Chapter 15 Conflict Management and Negotiation Skills - Vocabulary Flashcards

Conflict Definition

• Conflict is a natural, inevitable part of human relationships; it is inherent in any work or life setting (Thomas, 1976).

• Most definitions share three components (Thomas, 1992a, 1992b): (1) perceived incompatibility of interests, (2) some interdependence of the parties, and (3) some form of interaction.

• For discussion in this chapter, conflict is defined as occurring when an individual or group feels negatively affected by another individual or group.

• Healthcare settings are especially conflictual due to: high stress, strong emotions, scarce resources, competition, downsizing, mergers, excessive regulations, diversity/cultural issues, and multiple stakeholders’ demands (Gardner, 1992; Johnson, 1994).

• Time spent on conflict: research shows health care and non-health care managers spend an average of $30\%$ of their time dealing with conflict.

• Conflict can be positive or negative:

  • Positive/constructive conflict can stimulate motivation, commitment, high-quality work, and creative problem solving (Cosier & Dalton, 1990).

  • Negative/undconstructive conflict can divert effort from goals, affect psychological well-being, and lead to low-quality work and possible sabotage; severe conflict can cause resentment, tension, anxiety.

• In healthcare, conflict can impact patient care and outcomes (e.g., Forte, 1997; clinical environments; mortality/morbidity via medical errors).

• Lewicki, Weiss, and Lewin (1992) identify six major research areas in conflict:

  • micro-level (psychological)

  • macro-level (sociological)

  • economic-analysis

  • labor-relations

  • bargaining and negotiation

  • third-party dispute resolution

• Research framework follows: discuss types and levels of conflict first, then methods to deal with conflict (conflict resolution/management); includes individual decision making and negotiation skills.

Types of Conflict

• Four basic types (Kolb & Bartunek, 1992):

  • Goal conflict: two or more desired outcomes are incompatible; may involve conflicts between values/norms.

  • Cognitive conflict: ideas and thoughts within or between individuals are incompatible.

  • Affective conflict: feelings and emotions within or between individuals are incompatible.

  • Procedural conflict: disagreements about the process to resolve a matter.

• These types are not mutually exclusive (Case Study 15-1 illustrates overlap).

Levels of Conflict

• Five levels: intrapersonal, interpersonal, intragroup, intergroup, interorganizational.

Intrapersonal Conflict

• Occurs within an individual and may involve goal or cognitive conflict.

• Goal conflict within an individual: two or more alternative actions with important outcomes (Locke et al., 1994).

• Brehm & Cohen (1962) identify three intrapersonal conflict types related to alternative courses of action:

  • Approach/Approach: choosing between two positive outcomes (e.g., Judy Lewis offered two similar healthcare-related jobs).

  • Avoidance/Avoidance: choosing between two negative outcomes (e.g., rightsizing with relocation vs. layoff).

  • Approach/Avoidance: choosing an option with both positive and negative outcomes (e.g., relocate for advancement but leave family).

• Intrapersonal conflict can stem from cognitive dissonance: inconsistencies between beliefs/attitudes and behavior lead to a change in attitude to reduce dissonance.

• Role conflict types related to intrapersonal conflict:

  • Person-role conflict: role expectations clash with personal values/ethics.

  • Intrarole conflict: conflicting expectations within the same role (e.g., purchasing manager under cost pressure vs. medical director’s clinical priorities).

  • Interrole conflict: conflict between work and non-work role demands (e.g., extensive travel/work hours vs. family needs).

• Role ambiguity can amplify interpersonal conflict due to unclear performance expectations; may provoke aggression, hostility, withdrawal.

Interpersonal Conflict

• Natural outcome of human interaction; sources include:

  • Personal characteristics and issues (diversity, values, beliefs)

  • Interactional difficulties (poor communication, relational skills)

  • Perspective/perceptual differences (misperceptions, biases, incomplete information)

• Commonly involves goal conflict or role ambiguity; role ambiguity increases stress and conflict.

Intragroup Conflict

• Clashes within a group that affect group processes and effectiveness.

• Jehn & Mannix (2001) identify three intragroup conflict types:

  • Relationship conflict: interpersonal incompatibilities; tension, friction; personal dislike.

  • Task conflict: differences in viewpoints about the group task; may involve lively debate but lacks negative emotions.

  • Process conflict: disagreements about how to accomplish the task; duties and resource allocations (who does what).

Intergroup Conflict

• Occurs between groups within an organization.

