Dr. Catherine B. Matheson-Monnet presented on using force field analysis as a structured focus group activity. Force field analysis provides a framework for looking at factors that influence a situation by identifying enabling and restricting forces. Dr. Matheson-Monnet has used force field analysis in several research and evaluation projects involving new care models. She led an example brainstorming and ranking exercise using force field analysis to identify drivers and barriers related to the recent introduction of a client relationship management system. Participants found the exercise useful for conceptualizing factors influencing the new system.

1. Dr Catherine B Matheson-Monnet
c.b.matheson@soton.ac.uk
USING FORCE FIELD ANALYSIS AS A
STRUCTURED FOCUS GROUP ACTIVITY
Presentation to Wessex AHSN Learning Lab

2. Experience of using Force Field Analysis
A. No experience
B. Some experience
C. Extensive
experience
D. Other
No
experience
Som
e
experienceExtensive
experience
Other
88%
0%0%
13%

3. What do you already know about Force Field Analysis
A.Nothing
B. A little bit
C. A lot
D.Other
Nothing
A
little
bit
A
lot
Other
89%
0%0%
11%

4. How much do you already know about Kurt Lewin?
A.Nothing
B. A little bit
C. A lot
D.Other
Nothing
A
little
bit
A
lot
Other
89%
0%0%
11%

5. How much do you really want to know about FFA and KL?
A.Not at all
B. A little bit
C. A lot
D.Other
Notatall
A
little
bit
A
lot
Other
0%
11%
44%44%

6. LEARNING OUTCOMES
1.To define Force Field Analysis [FFA]
2.To explain how I have used FFA in
research and evaluation
3.To undertake a brainstorming and
ranking exercise based on FFA

7. 1. To define Force
Field Analysis [FFA]]

8. Force-Field Analysis
Used in social science,
psychology,
organisational
development, process
management and
change management
Provides framework for
looking at the factors
(forces) that influence
a situation e.g. a social
situation
Enabling
forces
Restricting
forces

9. Kurt Lewin B = ƒ (P, E)
Social psychologist: applied research, action
research* 1944 and group dynamics 1947
*a spiral of steps, each of which is
composed of a circle of planning, action,
and fact-finding about the result of the
action (Lewin, 1946, p35)
He talked of “field” that is dynamic and
reflects individual or collective mind i.e.
motives, values, needs, moods, goals,
anxieties, and ideals.
He thought the “field” could be visually
represented by making explicit driving and
restricting forces

10. FFA: Driving and blocking
movement towards a goal
Enabling
forces
Restricting
forces

11. Quantifying ‘enabling’ and
‘restricting’ forces
1
1
11111
1 1
1 1 1 1
1 1 1 1 1
11
11111
Enabling
forces
Restricting
forces

12. 2. To explain how I have
used FFA in research and
evaluation projects

13. FFA APPROACH FOR RESEARCH AND
EVALUATION OF NEW CARE MODELS
Very flexible and adaptable method
to gather quantitative and qualitative
data suitable for small or larger
groups and short or longer time slots
Used a FFA approach to research and
evaluation to gather collective views re
research questions, interventions or
proposed interventions
Can be done with participants of all
ages and in all contexts

14. Examples of evaluations using FFA approach
with NPT survey as part of structured focus group
CB Matheson-Monnet (2017) Using the Normalisation Process Theory [NPT] framework to
evaluate a new care model [NCM]: the Happy Healthy at Home [HHH] Enhanced
Recovery at Home [ER@H] Centre for Implementation Science. University of
Southampton. pp40. 11/2017. https://eprints.soton.ac.uk/417685/ See also pp24-
31 Independent evaluation of the Enhanced Recovery and Support at Home Service
https://cdn.southampton.ac.uk/assets/imported/transforms/content-
block/UsefulDownloads_Download/2B42EDD0659F413EBFA4D42FFD6287CB/ERS@
H%20-
%20Evaluation%20Report%20Finalised%2019122017.pdf#_ga=2.50378089.1919947
610.1565023954-1915557494.1486562982
P Darnton, CB Matheson-Monnet, F Campbell and L Beadle L (2018) Evaluation of the
Enhanced Recovery Service at Home [Happy, Healthy at Home and Frimley Health
Foundation Trust], Third NEHF Vanguard Evaluation Symposium: Out of Hospital
Urgent and Integrated Care, 14 March, slides 105-151
https://www.slideshare.net/WessexAHSN/happy-healthy-at-home-evaluation-
symposium-3
CB Matheson-Monnet CB, P Darnton, A Sibley A, J Sladen, T Benson, N Lawford and A Liles
(2018) Evaluation of the Enhanced Recovery Service at Home Service Team [Happy,
Healthy, at Home and Frimley Health Foundation Trust], Poster presentation, First
Implementation Science Research Conference, CLAHRC South London, Kings, College
London, 19 July https://twitter.com/DrCathWessexCIS/status/1019853576838025216

