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Handling Workplace Conflicts: Balancing Our Talking with ... · Project Failure Entrenched Conflict...
Transcript of Handling Workplace Conflicts: Balancing Our Talking with ... · Project Failure Entrenched Conflict...
5/21/2014
© University of Washington School of Nursing ‐ UWCNE.ORG 1
Handling Workplace Conflicts: Balancing Our
Talking with Thinking
Sara Kim, PhDResearch 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
2Discuss effective strategies for
engaging in conflict conversations.
Describe key contributing factors to both task- and relational based conflicts
in healthcare settings.
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1 2 3
UW Medicine Conflict Study
Conflict-Handling
Skills
Let’s Practice:
Application of Skills
Session Overview
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?
Reflection
Silence Kills (American Association of Critical Care Nurses & Vital Smarts, 2005)
Broken Rules
Mistakes
Lack of Support
IncompetencePoor Teamwork
Disrespect
Micromanage
TurnoverTurnover
SatisfactionSatisfaction
Pt SafetyPt Safety
QualityQuality MedicalErrors
MedicalErrors
CommitmentCommitment
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Cost of Workplace Conflict
Data Source: Workplace Conflict And How Businesses Can Harness It To Thrive, CPP, July 2008; William G. Bliss—Bliss & Associates
Average Employee Spends 2.8 hours/wk= $359 Billion
Replacement cost =150% of the Lost Staff’s Annual Salary
25% of Employees
Illness, Absence
10% of Employees Project Failure
Entrenched Conflict at Workplaces: Promoting Patient Safety Using an
Experiential Training Model
Funded by UW Medicine Patient Safety Innovation Programs (PSIP)
1 2 3
StructuredInterviews
SimulatedConflict-Handling
Encounters
E-learning Module Design
Study Components
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Elizabeth Buttrick, Manager, Program Operations, ISIS
1
Lindsay Boyd, RN, Cardiothoracic ICU, UWMC
Elise Frans, RN, Wound and Ostomy, UWMC
2
Isaac Bohannon, Program Director, Otolaryngology
3
4 Ryan Fehr, Assistant Professor, Foster School of Business
Sarah Shannon, Associate Professor, School of Nursing
5
6
PSIP Team Members
MD/NP/RN/Allied Health
Providers (UWMC, HMC,
NWMC)
Patient &Family Advisory
CouncilMembers(UWMC)
Target Interviewee Groups
UW MedicineLeaders
(UWMC, HMC)
Interviewees
Interview Questions
What work patterns affected healthcare team?
1
What contributed to the initial conflict?
What were your major patient care concerns?
2
What was the conflict regarding and who was involved?
3
4
How did or did not the conflict resolve? 5
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Recruited: n=108
Completed: n=94
Response Rate: 87%
Status: Interviews
Interviewees by Role
MD/NPn=40
Nurse, Allied Healthn=33
Leadersn=13
Patientsn=8
Status: Interviews
1
2
3
161 Unique Stories Collected
11 Specialties Represented
12 Residents (13.8% of Total)
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Conflict Over Procedure, Policy, Standard of Care
Interpersonal Frictions, Bad Behavior
Type of Conflict
ConclusionType of Conflict
ResourceDepletion
PowerDifferential
NegativeWhat
TriggersConflict?
Org.Structure
Communi-cation
Breakdown
De-humanization
Compe-tency/
Integrity
Self-Focus
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Consequences of Conflict
Morale
Entrenched Perception
Circumnavigate
Staff Confidence
Resource Allocation
StandardsImprovement
IndividualProvider
Organi-zation
Patient
Team
Isolation, Self-Doubt
Coping Strategies
Job Satisfaction
ProlongedHospital Stay
No timely care
Guilt, Confusion
“Take the conflict out of my earshot!”
“Be objective. Stick to the medical facts and opinions. Leave out personality issues in the conversation with patients.”
Attribution Errors
Attribution Errors
Her English is not good.He is known
for his bad temper.
The main culprit of
escalating the conflict was attending’s
emotion.
The resident The resident didn’t
appreciate teaching moments.
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Know Your Conflict Management Style
Thomas-Kilman Conflict Mode Instrument
Source: https://www.cpp.com/products/tki/index.aspx
Thomas-Kilman Conflict Mode Instrument: COMPETING
Source: https://www.cpp.com/products/tki/index.aspx
Out there to win
Exert power, rank, authority
Assertive
Uncooperative
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Thomas-Kilman Conflict Mode Instrument: ACCOMMODATING
Source: https://www.cpp.com/products/tki/index.aspx
UnassertiveCooperative
Yielding to other’s Position (against own will)
Other’s concern >Own concern
Thomas-Kilman Conflict Mode Instrument: AVOIDING
Source: https://www.cpp.com/products/tki/index.aspx
Unassertive
Uncooperative
Withdraw from threatening situations
Sidestepping orpostponing issues
Thomas-Kilman Conflict Mode Instrument: COLLABORATING
Source: https://www.cpp.com/products/tki/index.aspx
Solution seeking
Assertive & Cooperative
Concerned about underlying needs & mutual interests
Explore disagreementsto seek insights
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Thomas-Kilman Conflict Mode Instrument: COMPROMISING
Source: https://www.cpp.com/products/tki/index.aspx
You give up something,I will give up something.
Mildly Assertive & Cooperative
Prefer expedient, middle ground solutions
Thomas-Kilman Conflict Mode Instrument
Source: https://www.cpp.com/products/tki/index.aspx
Conflict Handling Skills
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In your experience, what is most difficult for you when
handling workplace conflicts?
Reflection
Conflict Management Skills
Common Ground
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Conflict Management Skills
Perspective TakingCognitiveSkills
EmotionalSkills
Conflict Management Skills
BehavioralSkills
Empathize
Handle Own Emotion
Avoid Escalation, Gossip, Retaliation
Initiate Dialogue
Establish Mutual Goals
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Perspective Taking
Perspective Taking
Check for Bias
Hold Judgment
Ask Questions
Mirror What You Hear
Agree on Steps Forward
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2
3
4
5
Emotion Handling
Separate Emotions from Facts
Focus on Behaviors
Establish Goals for Moving Forward
Communicate Feelings Appropriately
Create Mutual Expectations
1
2
3
4
5
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Emotion or Fact?
She was disrespectful to
me.
She was disrespectful to
me.
My manager is targeting me.
She gave me a bad evaluation.
My manager is targeting me.
She gave me a bad evaluation.
I felt demeaned.
I felt demeaned.
My professional judgment was
questioned.
My professional judgment was
questioned.
Avoid Pitfalls
Perspective Taking
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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!
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THANK YOU!
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