Force Field Analysis

The team will use the following tools to plan the solution:

• force field analysis
• generating alternative solutions (benchmarking)
• viability analysis
• program matrix

Mrs. Alvarez focuses the team first on the single most important cause of the waiting time problem, which seems to be the fact that the health center's schedule is not followed. Other related causes include poorly planned schedules and lack of staff punctuality. Mrs. Alvarez is confident that if the team solves these scheduling issues, the waiting time problem will be well on its way to being solved.

So all clinic personnel can be present, the task force schedules the exercise for when the clinic is not open. The team decides that to develop a plan of action to solve the problem of staff not following the schedule, they will use the same strategic planning process they used earlier in the quality improvement process when they were defining a strategic plan to fulfill the mission statement.

Mrs. Alvarez reminds the team to keep in mind that the ultimate goal is to decrease the waiting time of the users. She also reminds them that each vital cause will become a specific expected result of the interventions they decide to carry out. The first specific result they should expect to achieve, then, is: adherence to the schedule by the personnel. All of the forces in the table that follows will drive or resist the achievement of this result.

To begin the force field analysis, the team starts with a brainstorming session to determine the different forces that promote or hinder staff adherence to the schedule. Nurse Cruz draws two different columns on newsprint, one for the driving forces (the factors that promote adherence to the schedule), and the other for restraining forces (the factors that hinder adherence to the schedule). As the brainstorm continues, Nurse Cruz puts the ideas in the appropriate column.

Driving Forces	Restraining Forces
The law permits attendance control	Personnel have another job
Motivated personnel	Resistance to change
High felt need of the users	Personnel cannot be forced
Competition from the private sector	Users are used to waiting
Community participation	Organizational philosophy
Fear of privatization	Lack of budget
Pride in doing a good job	Government-mandated work hour limits
Incentive to do a good job	Low wages
	No data on attendance