PECH 1101- Conflict resolution in the workplace

What is conflict?

• it can be defined as a disagreement within oneself or between people that causes harm or has the potential to cause harm.

conflict Iceberg

• positions and behaviours

• assumptions

• beliefs and values

What causes communication and conflict?

• lack of communication creates mistrust and hostility

• complex multidisciplinary relationships dont help

• poor communication skills amongst HCP’S

• poor listening skills

• Listening is more than just taking in information.

• When another person is speaking, we are usually gathering our arguments and thinking up a rebuttal to the points we think the speaker is making.

• Since we are not really listening, we do not really hear what the other person is saying.

• As soon as there is a break, we jump in to make the points we have been carefully planning in our heads.

• Because we have not really heard what the other person has said we are not responding to what he/she said, but rather trying to make points of our own.

• We cannot listen and think at the same time!

How to resolve communication and conflict?

• Listen fully to what is being said.

• Do not plan your response.

• While the other person is speaking, listen for insights into what is important to the speaker. At what points does the speaker get energized, upset, angry or sad? What matters to the speaker?

• Check in with the speaker to ensure that you got the message right. Say something like, “I think I heard you say … Is that correct?”

• Pause and think about what else you might need to know.

• Ask further clarifying questions.

• Then respond to the speaker.

What causes emotion and conflict?

• Frustration

• Unresolved emotion is a critical contributor to the development and exacerbation of conflict between health care professionals and between providers and patients

• Research has found that HCPs often experience conflicts because of their inexperience and their place in the hierarchy of the medical care team, particularly when there is disagreement between trainees and senior staff

• HCPs express more frustration and confusion around ethical conflicts in their early years of training

• ØMoral distress occurs when health professionals know or think they know the ethically appropriate action to take, but are unable to carry it out for various reasons e.g. caring for the terminally ill.

• There are frequently conflicting views within the health care team, based on differing values and beliefs in what is the “right” or “moral” thing to do for the patient.

• Conflict is the natural result of the collision of these differing values and beliefs. Improving collaboration and communication amongst care providers will allow for the positive management and resolution of these difficult situations. Providers may not agree at all times, and yet they can and must learn how to respect and support each other.

What are some factors contributing to conflict?

ØHealth care systems are complex

ØHierarchical nature of medicine

ØDiversity of knowledge, power, and control

ØSocial diversity of providers and patients

ØEthical challenges that cannot be easily resolved

ØAnger and frustration with patients

ØExpressing negative opinions about colleagues in front of patients and other colleagues.

Avodiance

These are the “head in the sand” people.

This approach is low on assertiveness and cooperation.

 It is unlikely to satisfy anyone’s concerns.

Disadvantage:

ØLittle or no input

ØTemporizing

ØIssues will fester

ØFrustration results at lack of action

ØCommunication breakdowns can result

Disadvantage:-

• One’s input is ignored.

• People who uses this approach develop a reputation as “pushovers”

• Giving in often builds resentment later

Compromise

These are the “let’s split the difference” people.

 This approach is moderately assertive and moderately cooperative.

 It moderately satisfies everyone’s concerns.

Disadvantages:

ØCreative, collaborative options remain undiscovered.

Ø This approach can be seen as feeble or indecisive.

Ø Real issues are unresolved, so solutions are short-lived and fragile.

Competition

These are the “my way or the highway” people.

 This approach is highly aggressive and minimally cooperative

Disadvantages:

ØIssues will resurface because people do not feel heard.

ØThere may be silent acquiescence and a possibility of sabotage.

ØIt can create an environment of fear and lack of transparency.

ØFeedback from colleagues is unlikely (surrounded by “yes” people).

Disadvantages:

ØIt can take time to develop mutually agreeable outcomes.

ØThis approach can be overused and lead to frustration for those who need a decision as soon as possible.

Why is collaboration preferred?

In most situations, the best outcomes are achieved when the parties involved in the problem work toward resolution in a collaborative way.

 Using collaboration means that the parties who are in conflict focus on the interests or needs that lie beneath the conflict, rather than focusing on the positions that individuals may be proclaiming.(Remember the iceberg)

The goal is to work toward a resolution that allows everyone to get what they need, not to try to win or defeat the other person.

In addition to being more timely and cost-effective, using a collaborative, interest-based approach also allows the parties to maintain their relationships and create long-lasting, mutually satisfying outcomes.

What strategies for conflict resolution?

Who should be sitting at the table?

• If the involved players are not all participating in efforts to resolve the conflict then it is unlikely that a satisfactory and durable solution will be reached.

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• However, ascertaining who should be sitting at the table usually requires some reflection.

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•Frequently, only the obvious “suspects” are included in resolution efforts. This can lead to frustration, wasted time and energy and, ultimately, loss of faith in the process.

What are the main issues?

• Once again, the obvious “suspects” often tell only part of the story.

• Part of the preparation phase of efforts to resolve conflict should include a careful survey of the various issues that may be at stake.

Once the issues have been identified it is important to establish an order of priority, since it is extremely difficult to successfully negotiate more than one issue at a time. The priority of issues may be one of the first items to be negotiated by the parties

What are the origins of the issues?

Values-based conflicts or conflicts that raise ethical issues are often challenging to resolve and it may be wise to seek help from a neutral third-party from the outset.

Disagreements frequently occur about the goals of care as well as the route to take to achieve those outcomes

Rule-based conflicts may appear to be simple to resolve by referring to the rules that govern particular situations. Of course, that assumes that all parties feel the rules are relevant and equitable. A purely rule-based conflict may be fairly easy to resolve if all the parties subscribe to the rules.