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Dealing with Conflict in Health Care: The Next Dimension of Team Training

Dealing with Conflict in Health Care: The Next Dimension of Team Training. Scott Ellner , DO, MPH, FACS Vice Chairman of Surgery Saint Francis Hospital and Medical Center Hartford, Connecticut. JUNE 27, 2013. Blame and Shame. Identify Culture. Communication Behavior Rituals Tolerance.

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Dealing with Conflict in Health Care: The Next Dimension of Team Training

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  1. Dealing with Conflict in Health Care:The Next Dimension of Team Training Scott Ellner, DO, MPH, FACS Vice Chairman of Surgery Saint Francis Hospital and Medical Center Hartford, Connecticut JUNE 27, 2013

  2. Blameand Shame

  3. Identify Culture • Communication • Behavior • Rituals • Tolerance

  4. OR Safety AttitudesQuestionnaire - SAQ

  5. SAQ Participants N=165

  6. Dimensions and Service Line Comparison 2009:

  7. Launch of Team Training

  8. Team Training Tool • Session 1 – Crucial Conversations • Session 2 – Getting What You Want: Communication Strategies That Help You Get What You Need • Session 3 – When the Going Gets Tough: Achieving a Positive Outcome

  9. Why Team Training?

  10. Next Steps

  11. Presentation Objectives • Describe the root of conflict • Understand how to reframe during negotiations • Learn the Walk in the Woods Technique

  12. Conflict in Health Care

  13. Recipe for Conflict Complexity Vagueness ? Ambiguity Competition Hierarchy High stress

  14. Recipe for Conflict Mistrust Disruptive Behavior CO NS EQ UE NC ES Changes in Policy

  15. Is All Conflict Bad?

  16. Power and Negotiation

  17. Positional Bargaining

  18. Interest-Based Negotiation

  19. Positional Bargaining

  20. Walk in the Woods A Path to Interest-Based Negotiation

  21. Geneva, Switzerland 1982

  22. Step by Step Approach Problem Solution Self-Interests Aligned Interests Enlightened Interests Enlarged Interests

  23. Stakeholders

  24. Self-Interests (Phase 1) Problem Active Listening Building Confidence (Trust) Constructive and safe zone expression of interests What Gains can come from this meeting?

  25. Self-Interests Recognition of the complexity of the Problem Productive Conversation

  26. Enlarged Interests (Phase 2) REFRAMING Agreements Disagreements Self 1) Hire new staff 1) Reduce benefits 2) Measure quality 2) Enlarged Shared Mental Model

  27. Enlarged Interests

  28. Enlarged Interests How can we REFRAME to avoid this scenario?

  29. Enlarged Interests Identify and interpret each choice What is it we agree upon? Encourage questions to generate discussion REFRAMING

  30. Learning Steps Enlarged Interests Self Interests Unlearning Investment Physical Spiritual Emotional Financial New Learning

  31. Enlightened Interests (Phase 3) Imagine if….?

  32. Enlightened Interests

  33. Enlightened Interests No Commitment Zone Encourage open thinking and discussion Humor Creativity Exploration of ideas Spurring momentum

  34. Enlightened Interests Ease of Implementation Ranking of ideas 3 Examine the enlightened list Feasibility 2 1 Is it feasible? What is agreed upon? Ease of implementation?

  35. Enlightened Interests The Capacity to Imagine IDEAS IDEAS Deal Makers Deal Breakers 3 1 Further Negotiation 2

  36. Aligned Interests (Phase 4) Redefining Success Mesh We I Alignment Overlapping Interests

  37. Aligned Interests Creating Value for All Parties When I Succeed, then YOU Succeed….. …..When YOU Succeed, then WE Succeed Each party achieves a recognizable gain

  38. Aligned Interests Collaborative Fair Equitable Meets the Test of Time

  39. Aligned Interests Record and Sign the Agreement Celebrate the Agreement

  40. Action Steps Aligned Interests Enlightened Interests Negotiation from a Uni-dimensional approach

  41. Action Steps To a multi-dimensional approach

  42. Dimensions and Service Line Comparison 2009: 2013:

  43. Summary Conflict occurs everyday in everyway Self Interests = Presenting each party’s interests Enlarged Interests = Reframing occurs Enlightened Interests = Exploring the options Aligned Interests = Agreeing on recognizable gains The Walk in the Woods technique is a valuable strategy to use when negotiating conflict

  44. Thank You Scott Ellner, DO, MPH, FACS sce107@mail.harvard.edu

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