Strengths, weaknesses, opportunities, and threats in nursing

¶ … SWOT analysis focuses on identifying the internal strengths and weaknesses, along with the external opportunities and threats, for an organization. In this case, the SWOT analysis will be done on a specific situation, with a large number of items under each. The initial SWOT analysis for the situation presented is as follows

Strengths

Weaknesses

Opportunities

Threats

The problem has been identified

Overburdened nurses

Restructure nursing management

Poor customer perceptions/negative publicity

Experienced staff

Financing issues

Gain more funding

Board could deny financing

New leaders (Dr. M and Chief of Staff

Union constrains solutions

Build more individual accountability

Unions/culture could present roadblocks to change

A new CEO can accelerate this process

Nurses lack independence

New leaders = new culture

Capacity issues make it tough to change how things are done

Dr. M is a pro

Modest level of education in the department

Increase the level of education

Physicians are another potential roadblock

Obviously, there are more weaknesses than strengths, as this organization if foundering. The weaknesses are myriad, but most seem to relate to the organizational culture and the systems for doing things. The results are clear, however. The time to move patients is excessive. One shift has the burden of most of the paperwork. Customer satisfaction is decreasing, to the point where the news media is getting involved, which only creates a further downward spiral. Internally, the organization is beset by people defending their ways of doing things, or their turf. A lot of the old guard in the institution has been there for decades and seems completely resistant to change, despite the obvious struggles. Further, there may or may not be funding available to address some of the critical capacity issues.

The strengths seem to be with the newer managers, such as Dr. M and the new Chief of Staff. There should be a new CEO on the way, too. With a change at the highest levels of leadership, new life has been breathed into the organization. Problems are beginning to be identified, which will help in finding the best solutions. As much as the organizational culture is a problem, the staff are experienced and competent, which is definitely better than the alternative.

The real opportunity here is to leverage new leadership and negative publicity to change the systems and processes within the facility. New leaders can bring about new culture. Organizational change typically requires motivators -- not only are new leaders motivators but negative publicity in the press is as well. This creates impetus for change because it highlights the reality that the problems are not subject to Dr. M's misinterpretation -- they are real, noticeable by outsiders, and everybody can see that there is a problem. While there is expected to be significant resistance to change, it is harder for those resisting to argue that a problem does not exist when it is all over the media that a problem does exist. The roadblocks are numerous, however. There might not be funding for change -- the Board needs to get on board with that. Furthermore, the old guard of employees, the old CEO and the unions are all potential sources of roadblock.

Recommendation

The key recommendation here is to start with the start, and finish the leadership overhaul. This is a mainly political task, rather than operational, but getting a new CEO in place and bringing the Board on board with an organizational change plan is the most important step. Trying to make a small operational change without addressing the bigger issues is putting lipstick on a pig. Improving productivity here means getting the organization to think differently. Two pieces of the leadership puzzle are in place in Dr. M and the new medical Chief of Staff; now the old CEO needs early retirement and a new CEO brought in to complete the organization's leadership change. This will require the support of the Board. With a new leader, the culture of the organization can be changed. There is far too much emphasis on the old way of doing things when clearly the old way is resulting in poor performance. Entrenched employees and their union are not going to be receptive to change until they realize that they have no choice.