title: Megatrends, the annual report, possibilities.
abstract: The successful leader and manager have two very important challenges: to scan the horizon and not be thrown into crisis by not seeing predictable surprises, and to recognize the longer, more pervasive trends that are in the more distant future. In reality, these two processes merge and drive the future planning of the patient care enterprise. The merger of the operational imperatives and the long-range trends that create very different ways for us to work is the work of leaders. In the words of Senge and colleagues (2004), we are at the end of the era of hierarchical leadership and at the beginning of distributed, shared networks where "...becoming a real human being really is the primary leadership issue of our time" (p. 186). As we finish a year and begin a new one, it is time to look backward, look forward, and "see" the new world. We must also look into ourselves to see the inner work we need to do to meet the challenges of the next 5 years.
authors.affiliation: Kerfoot and Associates, Indianapolis, IN, USA. karlene@indy.rr.com
authors.forename: Karlene
authors.initials: K
authors.lastname: Kerfoot