Handling Workplace Conflicts: Balancing Our Talking with Thinking
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1 Handling Workplace Conflicts: Balancing Our Talking with Thinking Sara Kim, PhD Research Professor, Surgery Director of Educational Innovations and Strategic Programs, ISIS (Institute for Simulation and Interprofessional Studies) Context of My Talk Conflict in healthcare: Occurs at multiple points during various patient care stages Frequently left unrecognized, unaddressed and unresolved Can profoundly undermine the morale of individual providers, teams and organization Ultimately, it can harm patients Session Objectives 1 Describe key contributing factors to both task- and relational based conflicts in healthcare settings. 2 Discuss effective strategies for engaging in conflict conversations. Nursing UWCNE.ORG 1
2 Session Overview UW Medicine Conflict Study Conflict- Handling Skills Let s Practice: Application of Skills Reflection 1. What contributed most to triggering the conflict? 2. Could it be possible that you might have contributed to initiating, escalating, or prolonging the conflict? Silence Kills (American Association of Critical Care Nurses & Vital Smarts, 2005) Broken Rules Micromanage Satisfaction Mistakes Turnover Pt Safety Disrespect Commitment Quality Medical Errors Lack of Support Poor Teamwork Incompetence Nursing UWCNE.ORG 2
3 Cost of Workplace Conflict Replacement cost =150% of the Lost Staff s Annual Salary 25% of Employees Illness, Absence Average Employee Spends 2.8 hours/wk= $359 Billion 10% of Employees Project Failure Data Source: Workplace Conflict And How Businesses Can Harness It To Thrive, CPP, July 2008; William G. Bliss Bliss & Associates Entrenched Conflict at Workplaces: Promoting Patient Safety Using an Experiential Training Model Funded by UW Medicine Patient Safety Innovation Programs (PSIP) Study Components Structured Interviews Simulated Conflict- Handling Encounters E-learning Module Design Nursing UWCNE.ORG 3
4 PSIP Team Members Isaac Bohannon, Program Director, Otolaryngology Lindsay Boyd, RN, Cardiothoracic ICU, UWMC Elizabeth Buttrick, Manager, Program Operations, ISIS 4 Ryan Fehr, Assistant Professor, Foster School of Business 5 6 Elise Frans, RN, Wound and Ostomy, UWMC Sarah Shannon, Associate Professor, School of Nursing Interviewees Target Interviewee Groups MD/NP/RN/ Allied Health Providers (UWMC, HMC, NWMC) UW Medicine Leaders (UWMC, HMC) Patient & Family Advisory Council Members (UWMC) Interview Questions What was the conflict regarding and who was involved? What contributed to the initial conflict? What work patterns affected healthcare team? 4 What were your major patient care concerns? 5 How did or did not the conflict resolve? Nursing UWCNE.ORG 4
5 Status: Interviews Recruited: n=108 Completed: n=94 Response Rate: 87% Interviewees by Role Leaders n=13 Patients n=8 MD/NP n=40 Nurse, Allied Health n=33 Status: Interviews Unique Stories Collected 2 11 Specialties Represented 3 12 Residents (13.8% of Total) Nursing UWCNE.ORG 5
6 Type of Conflict Conflict Over Procedure, Policy, Standard of Care Interpersonal Frictions, Bad Behavior Type of ConflictConclusion Power Differential Resource Depletion What Negative Triggers Conflict? Communication Breakdown Self- Focus Org. Structure Dehumanization Competency/ Integrity Nursing UWCNE.ORG 6
7 Consequences of Conflict Guilt, Confusion No timely care Prolonged Hospital Stay Patient Isolation, Self-Doubt Coping Strategies Job Satisfaction Individual Provider Team Morale Circumnavigate Entrenched Perception Organization Take the conflict out of my earshot! Be objective. Stick to the medical facts and opinions. Leave out personality Staff issues in the conversation with patients. Confidence Resource Allocation Standards Improvement Attribution Errors Attribution Errors The Her main English He culprit is is The known not resident good. of escalating didn t for his bad the conflict appreciate temper. was attending s teaching emotion. moments. Nursing UWCNE.ORG 7
8 Know Your Conflict Management Style Thomas-Kilman Conflict Mode Instrument Source: Thomas-Kilman Conflict Mode Instrument: COMPETING Assertive Uncooperative Out there to win Exert power, rank, authority Source: Nursing UWCNE.ORG 8
9 Thomas-Kilman Conflict Mode Instrument: ACCOMMODATING Unassertive Cooperative Other s concern > Own concern Yielding to other s Position (against own will) Source: Thomas-Kilman Conflict Mode Instrument: AVOIDING Unassertive Uncooperative Sidestepping or postponing issues Withdraw from threatening situations Source: Thomas-Kilman Conflict Mode Instrument: COLLABORATING Assertive & Cooperative Explore disagreements to seek insights Solution seeking Concerned about underlying needs & mutual interests Source: Nursing UWCNE.ORG 9
10 Thomas-Kilman Conflict Mode Instrument: COMPROMISING Mildly Assertive & Cooperative You give up something, I will give up something. Prefer expedient, middle ground solutions Source: Thomas-Kilman Conflict Mode Instrument Source: Conflict Handling Skills Nursing UWCNE.ORG 10
11 Reflection In your experience, what is most difficult for you when handling workplace conflicts? Conflict Management Skills Common Ground Nursing UWCNE.ORG 11
12 Conflict Management Skills Conflict Management Skills Cognitive Skills Perspective Taking Establish Mutual Goals Emotional Skills Empathize Handle Own Emotion Behavioral Skills Avoid Escalation, Gossip, Retaliation Initiate Dialogue Nursing UWCNE.ORG 12
13 Perspective Taking Perspective Taking 1 Check for Bias 2 Hold Judgment 3 Ask Questions 4 Mirror What You Hear 5 Agree on Steps Forward Emotion Handling 1 Separate Emotions from Facts 2 Focus on Behaviors 3 Establish Goals for Moving Forward 4 Communicate Feelings Appropriately 5 Create Mutual Expectations Nursing UWCNE.ORG 13
14 Emotion or Fact? She was disrespectful to me. My manager is targeting me. She gave me a bad evaluation. I felt demeaned. My professional judgment was questioned. Avoid Pitfalls Perspective Taking Nursing UWCNE.ORG 14
15 Restore Dialogue! Institutional Resources Conclusion Conflict is part of our lives. If handled timely and effectively, conflicts can lead to constructive outcomes. Let s create positive ripple effects at UW Medicine! Nursing UWCNE.ORG 15
16 THANK YOU! Contact Information: Nursing UWCNE.ORG 16
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