• Nulty (1993) identifies four categories:

  • Vertical conflict: between different levels (supervisors vs. subordinates); may involve autonomy and control issues; also due to communication gaps or role ambiguity.

  • Horizontal conflict: between groups at the same level; each group pursues its own goals potentially at the expense of others.

  • Line-staff conflict: authority disputes between line managers and staff specialists; staff may control methods/resources; line managers push back.

  • Diversity-based conflict: race, gender, ethnicity, religion, etc.; can occur at all five levels.

• Case examples illustrate turf battles and cross-unit tensions (e.g., vascular surgeons vs. radiologists over balloon angioplasty; concerns about patient care vs. departmental autonomy).

Interorganizational Conflict

• Between organizations due to interdependence and system-wide goals.

• Integrated delivery systems (IDS) create closer connections across providers and insurers, increasing interorganizational conflict risks.

• Senior managers must handle more complex, cross-organizational conflicts.

Conflict Management (Conflict Resolution)

• Disagreements are inherent and normal; they can stem from perceptions, values, facts, motivations, or procedures.

• Differences can be damaging if unmanaged, but conflict can also clarify policy/procedures, relieve tensions, improve communication, and resolve problems.

• Thomas & Kilmann (1974) and Blake & Mouton (1964) provide five conflict-handling modes along two dimensions:

  • Assertiveness (satisfying one’s own concerns)

  • Cooperativeness (satisfying others’ concerns)

• The five modes:

  • 1) Competition (competitive/assertive, uncooperative) – win/lose approach; use coercive power; good for emergencies or enforcing unpopular actions; may be appropriate when quick, decisive action is needed or in strategies set by higher-level decisions.

  • 2) Collaboration (highly assertive and cooperative) – win/win approach; seeks creative, fully acceptable solutions for all; requires interdependence and equal power; demands time and organizational support.

  • 3) Compromise (middle ground) – give-and-take; may involve splitting the difference; suitable when goals are mutually exclusive or when parties are equally powerful; functionally useful but may not maximize outcomes.

  • 4) Accommodation (cooperative, unassertive) – smoothing differences; satisfies other party’s concerns; can be perceived as weak; effective short-term in emotionally charged conflicts or when the other party is more correct or the issue is less important to the accommodator.

  • 5) Avoiding (unassertive and uncooperative) – withdrawal or sidestepping; can delay resolution; often leads to frustration if unresolved conflict blocks goals.

• Premature compromise can be dysfunctional because it may bypass the real issues and foreclose better solutions.

Conflict Negotiation Models

• Rubin & Brown (1975) define negotiation as the process where two or more parties decide what each will give and take.

• Three major models have emerged (applicable in different contexts):

Distributive Model

• Originates in labor negotiations; describes dividing scarce resources; the classic win/lose or zero-sum framework.

• Viewed as adversarial; agreement achieved through concessions, withholding information, guarded communications, and the use of power.

• Tactics (Winder, 2003) – four win/lose strategies:

  • I want it all: extreme offers; concede grudgingly to induce compliance; pressure the other side.

  • Time warp: deadline-driven offers; good only until a specific time, otherwise withdrawn.

  • Good cop, bad cop: alternating supportive and threatening behaviors to sway the other party.

  • Ultimatum: take-it-or-leave-it propositions forcing acceptance with little or no concessions.

• Outcome: one side gains more than the other.

Integrative Model

• Also rooted in labor negotiations; cooperative, interest-based, solution-oriented; seeks mutual gains (win/win).

• Process involves recognizing a problem, generating options, evaluating solutions, and selecting one that maximizes joint gains (Lewicki et al., 1992).

• Filley (1975) six-step integrative decision-making model:
  1) Create an environment promoting equality, cooperation, communication, information sharing.
  2) Review and adjust perceptions.
  3) Review and adjust attitudes (maximize information sharing; clear past hostilities).
  4) Define the problem.
  5) Search for alternatives.
  6) Achieve consensus.

• Core principles: trust, cooperation, information sharing, and open communication; expand alternatives beyond current resources; emphasize mutual gains.

• Fisher & Ury (1981, 1991) “principled negotiation” approach within integrative framework:

  • Separate the people from the problem.

  • Focus on interests, not positions.

  • Identify BATNA (Best Alternative To a Negotiated Agreement) for both sides.

  • Invent options for mutual gain (brainstorming helps).

  • Insist on objective criteria to judge solutions.

