Beyond FMEA: the structured what-if technique (SWIFT)

J Healthc Risk Manag. 2012;31(4):23-9. doi: 10.1002/jhrm.20101.


Although it is probably the best-known prospective hazard analysis (PHA) tool, failure mode and effects analysis (FMEA) is far from the only option available. This article introduces one of the alternatives: The structured what-if technique (SWIFT). SWIFT is a flexible, high-level risk identification technique that can be used on a stand-alone basis, or as part of a staged approach to make more efficient use of bottom-up methods like FMEA. In this article we describe the method, assess the evidence related to its use in healthcare with the use of a systematic literature review, and suggest ways in which it could be better adapted for use in the healthcare industry. Based on the limited evidence available, it appears that healthcare workers find it easy to learn, easy to use, and credible. Especially when used as part of a staged approach, SWIFT appears capable of playing a useful role as component of the PHA armamentarium.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Humans
  • Medical Errors / prevention & control*
  • Patient Safety*
  • Risk Assessment / methods*
  • Risk Management
  • Safety Management / methods*