NUR 531 Module 6 SWOT Analysis Example

From Four Lists to Four Strategies: A SWOT and TOWS Analysis of Wren Valley Medical Center's Water Management Program

[Student Name]

Southern New Hampshire University

NUR 531: Interprofessional Leadership in Healthcare

SWOT Analysis

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

From Four Lists to Four Strategies: A SWOT and TOWS Analysis of Wren Valley Medical Center's Water Management Program

The root cause analysis of the Legionnaires' case on 4 East found that the hospital's water management program had stopped operating and that changes to the building went unassessed. Before designing a proactive assessment, the water management team needs a clear view of what it has to work with and what it faces. A SWOT analysis provides that view by sorting internal strengths and weaknesses from external opportunities and threats. Used alone, the method has a reputation for producing long lists that never become plans (Helms & Nixon, 2010). This paper therefore carries the SWOT into a TOWS matrix, pairs internal and external factors into strategies and concludes that the program's most urgent strategy is to use its new executive attention to lock in monitoring and review before the next construction phase begins.

Method

The water management team, which since the event has had two executive co-chairs from nursing and facilities, drafted the analysis in one ninety-minute session. Members wrote factors independently, then grouped and discussed them. Internal factors were limited to things the hospital controls: its people, plans, systems and budget. External factors were conditions outside its control: regulation, guidance, the building's surroundings, the patient population and planned work by outside contractors. Evidence for each factor came from the root cause analysis, the 2018 water management plan, the hospital's construction schedule and published sources.

The SWOT

Table 1 summarizes the factors the team agreed on.

Table 1

SWOT Analysis of the Water Management Program

Note. Composite analysis for a community hospital.

Reading the SWOT

Three patterns stand out. First, the strengths are recent. Most of them exist because of the event, which means they could fade as attention moves elsewhere, the same way the original team lapsed after its chair retired. Second, the weaknesses cluster around monitoring and memory: the program cannot see what its water is doing between the heater and the tap, and it relies on people remembering to flush rooms. Third, the most serious threat is internal to the hospital's calendar but external to the team's control. The next two renovation phases will again close rooms, adjust valves and bring in contractors, recreating the exact conditions that caused the case on 4 East.

CDC's review of Legionnaires' outbreaks found that changes nobody managed, such as construction and disruptions to water service, contributed to about a third of them (Garrison et al., 2016). For Wren Valley, the construction schedule is therefore not background; it is the central threat.

From SWOT to TOWS

Weihrich (1982) proposed the TOWS matrix to make SWOT produce strategies. It pairs each internal factor with each external one to generate four kinds of strategy: using strengths to seize opportunities, overcoming weaknesses by taking advantage of opportunities, using strengths to blunt threats and minimizing weaknesses while avoiding threats. Table 2 shows the strategies the team derived.

Table 2

TOWS Matrix Strategies for the Water Management Program

What the Matrix Leaves Out

A TOWS matrix is only as good as the factors fed into it, and two limits apply here. The analysis was drafted in a single session by people who had just lived through the event, so recent problems may be weighted more heavily than slower risks, such as the age of the building's pipes, that did not cause this case. And several factors, including staff awareness and contractor familiarity, rest on the team's judgment rather than on measurement. The team agreed to revisit the SWOT after the proactive assessment, when failure modes will have been scored, and again after the first renovation phase, so that the strategies can be checked against what actually happened.

Setting Priorities

Not every strategy can start at once. The team rated each by its likely effect on patient risk and the effort required. The weaknesses-with-threats strategy ranked first, because the next renovation phase begins in four months and automatic flushing orders can be built by informatics within weeks. The strengths-with-threats strategy ranked second for the same reason: construction walkthroughs cost little and address the largest threat directly. Capital funding for sensors and valves ranked third; it has the largest long-term effect but depends on a budget cycle. Rewriting the plan came last in sequence though not in importance, since it will draw on the results of the other three and on the proactive assessment to come.

The Nurse Leader's Role

Most of these strategies belong to facilities and informatics. Nursing's role is to bring the clinical stakes into each one. On the oncology unit, that means asking to be told whenever rooms close, reporting unused rooms to the water team, making sure nursing staff know why bottled water or filters are in use and speaking for immunosuppressed patients when construction schedules are set. It also means keeping the co-chairs' attention on the program once the event is no longer news, which may be the most important leadership task in the whole analysis.

Conclusion

The SWOT shows a water management program with new strengths born of a crisis, familiar weaknesses in monitoring and memory, useful external resources and one dominant threat: the construction that caused the last case is about to happen again. The TOWS matrix turns those findings into four strategies, and the team's priorities put automatic flushing orders and construction walkthroughs first. The proactive systems assessment that follows will test these strategies against the failure modes of the program itself.

References

Centers for Disease Control and Prevention. (2021). Developing a water management program to reduce Legionella growth and spread in buildings: A practical guide to implementing industry standards (Version 1.1). https://stacks.cdc.gov/view/cdc/114167

Centers for Medicare & Medicaid Services. (2018). Requirement to reduce Legionella risk in healthcare facility water systems to prevent cases and outbreaks of Legionnaires' disease (LD) (QSO-17-30, revised). https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/downloads/qso17-30-hospitalcah-nh-revised-.pdf

Garrison, L. E., Kunz, J. M., Cooley, L. A., Moore, M. R., Lucas, C., Schrag, S., Sarisky, J., & Whitney, C. G. (2016). Vital signs: Deficiencies in environmental control identified in outbreaks of Legionnaires' disease: North America, 2000-2014. Morbidity and Mortality Weekly Report, 65(22), 576-584. https://doi.org/10.15585/mmwr.mm6522e1

Helms, M. M., & Nixon, J. (2010). Exploring SWOT analysis: Where are we now? A review of academic research from the last decade. Journal of Strategy and Management, 3(3), 215-251. https://doi.org/10.1108/17554251011064837

Weihrich, H. (1982). The TOWS matrix: A tool for situational analysis. Long Range Planning, 15(2), 54-66. https://doi.org/10.1016/0024-6301(82)90120-0