15. Examples of evaluations using FFA approach
[with NPT survey beforehand] as part of structured focus group
CB Matheson-Monnet (2017) Using the Normalisation Process Theory
[NPT] framework to evaluate a new care model [NCM]: the Happy
Healthy at Home [HHH] Yateley Integrated Care Team [ICTs] Centre
for Implementation Science. University of Southampton. pp27.
07/2017. https://eprints.soton.ac.uk/417686/ See also pp14-19
Yateley ICT Evaluation Report Final v2, pp13-19
http://www.northeasthampshireandfarnhamccg.nhs.uk/documents/n
orth-east-hampshire-and-farnham-vanguard/evaluation
CB Matheson-Monnet (2018) Team Evaluation, in Integrated Care
Teams, Yateley ICT 14 March, Third NEHF Vanguard Evaluation
Symposium: Out of Hospital Urgent and Integrated Care, 14 March,
slides 164-165 https://www.slideshare.net/WessexAHSN/happy-
healthy-at-home-evaluation-symposium-3

16. Examples of evaluations using FFA approach
[with NPT survey beforehand] as part of structured focus group
CB Matheson-Monnet (2018) Using the Normalisation Process Theory [NPT] to evaluate a New
Care Model: the Happy, Healthy at Home [HHH] Enhanced Integrated Teams [EICTs] in
Farnborough. Centre for Implementation Science. University of Southampton. Wessex AHSN
https://eprints.soton.ac.uk/id/eprint/424113 See also Farnborough ICT Evaluation Report
Final, pp17-27 http://www.northeasthampshireandfarnhamccg.nhs.uk/documents/north-
east-hampshire-and-farnham-vanguard/evaluation
CB Matheson-Monnet (2018) Using the Normalisation Process Theory [NPT] to evaluate a New
Care Model: the Happy, Healthy at Home [HHH] Enhanced Integrated Teams [EICTs] in
Aldershot. Centre for Implementation Science. University of Southampton. Wessex AHSN.
https://eprints.soton.ac.uk/id/eprint/423794 See also Aldershot ICT Evaluation Report Final,
pp18-27 https://www.northeasthampshireandfarnhamccg.nhs.uk/documents/north-east-
hampshire-and-farnham-vanguard/evaluation
CB Matheson-Monnet (2018) Using the Normalisation Process Theory [NPT] to evaluate a New
Care Model: the Happy, Healthy at Home [HHH] Enhanced Integrated Teams [EICTs] in Fleet.
Centre for Implementation Science, University of Southampton. Wessex AHSN
https://eprints.soton.ac.uk/id/eprint/423793 See also Fleet ICT Evaluation Report Final
https://www.northeasthampshireandfarnhamccg.nhs.uk/documents/north-east-hampshire-
and-farnham-vanguard/evaluation pp16-25

