Preparing for change: strategic foresight scenarios.

Most people need stimulus to move from worrying about current problems to planning for the future. A carefully crafted strategic foresight scenario (SFS) can provide that stimulus. Recently, Allen Memorial Hospital, a 240-bed facility in Waterloo, Iowa, set up a management development team to help prepare hospital staff for changes that were expected to result from a reengineering study. One of the techniques they chose was to create an SFS. Strategic foresight exercises are often used at the highest management levels of corporations to prepare for strategic planning. At Allen, the exercise was prepared for use at all levels of staff to prepare for imminent change. A good scenario can stimulate foresight; it can show how relevant driving forces may affect not only the industry but also your individual health system. It identifies specific forces affecting healthcare delivery systems, tests assumptions for the future, assesses alternative and plausible futures and can form a springboard for future planning. A group of six employees considered factors that would affect healthcare delivery in 2005, drew on their creative energies and wrote a scenario (which is included in the article). The scenario is carefully written and follows a story line that is personal and specific to Allen. When presented to a group of senior managers, it was received with great interest and prompted discussion that ran beyond the designated meeting time. The SFS exercise successfully prepared staff at Allen for change, not by predicting the future but by modeling and inspiring an open-mindedness and active approach to the future.