CONFLICT IS AN ACTIVE DISAGREEMENT BETWEEN PEOPLE WITH

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2 by Rose Seavey, MBA, BS, RN, CNOR, CRCST, CSPDT President/CEO of Seavey Healthcare Consulting Managing Conflict LEARNING OBJECTIVES 1. Explain organizational benefits of 2. Review five basic strategies to manage 3. List steps to mediate between employees 4. Present eight best practices to manage 5. Address how trust affects management CONFLICT IS AN ACTIVE DISAGREEMENT BETWEEN PEOPLE WITH opposing opinions or principles. Its results can be minor (e.g., a difference of opinion) or more serious (e.g., individuals are incompatible). At the extreme, outright opposition can hinder the attainment of healthcare facility and/or departmental goals. In a labor-intensive healthcare facility with many departments employing numerous people, is almost inevitable. What follows are some of the reasons: Increasingly limited resources Differing goals or outcomes Role ambiguity ( Whose job is it? Who is responsible? ) Stressful working relationships Individual differences (diversity) Organizational issues Communication problems A Central Service (CS) manager s ability to address impacts the work environment and creates employee cooperation (and goal attainment) or (and goal blockage). OBJECTIVE 1: EXPLAIN ORGANIZATIONAL BENEFITS OF CONFLICT There are potential organizational benefits to. Managers may more thoroughly analyze goals and the strategies to attain them to establish priorities. Differences of opinion and perspectives about work processes can lead to performance improvements as work tasks are discussed, reviewed, revised and implemented. Another benefit: managers can practice and improve upon their decision-making and problem resolution skills as they manage within their areas of responsibility. As Figure 1 indicates, some observers believe may actually contribute to optimal organizational performance. When reviewing Figure 1, note the level of is graphed on a line from low to high. As well, an organization s level of performance can be graphed from low to high. A low level of This series of self-study lessons on CS topics was developed by the International Association of Healthcare Central Service Materiel Management (IAHCSMM), and can be used toward CRCST re-certification or toward nursing credits. Pfeidler Enterprises and IAHCSMM both offer grading opportunities. Earn Continuing Education Credits Online: Nursing Credit: Pfiedler Enterprises will award nursing credit for this Self-Study Lesson Plan. Pfiedler Enterprises is a provider approved by the California Board of Registered Nursing, Provider Number CEP 14944, for 1 contact hour. Obtaining full credit for this offering depends upon attendance, regardless of circumstances, from beginning to end. Licensees must provide their license numbers for record keeping purposes. The certificate of course completion issued at the conclusion of this course must be retained in the participant s records for at least four (4) years as proof of attendance. In order to receive credit you must go to and complete the test, evaluation and registration forms. Once completed, you will be directed to print your certificate of completion. Scoring: IAHCSMM will award credit for this Self- Study Lesson Plan toward the renewal of a CRCST certification. To receive IAHCSMM credit, please visit for online grading (nominal fees will apply). Each 20 question online quiz with a passing score of 70% or higher is worth two points (2 contact hours) toward CRCST re-certification of 12 CEs. For more information: For questions or problems about Nursing Credits available for this lesson plan, please contact tonia@pfiedlerenterprises.com. For questions about IAHCSMM Credit available for this lesson plan, please contact us at or mailbox@iahcsmm.org. MAY / JUNE 2016 Communiqué 51

3 Figure 1: Conflict Yields Optimal Performance Level of Performance Level of Conflict and performance yields stagnation, and when there is a high level of and a high level of performance, chaos is likely. Figure 1 suggests that optimal organizational results occur at the intermediate point, where the levels of and performance cross. Allowing healthy can actually help to improve situations by: Engaging employees (e.g., the ability to voice their opinions in a professional manner) Getting employees attention (e.g., Chaos Chaos Figure 2: Five Conflict Management Strategies Very Assertive Competition Optimal Results staying focused on task) Improving employee relationships (e.g., feeling comfortable enough to disagree can strengthen relationships over the long run) Improving employee morale (e.g., allowing them to speak freely) Improving ideas (e.g., speaking freely and not being afraid of ) OBJECTIVE 2: REVIEW FIVE BASIC STRATEGIES TO MANAGE CONFLICT A manager s assertiveness (desire to meet Collaboration departmental needs) and willingness to cooperate (desire to meet the other party s needs) are factors that influence the selection of management strategies. This relationship is illustrated in Figure 2. When reviewing Figure 2, note that the degree of cooperation ranges from not cooperative to very cooperative and the degree of assertiveness ranges from not assertive to very assertive. Five