17. Examples of evaluations using FFA approach [with NPT survey
beforehand] as part of structured focus group
CB Matheson-Monnet (2018) Using the NPT framework to evaluate the
Enhanced Integrated Care Teams [EICTs] in Farnborough, Aldershot and
Fleet localities. Southampton: CIS/University of Southampton/Wessex
AHSN. pp 35. 02/2018. https://eprints.soton.ac.uk/id/eprint/423795
CB Matheson-Monnet (2017) Using the Normalisation Process Theory [NPT]
framework to evaluate a new care model [NCM]: the My Life a Full Life
Integrated Local Services [ILS]. Centre for Implementation Science.
University of Southampton. Wessex AHSN pp25. 07/2017.
https://eprints.soton.ac.uk/423793/
CB Matheson-Monnet, CF Brooks, A Argyropoulos and RE Guerrero-Luduena
(2019) Independent evaluation of the piloting of the implementation of
MymHealth [myCOPD, myHeart and myDiabetes] by Dorset CCG. Experience
of Service Users. 03/2019. Poster presentation for BMJ International Forum
on Quality and Safety in Healthcare, Glasgow, Scottish Exhibition Centre,
26-28 March
https://twitter.com/DrCathWessexCIS/status/1111589589662294016

18. 3. To undertake a ‘FFA’ inspired
brainstorming and ranking
exercise about the recent
introduction of CRM [Client
Relationships Management] in
Wessex AHSN FFAFF

19. Force Field Analysis
DRIVERS
Driving
forces?
Restricting
forces?
Drivers Barriers

20. BARRIERS
2. “Post-its” collected and put on board/flipchart
1.Write 2-3 BARRIERS to CRM: one per “post-it”
3. “Post-its” put into categories
4. Allocate your 3 votes to your most important
BARRIER category/categories
See Matheson and Matheson 2009

21. DRIVERS
2. “Post-its” collected and put on board/flipchart
1.Write 2 DRIVERS re CRM: one per “post-it”
3. “Post-its” put into categories
4. Allocate your 3 votes to your most important
DRIVER category/categories
See Matheson and Matheson 2009

22. Thoughts and feelings about your experience of
FFA brainstorming and ranking exercise?

23. 11111
11
Enabling forces Restricting forces
Flexibility/autonomy/responsiveness
[5] [12%]
No traditional boundaries [11] [26%]
Team especially MDT work [11] [26%]
Patient outcomes [17] [40%]
Time pressures [12] [29%]
Examples of ranking drivers and barriers to
NCMs/Innovationor QI intervention
[n=votes] and[percentageof overall votese.g. n=42]
IG issues [1] [0.2%]
IT not working/no internet access [2] [4.8 %]
Unclear/unknown to outsiders [13] [54%]
Shortage of staff/competing demands [11] [26%]
Leadership [1 ] [0.2%]
DRIVERS BARRIERS

24. Now you know about it, do you think you may have
actually used Force Field Analysis in the past?
A. Yes
B. No
C. Not sure
Yes
No
Notsure
50%
30%
20%

25. Are you likely to use Force Field Analysis
in future?
A. Yes
B. No
C. Not sure
Yes
No
Notsure
90%
10%
0%

26. LEARNING OUTCOMES
1. I defined Force Field Analysis [FFA]
2. I explained how I have used FFA in
research and evaluation
3. We undertook a FFA inspired
brainstorming and ranking exercise in
relation to the introduction of CRM

27. Thank you

28. References
Lewin K (1951) Field Theory in Social Science. New York: Harper and Row
Lewin K (1943) Defining the Field at a Given Time. Psychological Review, 50, 3: 292–
310
Lewin, K. (1946) Action research and minority problems. J Soc. Issues, 2, 4: 34–46
Matheson CB and Matheson D (2013) Evaluation of the East Midlands Healthcare
Workforce Deanery Programme for Educational Supervisors Training [PEST]. Final
Report. Nottingham and Leicester EMHWD. pp50. 01/2013
Matheson CB and Matheson D (2009) Déballage d’idées, catégorisation et
hiérarchisation comme activités structurées en groupe focalisé. Pédagogie
médicale 10, 3, 61-63 http://dx.doi.org/10.1051/pedmed/2008021 and
https://eprints.soton.ac.uk/384175/
Matheson CB (2006) Optimal Cultural Distance: a new conceptual framework about
higher education and young and mature students and potential entrants from
under-represented socio-economic groups. PhD thesis. City University, London. pp
200 https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.446452
Matheson CB (2000) Facilitating the transition from primary to secondary school.
Report. Northampton Borough Council.pp50