Professionalism/Customer Service in the Health Care Environment

1. Professionalism/Customer Service in the Health Care Environment Conflict Resolution Lecture b – Managing Conflict This material (Comp 16 Unit 6) was developed by The University of Alabama Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000023. This material was updated in 2016 by Bellevue College under Award Number 90WT0002. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

2. Managing ConflictLearning Objectives • Describe various styles for handling conflict. • Identify ways to minimize dysfunctional conflict in a group.

3. Handling Conflict • Thomas-Kilmann conflict mode instrument • Five conflict-handling modes • Two dimensions: • Assertiveness: Individual seeks to satisfy own concerns • Cooperativeness: Individual seeks to satisfy others’ concerns Schaubhut, 2007; Thomas & Kilmann, 2016

4. Handling Conflict Continued • Thomas and Kilmann’s five conflict-handling classifications: • Competition (assertive–uncooperative) • Avoidance (unassertive–uncooperative) • Compromise (middle ground) • Accommodation (unassertive–cooperative) • Collaboration (assertive–cooperative) Schaubhut, 2007; Thomas & Kilmann, 2016

5. Thomas and Kilmann Conflict Management Styles Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016

6. Thomas and Kilmann Conflict Management Styles Continued Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016

7. Thomas and Kilmann Conflict Management Styles Continued 2 Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016

8. Thomas and Kilmann Conflict Management Styles Continued 3 Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016

9. Thomas and Kilmann Conflict Management Styles Continued 4 Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016

10. Individual Intentions or Preferences in Conflict Situations • Individual conflict-handling preferences relate to Thomas and Kilmann’s classifications • Collaboration: Win–win • Competition: Inconsequential or quick decisions • Accommodation: Enhances long-term relationships • Response to a conflict can change over time Schaubhut, 2007; Thomas & Kilmann, 2016

11. Individual Intentions or Preferences in Conflict Situations Continued • Innate preferences for handling conflict • Enduring response traits or dispositions for dealing with conflict • Correspond to Thomas and Kilmann’s conflict handling styles Sternberg & Soriano, 1984

12. Conflict Intensity Continuum • Deliberate efforts to undermine the other party • Physical violence • Threats and ultimatums • Verbal attacks • Questioning/challenging others • Minor disagreements and misunderstandings • Absence of conflict Bowers & Ferror, 2014; Robbins & Judge, 2017

13. Fuel for Conflict • Health IT implementations involve change. • Change is stressful. • People respond to stress in different ways. • Stress can lead to conflict. • Maintaining a professional demeanor is the best path.

14. Conflict Intensity Continuum Continued • Deliberate efforts to undermine the other party • Threats and ultimatums • Verbal attacks Robbins & Judge, 2017

15. Conflict Intensity Continuum Continued 2 • Questioning/challenging others • Minor disagreements and misunderstandings • Absence of conflict Robbins & Judge, 2017

16. Language That Escalates or Deescalates Conflict Phrases to Avoid: • I’ll try • You’ll have to • I didn’t create the problem • It’s super easy • That’s the policy • It’s not my job • You should never • I can’t • You don’t understand • You’re not listening Phrases to Use: • I will • Let’s • I understand how you feel • Can I ask you to…? • Have you tried…? • Would you like…? • I’m sorry you had that experience • I can Downey, 2012; U.S. Chamber of Commerce Foundation, 2015

17. Results of Conflict • Positive or functional conflict can result in • Better decisions • Improved creativity and innovation • An environment in which group members feel engaged • Self-evaluation and positive change • Functional conflict can lead to • Improved decisions • Allowing all points of view, including minority views, to be included in key decisions

18. Results of Conflict Continued • “Groupthink” • Team shuts down conflicting ideas • Team begins to think alike • Role of functional conflict • Can reduce groupthink • Improves the quality of decisions • Furthers creation of new ideas • Stimulates engagement and interest in group members • Provides a vehicle for surfacing, discussing, and resolving tensions • Promotes reassessment • Increases probability of response to change Janus, 1972; Robbins & Judge, 2007/2017; Todorova, Bear, & Weingart, 2014