management strategies become possible: 1. STRATEGY ONE: AVOIDANCE (NOT COOPERATIVE; NOT ASSERTIVE) The manager exerts little effort to satisfy either his/her own or the other person s or department s goals. Tactics include withdrawing from the situation, avoiding contact with the other person and refusing to discuss the situation creating the. When avoidance occurs, critical issues may go unaddressed, and issues may continue or even worsen. When might a avoidance strategy be used? Examples include: For unimportant issues When the manager knows he/she can t win the When other people are judged able to more effectively resolve the When there is an interest in reducing tension and stress When the issue is a symptom of a problem rather than a problem itself Degree of Assertiveness Not Assertive Avoidance Mutual Problem-Solving Degree of Cooperation Accommodation Very Cooperative 2. STRATEGY TWO: ACCOMMODATION (VERY COOPERATIVE; NOT ASSERTIVE) Managers using this strategy attempt to achieve the other person s or department s goal rather than their own. This may be a useful approach when the other party is stronger, when the issue is judged unimportant by one party, or when the relationship with the other person or department is unimportant. Problems include limited creativity and a reduced 52 Communiqué MAY / JUNE

4 NURSING LESSON PLAN interest in the search for solutions. Conflict accommodation can be useful when: The manager knows he/she is wrong, wants to learn, and/or wants to be seen as reasonable. Issues are more important to the other party, and use of the strategy will be viewed as cooperation. The manager wants to help others learn from mistakes. 3. STRATEGY THREE: COMPETITION (NOT COOPERATIVE; VERY ASSERTIVE) This strategy focuses only on attaining one s goals. Tactics include the use of authority (power) and a reliance on rules and policies. It is useful when quick and decisive action is needed. Problems include affected relationships, limits to creativity, and a reduced search for solutions. Conflict competition might be useful: When quick action is needed. On important issues where unpopular actions must be implemented. On vital issues when the manager knows he/she is right. When a manager wants to use noncompetitive behavior to benefit for his/her department. 4. STRATEGY FOUR: COLLABORATION (VERY COOPERATIVE; VERY ASSERTIVE) This strategy focuses on discovering a solution that best interests both parties. No assumption is made that both parties must give up something to gain something else. This strategy is typically time consuming, and it may not be useful when issues involve the values of the parties attempting to resolve the. Conflict collaboration can be useful: To find a mutually beneficial solution when concerns of both parties cannot be compromised. When the manager wants to learn. To merge inputs from people with different views. To gain commitment. To improve feelings that have previously affected relationships. 5. STRATEGY FIVE: MUTUAL PROBLEM SOLVING (MULTI-STRATEGY METHOD) This strategy, like collaboration, focuses on solutions in the best interest of both parties. It is often accomplished through fixed sum negotiation: each party gains and loses something. This creates a problem when: Managers realize they must give up something to gain something. Mutual problem solving may be useful: Goals are important, but not worth the potential disruption of more assertive tactics. The other party has equal power and is committed to mutually beneficial goals. Attaining temporary settlement of a complex issue. Generating a useful solution when time is critical. Collaboration or competition is not successful. Alternative resolution strategies are planned. OBJECTIVE 3: LIST STEPS TO MEDIATE CONFLICT BETWEEN EMPLOYEES CS managers who effectively manage contribute to departmental efficiency. Sometimes speaking with affected employees individually is useful, especially when the is complicated or serious. Avoid jumping to conclusions and keep an open mind as conversations and meetings about the evolve. What follows are six steps that can be followed to manage a discussion of employees who are involved in : Step 1 Set the tone. Establish an open and non-threatening atmosphere for the meeting. A statement, I ve noticed something seems to be different between you two lately, and I hope it is something we can discuss is better than I know there is a problem and we must address it now. Step 2 Focus on discovering employees feelings. This can help staff members release their emotions and clear the way for an effective solution. Allow employees to talk out their feelings and then summarize and restate them for clarification. Avoid any indication of approval or disapproval about what is said and do not question, criticize, interpret or sympathize. Employees asked to express themselves frequently become encouraged to start talking, and it becomes easier to move from emotions and feelings to reasons and solutions. Effective managers know they must first deal with emotions. Step 3 Obtain the facts. Fact finding involves patient listening, careful review and clarification, and listening for what is not said. Depersonalize the by addressing it as if it could occur with anyone. Ask affected employees to pretend they are managers trying to discover what has contributed to the, and ask each employee to think about how the other person may have seen the situation. Step 4 Ask for help. Conflicting parties should be asked to help resolve the. This tactic is typically much better than telling employees what they should do to resolve it. Employees will be more willing to resolve the because their self esteem needs will be addressed. Lead the employees toward future actions. It is each employee s responsibility to resolve the ; a manager can only facilitate discussion, add suggestions and secure commitment for resolution. Step 5 Obtain commitment. After agreement, ask the employees to commit to performing their part of the solution. MAY / JUNE 2016 Communiqué 53

