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SWOT and Force Field Analysis
Healthcare Organization and Management · Chapter 9: Goal Setting, Analysis Tools, and Strategic Alignment in HealthcareSection 9.2 · lesson 55 of 1059 min · free with a free account
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In this lesson
Using SWOT to assess position and force field analysis for change.
- Classify SWOT entries using the internal-external and present-prospective dimensions
- Avoid four common SWOT classification errors
- Turn a SWOT into strategic moves through paired reading
- Apply force field analysis by reducing restraining forces
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Transcript
Everything said in the video, section by section (1,168 words). Read along, or search it.
Opening Case
A Forty-One Entry SWOT
Larkfield's planning team has a draft SWOT. It runs to forty-one entries. Its first strength reads, our reputation is excellent. Its first threat reads, nurse recruitment is hard. It looks thorough, and a board would probably accept it. But is it an analysis, or just four lists? By the end, you'll be able to tell.
Two Dimensions
Internal or External, Present or Prospective
A SWOT assesses position in four categories, built from two dimensions. The first is internal versus external. Internal means within the organization's control. External means not. The second is present versus prospective. Present means demonstrable now. Prospective means it hasn't happened yet. So strengths and weaknesses are internal and present: assets and gaps Larkfield holds today. Opportunities and threats are external and prospective: developments it could exploit, or that could hurt it. An entry that fails either test sits in the wrong box, and it produces strategies aimed at things the organization can't act on.
Three Disciplines
Evidence, Comparison, and Few Items
Three disciplines make a SWOT useful. First, evidence for every entry: a measure, a comparison, an outside report. An entry with no evidence is an opinion. Second, relative claims. A strength is strong compared with something. Good staff isn't a strength. Nurse retention clearly better than comparable local employers, in a scarce group, is. Third, a limited number of items. Forty entries rank nothing, and building them exhausts the group before the analysis starts. Three or four per box, chosen for importance, is usable.
Classification Errors
Four Ways a SWOT Goes Wrong
Four classification errors destroy a SWOT. One: internal items filed as external. Our waits are too long is a weakness, not a threat, because Larkfield controls its waits. Filing it as a threat turns a fixable problem into weather to endure, which is exactly why the error is tempting. Two: aspirations recorded as strengths. Our commitment to integrated care is a strength only if that care is visibly delivered. It's the commonest error, and the most uncomfortable to fix. Three: assertions with no evidence. Larkfield's reputation may well be excellent. A strategy built on it is still built on an untested premise. Four: weaknesses disguised as threats. Hard recruitment is a threat if the labor market changed for everyone, and a weakness if comparable hospitals recruit fine. Comparison decides.
Quick Check
A Regional Technologist Shortage
Quick check. Larkfield can't fill three radiology technologist posts. Every hospital in the region reports the same shortage, and state data show fewer graduates. Where does it belong in Larkfield's SWOT? Pause, and decide. A threat. The comparison shows the cause is outside Larkfield's control: every comparable hospital faces it, and the supply of graduates is shrinking. Weakness is tempting, because the empty posts are Larkfield's. If nearby hospitals were filling the same posts easily, it would be a weakness.
Paired Reading
Four Pairings, Four Kinds of Move
A SWOT isn't finished when the boxes are full. The analysis is the paired reading, and each pairing generates a different kind of move. Strength with opportunity is the offensive move. Larkfield's strong nurse retention, with a clinic asking for a partner, means it could staff a shared pathway a rival couldn't. Weakness with threat is the defensive move, and the most urgent. Long waits in two clinics, with a rival opening nearby, must be fixed before it opens. Strength with threat is the protective move: which strength blunts which threat? And weakness with opportunity is the conversion question: what would we have to build to take it? Four filled boxes that are never read in pairs are four lists, not an analysis.
SWOT Limits
Adding Likelihood, Timing, and a Date
A SWOT also has limits. It's a snapshot with no weighting. It can't say which strength matters most, how likely a threat is, or how long an opportunity stays open. Two cheap additions help. Mark each outside item with a rough likelihood and timing, so a threat arriving next quarter isn't weighed like one that might come in five years. And date the analysis, with a review date. A SWOT more than a year old may describe a position the organization has already left.
Force Field Analysis
Driving and Restraining Forces
SWOT assesses position. Force field analysis, from the psychologist Kurt Lewin, examines movement: one specific change, and the forces acting on it. Say Larkfield plans to move its wound-care clinic to the Eastside community health center. Driving forces push toward it: shorter trips, freed hospital space, and a willing partner. Restraining forces hold it back: no diagnostic support at the new site, staff travel time, and no system access there. The arrow weights are judgments, not measurements, and the diagram should say so. Their value is in comparing forces, not in the numbers.
Key Insight
Removing a Restraint Beats Pushing Harder
Here's the insight that makes the tool worth using. Reducing a restraining force usually moves a change further than adding a driving force. Push harder against unaddressed resistance, and the resistance pushes back harder. The change moves a little, then slips back when the pressure stops. Remove a restraint, and the situation itself changes, so the change holds without constant effort. Faced with resistance, the instinct is to argue harder, add incentives, or use authority. All three add driving force. Here, the better move is arranging diagnostic support at Eastside.
Running the Session
Getting Honest Restraining Forces
A force field is only as honest as its restraining forces, and that depends on the room. Three conditions matter. The people who'll live with the change must be present, because the restraints are mostly theirs. Without them, you list only what managers imagine. Naming a restraint must not be treated as opposing the change. The chair says so, then acts that way the first time it happens. And the change's sponsor shouldn't chair. People won't volunteer objections to the person who proposed it. A session that produces four driving forces and one restraining force hasn't learned about the change. It's learned about the session.
Quick Check
A Quiet Room for Handover
Quick check. Larkfield wants a structured handover format on three units. Nurses say handover happens at a crowded station, with constant phone calls and interruptions. Which first step would a force field point to? Pause, and decide. A quiet handover room. The interruptions are the restraint, and removing them changes the situation, so the new format can hold. The memo and the award are tempting, because they're quick and visible. But both add pressure against a restraint that's still there.
Using Both Tools
Position First, Then the Change
The two frameworks answer questions in sequence. SWOT comes first: where does the organization stand, and what are its strategic issues? Force field comes later, applied to a specific change that's been chosen, asking what will make it move. A force field on a position just confuses. A SWOT on one operational decision produces four lists nobody needs. Back to Larkfield's draft. Cut to a dozen entries, each with its evidence named, then read in pairs, it becomes an analysis. And date both. A decision whose analysis can't be produced gets reopened.
Key Takeaways
Evidence, Pairs, and Restraints
To recap. SWOT rests on two dimensions: internal or external, present or prospective. Every entry needs evidence and a comparison, three or four to a box. The paired reading turns four boxes into moves. In a force field, removing a restraint usually beats adding a push. And use SWOT for position, then force field for a chosen change.
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