That's not good for patients. And now that health reform has upped the ante, linking reimbursement to quality and patient perception of care metrics, it's clear that managers must help employees handle their conflicts productively.
In times of rapid change, stress levels escalate, conflicts rise, and people's ability to collaborate breaks down.
That's bad news for patient care, safety, and satisfaction, and it could be bad news for an organization's very survival. The truth is, unresolved conflict has a way of breeding more conflict. Resentment builds. Communication breaks down. Turnover increases. Patient care suffers. And pretty soon leaders are spending all their time running interference and putting out fires instead of, well, leading.
In my new book coauthored with Barbara Filner and Lisa Maxwell, The Exchange Strategy for Managing Conflict in Health Care puts health care leaders back in the driver's seat of their organizations. It's a "go-to guide" that details the four-stage conflict resolution process also known as The Exchange®. This process is derived from the mediation and conflict resolution practices used for thirty years at the National Conflict Resolution Center.
The Exchange combines a proactive, step-by-step process with unique communication skills that together produce positive results. Through the four stages, managers learn to disarm challenging emotions, model interest-based understanding, and lead joint problem-solving collaborations among their staff, patients, and families.
Because so many levels of interaction exist in health care, and so many different professional skills are involved, the health care industry is a perfect setting for The Exchange.
Read on for ten tips on resolving conflict at your health care facility.
Respond-don't react. Aikido is a defensive art in which the participant does not seek conflict but also does not fear it or run from it. It is an art that requires the practitioner to be centered and calm. In other words to be able to respond, not react. To accomplish this, an Aikidoist throws his opponent off balance without hurting him, giving him a different view of the situation.
That is precisely what anyone should do if they are on the receiving end of a verbal attack. If you can remain curious about the content and not be thrown by the delivery-making use of the Aikido stance!-wondering what is going on for her and being open to her perspective, it will help you utilize The Exchange skills.
Depersonalize the situation. The ability to depersonalize an attack helps. Many times conflict arises out of an attacker's needs rather than a shortcoming in you or the other affected party. Relaxed, open body language and a willingness to listen convey the seriousness with which you take their concerns. If you react in your body and appear defensive or hostile, it will only escalate emotions
Choose the right leader. The leader chosen to lead disputing parties through The Exchange needs to be someone who is respected by both parties. It should also be someone who has ties to those involved and is a normal part of the chain of command. However, make sure the power distance between the parties and the convener isn't too great.
Choose the right time. Health care settings present a unique challenge when it comes to conflict resolution because it is not unusual due to varying shifts for the two individuals to not be scheduled together again for some time. This is another important reason why the convener chosen should be someone who is close to both parties. Having someone leading the process who knows the individuals' schedules will make expediting the process much easier.
Start with an icebreaker. The Exchange teaches that you should begin with an icebreaker. This is not just a light introductory activity. It is a way to non-confrontationally initiate a conversation about difficult issues. An ideal icebreaker asks for a person's own take on something that's both work-related and positive.
Listen. Often the best resolutions come from listening carefully to what the other person has to say. Being an active listener sends the message that you are genuinely concerned about him or her and the dispute. Put plainly and simply, it's the best way to get good information.
Use and encourage positive language. This one might seem like a no-brainer, but any frustrated health care leader knows how easy it can be to slip into negativity after a conflict has affected their department or team. Always think before you speak. Use positive, easy-to-understand language. Don't fall into repeating, verbatim, paragraphs from your facility's HR manual.
Build trust. In the first stage of The Exchange, the manager in charge of resolving the conflict will meet individually with each of the parties involved. This is an important first step because it provides the convener with a chance to build some trust with each party, and this will help the joint session be productive.
Use the 5 Ds to find solutions. After the hard stuff has been worked out, it's time to talk about solutions. One at a time, the parties talk about each issue and then decide together what to do about it. The 5 Ds provide a convenient guide:
Define-Make sure all parties are clear on what is meant by the issues discussed.
- Discuss-Each party gets an opportunity to talk about what they expected of the other person during the events that led to the conflict.
- Determine Interests-After acknowledging the employee perspectives and interests, the manager addresses any workplace expectations around the topic.
- Decide-Examine the possible solutions to remedy the situation.
- Document-Writing down decisions, either as memoranda or as agreements, will avoid misunderstanding later.
End on a positive note. Once the parties have had a chance to joint problem-solve, and a plan has been made, put a positive spin on the next steps. This will set expectations and encourage more collaboration going forward. Be specific and upbeat. Praise each party individually and jointly. Revisit each party's strengths, and what they contributed to The Exchange, even if it was just the willingness to participate.
Disputes are bound to pop up even in the most cordial of work environments. Throw in the stress and high-stakes nature of working in health care and you can almost guarantee that conflict will arise. The good news is that when you're armed with the tools you need to work toward productive resolutions, you, your doctors, nurses, and other medical and non-medical staff members can use them to strengthen your organization rather than harm it.
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Steven Dinkin, Barbara Filner, and Lisa Maxwell also collaborated on
The Exchange: A Bold and Proven Approach to Resolving Workplace Conflict
(CRC Press, 2011, ISBN: 978-1-4398529-8-9, $39.95, www.ncrconline.com).
About the Authors:
Steven P. Dinkin is coauthor of The Exchange Strategy for Managing Conflict in Health Care: How to Defuse Emotions and Create Solutions When the Stakes Are High (McGraw-Hill, 2012, ISBN: 978-0-0718019-6-6, $22.00, www.ncrconline.com) and The Exchange: A Bold and Proven Approach to Resolving Workplace Conflict (CRC Press, 2011, ISBN: 978-1-4398529-8-9, $39.95, www.ncrconline.com), and is president of National Conflict Resolution Center.
About the Books:
The Exchange Strategy for Managing Conflict in Health Care: How to Defuse Emotions and Create Solutions When the Stakes Are High (McGraw-Hill, 2012, ISBN: 978-0-0718019-6-6, $22.00,www.ncrconline.com) is available at bookstores nationwide and from major online booksellers.
The Exchange: A Bold and Proven Approach to Resolving Workplace Conflict (CRC Press, 2011, ISBN: 978-1-4398529-8-9, $39.95, www.ncrconline.com) is available at bookstores nationwide and from major online booksellers.
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