5 This can typically be accomplished with an oral statement about the who, what, when and how of the resolution plan. Step 6 Follow up. Schedule a followup meeting to assure that the solution has been implemented and is working. If the continues, determine possible reasons and address them. Sometimes, managers must have their own plan ready, review it with the employees and inform them that this alternative will be necessary if resolution is not possible. OBJECTIVE 4: PRESENT EIGHT BEST PRACTICES TO MANAGE CONFLICT A best practice is a way of performing an organizational function or process that is better than all other methods. The term typically applies to procedures used by organizations, but it can also be applied to suggested behavior for individuals. Best practices to resolve s must recognize that resolution strategies should confront the itself rather than the other person. Remember that the problem not the other person is the enemy. All parties work for the same organization, are concerned about it and want their employer to improve. They cannot add value to the organization when they are in with another team member. Effective CS managers use the following best practices to manage organization : They are aware of how they typically handle. They determine whether subconscious, procedural or psychological needs are impacted by the. Note: Thinking about what will happen if the is not addressed may help to clarify one s needs. They assess the mechanics for resolution efforts, including who, what, where, why and when, and the ground rules for effectively managing the situation. They know it is critical to understand the other person before they are understood by the other person; in other words, they listen carefully to understand the other person s point of view. They clearly assert their needs. They are specific, respect the needs of the other party, build on what they learn, and continue listening. They are flexible as they identify the issues, generate alternatives and determine how challenges will be addressed. They recognize that impasses may occur that must be managed. Tactics include breaking a resolution process into manageable parts, restating or considering new options, reaffirming the ground rules for the resolution process and, sometimes, taking a break and returning to the issue at another time. They build workable agreements. This most frequently occurs when all affected parties assist with implementation, when realistic action steps are taken and when the agreement is future oriented. OBJECTIVE 5: DISCUSS HOW TRUST IMPACTS CONFLICT MANAGEMENT Trust relates to the beliefs and expectations about another person, based upon one s experience. Staff members who trust their superiors are more self assured, open, willing to take risks and accept change, and more aligned with the facility and the department in which they work. Trust encourages collaboration (winwin resolution) and creativity. The best CS managers build and maintain trust. They are ethical, dependable (consistent and reliable), fair, loyal and competent. They admit mistakes, acknowledge, as necessary, the need for their own personal improvement, and request feedback (and consider it) in efforts to improve. They share information that is useful to others and openly acknowledge the help of their associates. They also change their position when confronted with a better idea, and they are considerate of how others will react to their recommendations. When genuine trust is ingrained into an organizational culture, there is typically an increased willingness to resolve in a manner beneficial to both parties and, in the process, to the organization and the departments within it. Healthcare organizations most effective in building and maintaining trust are ethical and socially responsible, and they provide high-quality and ongoing training and development opportunities for their staff members. The best facilities also provide job security and they promote open communication up, down and across the organization. IN CONCLUSION Conflict in healthcare organizations can yield positive outcomes, especially when Central Service managers utilize best practices of resolution. As well, an organizational culture that emphasizes trust of and respect for staff members at all levels is important to assure that benefits rather than hinders the attainment of organizational goals. RESOURCES 1. british/ html susan-steinbrecher/resolving--sixsi_b_ html. 54 Communiqué MAY / JUNE