19. Results of Conflict Continued 2 • Negative or dysfunctional conflict: • “Among the undesirable consequences are poor communication, reductions in group cohesiveness, and subordination of group goals to the primacy of infighting among members.” Choudhary2014; Robbins & Judge 2017

20. Minimizing DysfunctionalConflict in Groups • Add new or relevant information • Reward dissent • Create more diverse and heterogeneous groups • Restructure existing groups to upset the status quo • Include a devil’s advocate

21. Minimizing DysfunctionalConflict in Groups Continued • Check to see if there’s actually disagreement vs. miscommunication • Encourage open discussions of differences • Ask disagreeing parties which elements of the issue under discussion are most important to them • Identify shared interests among the group members Robbins & Judge 2017

22. Conflict ResolutionSummary – Lecture b • Conflict may result in positive or negative outcomes. • May help parties think creatively about solutions • May damage relationships when handled poorly • People handle conflict in different ways. • By contributing in productive exchange • By becoming defensive • Dysfunctional conflict in a group can be minimized with the right words and actions.

23. Conflict ResolutionReferences – Lecture b References Bowers, P., & Ferron, L. (2014). Confronting conflict with higher-ups. American Nurse Today, 9(1): 52. Choudhary, J. D. (2014, May). Lateral violence in healthcare environments: Anne Arundel Community College’s approach to teaching conflict management skills. Nevada RNFormation. Downey, J. (2012). “I” language series: Responsibility and building relationships. Relationship communication skills. Retrieved from http://verysmartgirls.com/relationship-communication-skills/i-language-series-responsibility-and-building-relationships Janus, I. L. (1972). Victims of groupthink: A psychological study of foreign-policy decisions and fiascoes. Oxford, UK: Houghton Mifflin. O’Connell, M. R. (2014). Conflict’s positive and negative aspects [weblog comment]. Retrieved from https://Viaconflict.wordpress.com/2014/02/16/conflicts-positive-and-negative-aspects Rahim, M. A. (2011). Managing conflict in organizations, 4th ed. New Brunswick, NJ: Transaction Publishers. Registered Nurses Association of Ontario. (2012). Managing and mitigating conflict in healthcare teams. Retrieved from http://rnao.ca/sites/rnao-ca/files/Managing-conflict-healthcare-teams_hwe_bpg.pdf Robbins S. P., Judge T. A. (2007). Organizational behavior, 12th ed. Upper Saddle River, NJ: Pearson Prentice Hall.

24. Conflict ResolutionReferences – Lecture b Continued Schaubhut, N. A. (2007). Technical brief for the Thomas-Kilmann conflict mode instrument: Description of the updated normative sample and implications for use. CPP Research Department. Retrieved from https://www.cpp.com/Pdfs/TKI_Technical_Brief.pdf Sherman, R. (2012). Carefronting: An innovative approach to managing conflict. American Nurse Today, 7(10). Retrieved from http://www.americannursetoday.com/carefronting-an-innovative-approach-to-managing-conflict Sternberg, R. J., & Soriano, L. J. (1984). Styles of conflict resolution. Journal of Personality and Social Psychology, 47(a),115–126. Thomas, K. W., & Kilmann, R. H. (2015). An overview of the Thomas-Kilmann conflict mode instrument (TKI). Retrieved from http://www.kilmanndiagnostics.com/overview-thomas-kilmann-conflict-mode-instrument-tki Todorova, G., Bear, J. B., & Weingart, L. R. (2014). Can conflict be energizing? A study of task conflict, positive emotions, and job satisfaction. Journal of Applied Psychology, 99(3), 451–467. U.S. Chamber of Commerce Foundation. (2016). Words to avoid that escalate conflict. Retrieved from http://institute.uschamber.com/words-to-avoid-that-escalate-conflict

25. Conflict ResolutionReferences – Lecture b Continued 2 Images Slide 5: Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016. Slide 6: Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016. Slide 7: Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016. Slide 8: Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016. Slide 9: Adapted from Schaubhut, 2007; Thomas & Kilmann, 2016. Slide 13: Microsoft clip art; used with permission from Microsoft.

26. Professionalism/Customer Service in the Health Care EnvironmentConflict ResolutionLecture b This material was developed by The University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000023. This material was updated in 2016 by Bellevue College under Award Number 90WT0002.