D ecreasing P atient-Provider C onflict

1. DecreasingPatient-Provider Conflict University of Utah Dialysis Program

2. What is DPC and Why Should I Care • DPC stands for Decreasing Patient/Provider Conflict • ESRD stakeholders from Regional ESRD Networks developed this plan in response to recorded patient complaints and involuntary patient discharges. • Resolving any Patient/Provider Conflict in a timely and appropriate manner is paramount to the success of any dialysis clinic and patient care model. • The University of Utah, feeling DPC is highly important, has decided to make this issue a mandatory training module for all staff.

3. 8 STEPS TO RESOLVING C-O-N-F-L-I-C-T Create a Calm Environment Open Yourself to Understanding Need a Non-Judgmental Approach Focus on the Issue Look For Solutions Implement Agreement Continue to Communicate Take Another Look

4. Create a Calm Environment • In order to effectively address a conflict, you need to be aware of the physical surroundings, as well as thoughts and feelings you are experiencing because of the conflict

5. How To Create A Calm Environment • Assess the situation. • Use private settings to address the conflict. • Remain calm yourself… you set the tone. • Demonstrate an open and non-threatening attitude.

6. Open Yourself to Understanding Others • When addressing conflict, it is important to acknowledge the perspective and feelings of the other individuals involved

7. How to Open Yourself to Others • Listen closely to what the client is telling you about the complaint or concern. • Show that you are trying to understand what the other individual is saying about the conflict. • Recognize and accept that a patient has the right to disagree, question, or refuse medical recommendation. • Remember that many factors affect how people handle conflict including culture, age, race, gender, economic status, family, upbringing and education level.

8. Need a Non Judgmental Approach • As A Dialysis Professional, it is important for you to maintain an objective professional approach as you address the conflict. • Understand how you react to conflict and prepare yourself to remain professional • Avoid using remarks towards the patient that are blaming, threatening or those that project guilt • Understand others have different values and beliefs… and that’s okay. • Avoid using your authority as a health care professional to impose your view • Make no assumptions about a patients ability to understand or comprehend what you are trying to communicate

9. When Conflict Occurs, there is a tendency to loose sight of the issue that started the conflict in the first place. FOCUS ON…….. 1) Using positive communication skills such as repeating or clarifying what has been said in an effort to understand the conflict 2) Seek patient agreement on what the conflict is 3) Demonstrate a willingness to address the conflict, i.e. give the patient all your attention and cease all other activity 4) Maintain focus on the agreed upon issue. Don’t go off onto topic Z when the conflict is about A Focus on the Issue

10. Look for Solutions • Not all conflicts can be resolved nor are all conflicts based on valid complaints. BUT working in collaboration with the patient will improve the likelihood of a positive outcome.

11. How to Look for Solutions • Brainstorm possible solutions with the patient. Ask the patient what he or she wants to accomplish. • Hold a care conference and enlist family members, friends, staff or other individuals whom the patient trusts in an effort to solve the problem. • Be creative and flexible. Consider all available options to resolve the conflict • Let the patient know that even if the entire problem cannot be fixed, there are parts of the conflict that can be resolved. • Only make promises you can keep.

12. Implement Agreement • Use actions statements to describe the agreement. • Document in Clinical Vision and communicate to your managers and other staff that an agreement has been met. • Be consistent with any arrangements that are made. Agreeing to change some aspect of normal clinic operations and not following through will likely lead to more conflict.

13. Continue to Communicate • Effective resolution of a conflict requires follow-up communication. This will allow you to monitor the progress being made, and will demonstrate to the patient your commitment to resolving the conflict.

14. How to Communicate Effectively • Get a specific time frame in which you plan to sit down with the patient again to look at the changes that were made and evaluate the effectiveness of the changes • Be open and ready to deal with the fact that not all conflict is easily resolved. Also be ready to revisit steps in the DPC Model • If it is evident that the conflict is continuing, consider involving the Social Worker or Manager

15. Take Another Look • Handling a conflict, like successfully performing dialysis related tasks, requires PRACTICE, UNDERSTANDING, EDUCATION and MONITORING. Regardless of whether a conflict is minor or major, reviewing the steps used in addressing conflict will be beneficial.

16. Taking Another Look • Meet with other staff members to discuss other possible ways of responding to conflict. • Seek additional resources that can educate you on professionalism and conflict resolution. • Take a Close look at the role you have played in work related conflicts. • Evaluate and try to understand the roots of each conflict.

17. One more time…… What is DPC? DECREASING PATIENT/PROVIDER • Create a Calm Environment • Open Yourself to Others • Need a Non-Judgmental Approach • Focus on the Issue • Look for Solutions • Implement Agreement • Continue to Communicate • Take Another Look