Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California90024, USA.
J Am Coll Radiol. 2011 Mar;8(3):175-9. doi: 10.1016/j.jacr.2010.08.022.
In facing future developments in health care, scenario planning offers a complementary approach to traditional strategic planning. Whereas traditional strategic planning typically consists of predicting the future at a single point on a chosen time horizon and mapping the preferred plans to address such a future, scenario planning creates stories about multiple likely potential futures on a given time horizon and maps the preferred plans to address the multiple described potential futures. Each scenario is purposefully different and specifically not a consensus worst-case, average, or best-case forecast; nor is scenario planning a process in probabilistic prediction. Scenario planning focuses on high-impact, uncertain driving forces that in the authors' example affect the field of radiology. Uncertainty is the key concept as these forces are mapped onto axes of uncertainty, the poles of which have opposed effects on radiology. One chosen axis was "market focus," with poles of centralized health care (government control) vs a decentralized private market. Another axis was "radiology's business model," with one pole being a unified, single specialty vs a splintered, disaggregated subspecialty. The third axis was "technology and science," with one pole representing technology enabling to radiology vs technology threatening to radiology. Selected poles of these axes were then combined to create 3 scenarios. One scenario, termed "entrepreneurialism," consisted of a decentralized private market, a disaggregated business model, and threatening technology and science. A second scenario, termed "socialized medicine," had a centralized market focus, a unified specialty business model, and enabling technology and science. A third scenario, termed "freefall," had a centralized market focus, a disaggregated business model, and threatening technology and science. These scenarios provide a range of futures that ultimately allow the identification of defined "signposts" that can suggest which basic features among the "possible futures" are playing out. Scenario planning provides for the implementation of appropriate constructed strategic responses. Scenarios allow for a pre-prepared game plan available for ready use as the future unfolds. They allow a deliberative response rather than a hastily constructed, urgent response.
在面对未来医疗保健的发展时，情景规划为传统战略规划提供了一种互补的方法。传统的战略规划通常包括在选定的时间范围内预测未来的一个单一时间点，并规划首选方案以应对未来，而情景规划则在给定的时间范围内创造了多个可能的潜在未来的故事，并规划了首选方案以应对多个描述的潜在未来。每个情景都是故意不同的，而不是共识的最坏情况、平均情况或最佳情况预测；情景规划也不是概率预测过程。情景规划侧重于高影响力、不确定的驱动力，这些驱动力在作者的例子中影响了放射学领域。不确定性是关键概念，因为这些力量被映射到不确定性的轴上，这些轴的两极对放射学有相反的影响。选择的一个轴是“市场焦点”，两极分别是集中的医疗保健（政府控制）与分散的私人市场。另一个轴是“放射科的商业模式”，一极是统一的单一专业，另一极是分裂的、分散的亚专业。第三个轴是“技术和科学”，一极是使放射科受益的技术，另一极是对放射科构成威胁的技术。然后，将这些轴的选定极点组合起来创建 3 个情景。一个情景，称为“创业主义”，由分散的私人市场、分散的商业模式和威胁性的技术和科学组成。第二个情景，称为“社会化医疗”，具有集中的市场焦点、统一的专业商业模式和使能技术和科学。第三个情景，称为“自由落体”，具有集中的市场焦点、分散的商业模式和威胁性的技术和科学。这些情景提供了一系列未来，最终可以确定哪些基本特征正在“可能的未来”中发挥作用。情景规划为实施适当的构建战略响应提供了条件。情景规划为未来展开时可随时使用的预先准备的游戏计划提供了条件。它们允许进行深思熟虑的响应，而不是仓促构建的紧急响应。
