Quality in Healthcare

Force Field Analysis

By Bjørn Andersen, Tom Fagerhaug, and Marti Beltz

Force field analysis is based on the assumption that any situation is the result of forces for and against the current state being in equilibrium. Countering the opposing forces and/or increasing the favorable forces will help induce a change.

Conduct a force field analysis through the following steps:

• Brainstorm all possible forces inside and outside the organization that could work for or against the solution.
• Assess the strength of each of the forces.
• Place the forces in a force field diagram, with the length of each arrow in the diagram proportional to the strength of the force it represents.
• For each force, but especially the stronger ones, discuss how to increase the forces for the change and reduce those against it.

Example

An office-based surgery center needed to uncover patients’ use of herbal supplements and instruct them to cease use some time before surgery.

The center decided upon a number of different actions. Some revolved around the preoperative telephone interview conducted days in advance of the procedure:

• Allocating two “silent rooms” in which to conduct these interviews.
• Instructing the interviewers to press for clear answers to questions regarding patients’ use of supplements.
• Developing an interview guide/checklist where the interviewer can check off responses obtained to record the answers.
• In the longer run, employing at least one nurse with language skills beyond English.

Realizing that some of these remedies might meet with resistance from staff or patients, the analysis team decided to assess the implementation situation using force field analysis. The analysis is shown below. 

This force field analysis identifies patients’ embarrassment or reluctance to answer honestly as the most serious obstacle. In favor of implementation, the much higher likelihood of avoiding supplement-related complications should induce interviewers to be more persistent in obtaining answers.