1. Colonel Zulfiquer Ahmed Amin
M Phil, MPH, PGD (Health Economics), MBBS
Armed Forces Medical Institute (AFMI)

2. SWOT Analysis
SWOT analysis is an analysis framework used to evaluate a company's
competitive position and stands for ‘Strengths, Weaknesses,
Opportunities, and Threats’. It is a tool that identifies the strengths,
weaknesses, opportunities and threats of a business. Specifically,
SWOT analysis is a foundational assessment model that measures
what an organization can and cannot do as well as its potential
opportunities and threats.
Strengths and weaknesses are internal to the company (think:
reputation, patents, location). You can change them over time but not
without some work. Opportunities and threats are external (think:
suppliers, competitors, prices)—they are out there in the market,
happening whether you like it or not. You can’t change them.

9. Internal Analysis
The internal analysis of any organization should include its culture,
expertise, resources, and unique qualities within the market place.
The extent to which an organization could adapt to changing
circumstances is also a factor that needs to be considered.

10. Within the broad area of ‘culture’ one should consider the different
aspects of organization’s ethos, beliefs, public image, and structure.
Regarding expertise, how easy is this to retain or increase? How
many of your people play a key role or have vital skills, and how does
this compare to your competitors? To what extent does this
‘expertise’ help to maintain your organization’s market share and
brand positioning?
Resources include: financial position, buildings, plant, machinery,
and other physical infrastructure.
Unique Qualities are those ‘things’ that are exclusive to your
organization, such as special contracts, customers, patents, and
trade secrets. Within this area you should also consider your
research and development (R&D) capabilities.

11. Strengths
A ‘strength’ is something that has a positive implication. It adds
value, or offers your organization a competitive advantage. Strengths
include tangible assets such as available capital, equipment, credit,
established and loyal customers, existing channels of distribution,
copyrighted materials, patents, information and processing systems,
and other valuable resources.

12. Traditional SWOT analysis views strengths as current factors that
have prompted outstanding organizational performance. Some
examples include the use of state-of-the-art medical equipment,
investments in healthcare informatics, and a focus on community
healthcare improvement projects. Other strengths might include
highly competent personnel, a clear understanding among
employees of the organization’s goals, and a focus on quality
improvement.

13. The sort of questions you can ask to ascertain your strengths are:
● What do we do well?
● What qualities or aspects persuaded our customers to choose our
product or service?
● What resources do we have at our disposal?
● What do others see as our strengths?
● What areas are we seen as being expert in?
● What advantages do we have over our competition?

14. Weaknesses
These are the characteristics of your product or service that are
detrimental to growth. Weaknesses are those things that detract
from the value of your offering or place you at a disadvantage when
compared with your competitors.
You are located in the north of the country but 85% of your customers are in the
south. This means that not only are your distribution costs significantly higher than
some of your competitors but you are unable to offer guaranteed next day delivery
in line with your competition.

15. Weaknesses are organizational factors that will increase healthcare
costs or reduce healthcare quality. Examples include aging healthcare
facilities and a lack of continuity in clinical processes, which can lead
to duplication of efforts. Weaknesses can be broken down further to
identify underlying causes. For example, disruption in the continuity
of care often results from poor communication. Weaknesses also
breed other weaknesses. Poor communication disrupts the continuity
of care, and then this fragmentation leads to inefficiencies in the
entire system. Inefficiencies, in turn, deplete financial and other
resources.

16. Other common weaknesses include poor use of healthcare
informatics, insufficient management training, a lack of financial
resources, and an organizational structure that limits collaboration
with other healthcare organizations. A payer mix that includes large
numbers of uninsured patients or Medicaid patients can also
negatively affect an organization’s financial performance, and a lack
of relevant and timely patient data can increase costs and lower
the quality of patient care.

17. The type of questions you would be asking and discussing to identify
your weaknesses are:
● What can be improved or altered?
● What do we do badly?
● How do we compare with others?
● How does our performance compare with our competitors?
● What have our customers told us?
● How did we respond to this feedback?
● What should we avoid?
● How do third parties judge our performance or service?
● Have we self-imposed any constraints?
The more accurately you identify your weaknesses, the more valuable the SWOT
analysis will be. However, because weaknesses are by definition internal there can
be a lot of resistance to admitting to them.

18. External Analysis
External factors include the environment your organization operates
in, its market, ecosystem, and all of the third parties involved.
The market refers to the market sector you supply your goods or
services to even if this is done on a not-for-profit basis. It includes all
of your customers.

19. The ecosystem is something that exists beyond the market per se and
includes current and future technologies as well as current and
proposed business models. For example, the ecosystem in which
book publishing exists consists of high street bookshops, non-
specialist retailers (supermarkets etc.), online book retailers
(Amazon, Smashwords, etc.), as well as libraries and other places
where people can obtain books. It also encompasses the
technologies available, including those still in their infancy like
‘printing on demand.’ These new technologies can destabilize your
existing business strategy if they are ignored or disparaged simply
because they are as yet unproven. Aside from technology, the
ecosystem includes the social, economic, and political environment
that you operate in.

20. Third parties are all of the other entities you deal with who are not
your customers (and therefore part of the ‘market’). They include
your suppliers, partners, and competitors, and may also include
government and regulatory bodies, the media, or any other group
that you need to deal with in the course of doing business.

