Future Search The Method

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Healthcare Overview

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.

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."


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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