• Case Study 15-4 demonstrates applying principled negotiation: acknowledge emotional aspects, set ground rules, emphasize relationship building, identify interests, generate options, and use objective criteria.

Interactive Model

• When negotiations become locked in a win/lose stance, a third party can facilitate (mediation/arbitration/consultation).

• Third-party facilitators may have high or low control over process and outcomes; their role varies by intraorganizational vs. interorganizational contexts.

• Interactive negotiation emphasizes deeper problem analysis, joint problem solving, improved communication, reframing priorities, and sustainable relationships rather than binding agreements alone.

• Goals: reduce misperceptions, improve intergroup attitudes, foster creative solutions, and build lasting working relationships.

Benefits and Implications of Conflict Resolution Skills

• Effective conflict-resolution skills contribute to leadership effectiveness and perceived competency (Gross & Guerrero, 2000; Stamato, 2004).

• Eckerd College study (Management Development Institute, 2003) found:

  • A strong link between conflict-resolution skills and leadership effectiveness/promotion potential.

  • Positive conflict behaviors (creating solutions, expressing emotions, outreach) correlated with leadership success.

  • Destructive behaviors (winning at all costs, anger, demeaning others, retaliation) negatively affected career progression.

  • Avoidance is particularly problematic for potential negotiators.

• Overall message: negotiation is not zero-sum; skilled conflict resolution enhances leadership and organizational outcomes.

Conclusion and Takeaways

• Conflicts arise from multiple sources and can be managed through appropriate strategies.

• Collaborative/ integrative approaches are encouraged as a default to maximize joint gains and preserve relationships.

• Organizations must develop conflict-management competencies and tailor strategies to context, stakeholders, and power dynamics.

Case Studies: Brief Highlights and What to Watch For

• Case Study 15-1 Who’s the Boss?

  • Dr. Jordan (chief of surgery) vs. Mary Jones (board chair) over authority to address care quality; conflict includes goal, cognitive, affective, and procedural elements.

• Case Study 15-2 Turf Battles (Intergroup conflict)

  • Radiologists vs. vascular surgeons about balloon angioplasty; issues of authority and staffing impact; horizontal/vertical elements.

• Case Study 15-3 The Managed Care Factor (Horizontal/intergroup nuance)

  • Cedars-Sinai vs. a West Coast HMO over utilization days; employer-physician tensions; potential staff reappointment decisions.

• Case Study 15-4 Creating a Win/Win Situation (Principled negotiation in action)

  • Anesthesiology department vs. hospital administration; focus on interests, objective criteria, and shared goals (operating room open/efficient use).

• Case Study 15-5 Health Care System Versus Insurance (Interorganizational conflict)

  • UAB vs. UnitedHealthcare over network designation and reimbursement terms; winners/losers depend on provider access and patient care implications.

• Case Study 15-6 Musical Operating Rooms (Operational conflict)

  • Scheduling conflicts across departments with differing priorities; leadership challenge for efficient OR use.

• Case Study 15-7 What Went Wrong? (Negotiation strategy and risk of strikes)

  • Union negotiations; misalignment of expectations; need for win/win resolution strategy and mediator use.

• Case Study 15-8 Healthy Conflict Resolution

  • Senior physician schedule conflicts with staff; illustrates escalation dynamics and need for proactive conflict management.

• Case Study 15-9 Conflict-Handling Styles

  • Scenarios demonstrating choosing appropriate conflict-handling styles across radiology, recruitment, outreach program, academic curriculum, and group practice contexts.

Key Terms to Remember

• BATNA: Best Alternative To a Negotiated Agreement (conceptual anchor for negotiations).

• Interorganizational conflict: conflict between organizations due to interdependence and system-wide goals.

• Intrinsic vs. extrinsic conflicts: sources stemming from personal values vs. structural/organizational pressures.

• Five levels of conflict: intrapersonal, interpersonal, intragroup, intergroup, interorganizational.

• Five conflict-handling modes: Competition, Collaboration, Compromise, Accommodation, Avoiding.

• Distributive vs. Integrative vs. Interactive negotiation models: win/lose vs. win/win vs. third-party mediated processes.

Formulas and Numbers (quick reference)

• Time spent on conflict (healthcare/management): $30\%$ of time.

• Impact estimates:

  • Performance problems from strained relationships: $\ge 65\%$.

  • Involuntary employee departures due to conflict: up to $50\%$.

• Percentages and outcomes cited throughout the chapter reflect research benchmarks and case context.