of Care Groupwww.balanceofcare.com
2UNESCO1st International Conference on Anticipation, Trento 5-7 November 2015
2
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
3
‘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
1st International Conference on Anticipation. Trento 5-7 November 2015
4
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
5
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
1st International Conference on Anticipation, Trento 5-7 November 2015
6
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)
1st International Conference on Anticipation, Trento 5-7 November 2015
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 wheremore 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
10
Time from admission to CT Scan
0
50
100
150
200
250
<=1 1-3 3-24 >24 NK
Hours from admission to CT Scan
No
of p
atie
nts
adm
itted
2010-11
2011-12
1st International Conference on Anticipation, Trento 5-7 November 2015
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
111st International Conference on Anticipation, Trento 5-7 November 2015
12
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’
1st International Conference on Anticipation. Trento 5-7 November 2015
13
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
1st International Conference on Anticipation. Trento 5-7 November 2015
14
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 front-line’
1st International Conference on Anticipation. Trento 5-7 November 2015