21. Opportunities
Opportunities can occur for a variety of reasons and may result from
changes within the market, customer lifestyle changes, advances in
technology, new production methods, etc.

22. Traditional SWOT analysis views opportunities as significant new
business initiatives available to a healthcare organization. Examples
include collaboration among healthcare organizations through the
development of healthcare delivery networks, increased funding for
healthcare informatics, community partnering to develop new
healthcare programs, and the introduction of clinical protocols to
improve quality and efficiency. Integrated healthcare delivery
networks have an opportunity to influence healthcare policy at the
local, state, and national levels. They also have an opportunity to
improve patient satisfaction by increasing public involvement and
ensuring patient representation on boards and committees.

23. Organizations that are successful at using data to improve clinical
processes have lower costs and higher-quality patient care. For
example, healthcare organizations with CMS Hospital Compare
quality scores above the 90th national percentile are eligible for
CMS pay-for-performance incentives. The greater the number of
organizations achieving such scores, the greater patients’ access to
quality healthcare. Such scores also enhance an organization’s
reputation in the community.

24. The greater your ability to identify potential threats the more
proactive you will be able to be in your planning for and responding
to such events.
Threats

25. Threats are factors that could negatively affect organizational
performance. Examples include political or economic instability;
increasing demand by patients and physicians for expensive medical
technology that is not cost-effective; increasing state and federal
budget deficits; a growing uninsured population; and increasing
pressure to reduce healthcare costs.

26. Matching and Converting
There are two simple methods, referred to as ‘matching’ and
‘converting,’ that organizations can utilize when applying the results
of the SWOT analysis to strategy decisions.

27. Matching uses competitive advantage to pair strengths with
opportunities. Example:
In the 1980s UK clothing retailer Marks and Spencer had a strong
presence in the high street and a customer base that bought on the
basis of quality rather than price. M&S were able to leverage these
strengths to exploit the opportunity to sell high-quality food and
beverages to its customers. The company began by selling pre-
prepared sandwiches and snacks that were made from higher-quality
ingredients than its competitors were using. This focus on quality was
unique at the time and enabled M&S to corner the market until its
competitors began to copy the formula. Thirty years later M&S s still a
major player in the UK quality food and beverage market and these
items account for a substantial portion of its total profits.

28. Converting means converting weaknesses or threats to strengths or
opportunities. For example,
Many island-based Scottish whisky distilleries are unable to expand
their production facilities because of environmental or logistical
issues. This weakness can be converted into a strength by stressing
the artisan nature of the product and making the limited production
synonymous with exclusivity. This means that they can maintain high
retail prices and reasonable profits even when losing market share to
industrial scale producers.

29. SWOT MATRIX

30. Steps in SWOT Analysis
The primary aim of strategic planning is to bring an organization into
balance with the external environment and to maintain that balance
over time. Organizations accomplish this balance by evaluating new
programs and services with the intent of maximizing organizational
performance. SWOT analysis is a preliminary decision-making tool
that sets the stage for this work.
Step 1 of SWOT analysis involves the collection and evaluation of key
data. Depending on the organization, these data might include
population demographics, community health status, sources of
healthcare funding, and/or the current status of medical technology.
Once the data have been collected and analyzed, the organization’s
capabilities in these areas are assessed.

31. In Step 2 of SWOT analysis, data on the organization are collected
and sorted into four categories: strengths, weaknesses,
opportunities, and threats. Strengths and weaknesses generally
stem from factors within the organization, whereas opportunities
and threats usually arise from external factors. Organizational
surveys are an effective means of gathering some of this
information, such as data on an organization’s finances, operations,
and processes.

33. Step 3 involves the development of a SWOT matrix for each business
alternative under consideration. For example, say a hospital is
evaluating the development of an ambulatory Surgery Center (ASC).
They are looking at two options; the first is a wholly owned ASC, and
the second is a joint venture with local physicians. The hospital’s
expert panel would complete a separate SWOT matrix for each
alternative.
Step 4 involves incorporating the SWOT analysis into the decision-
making process to determine which business alternative best meets
the organization’s overall strategic plan.

34. Force Field Analysis
Force field analysis is an examination of the forces driving or hindering
organizational change. Force field analysis takes SWOT analysis a step
further by identifying the forces driving or hindering change—in other
words, the forces driving its strengths, weaknesses, opportunities, and
threats. Forces that propel an organization toward goal achievement
are called helping forces , while those that block progress toward a
goal are called hindering forces .

35. After identifying these positive and negative forces, organizations
can develop strategies to strengthen the positives and minimize the
negatives. For an organization to achieve success, the driving forces
must outweigh the resisting forces. When this state is reached,
organizations are able to move from their current reality to a
preferred future.

37. Gantt chart
A Gantt chart is a type of bar chart that illustrates a project schedule,
named after their inventor, Henry Gantt (1861–1919).
A Gantt chart, commonly used in project management, is one of the
most popular and useful ways of showing activities (tasks or events)
displayed against time. On the left of the chart is a list of the
activities and along the top is a suitable time scale. Each activity is
represented by a bar; the position and length of the bar reflects the
start date, duration and end date of the activity.

38. Gantt Chart allows us to see at a glance:
- What the various activities are
- When each activity begins and ends
- How long each activity is scheduled to last
- Where activities overlap with other activities, and by how much
- The start and end date of the whole project

40. A simple Gantt chart