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.

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Presentation transcript:

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

OR Safety Attitudes Questionnaire - SAQ 12. In the OR, it is difficult to discuss errors

SAQ Participants N=165

Dimensions and Service Line Comparison 2009:

Launch of Team Training

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

Why Team Training?

Next Steps

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

Conflict in Health Care

Recipe for Conflict ? Ambiguity Complexity Vagueness Competition Hierarchy High stress

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

Is All Conflict Bad?

Power and Negotiation

Positional Bargaining

Interest-Based Negotiation

Positional Bargaining

Walk in the Woods A Path to Interest-Based Negotiation

Geneva, Switzerland 1982

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

Stakeholders

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

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

Enlarged Interests (Phase 2) AgreementsDisagreements 1) Hire new staff1) Reduce benefits 2) Measure quality 2) REFRAMING Self Enlarged Shared Mental Model

Enlarged Interests

How can we REFRAME to avoid this scenario?

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

Learning Steps Self Interests Enlarged Interests Investment Physical Emotion al Spiritual Financial Unlearning New Learning

Enlightened Interests (Phase 3) Imagine if….?

Enlightened Interests

No Commitment Zone Encourage open thinking and discussion Humor Creativity Exploration of ideas Spurring momentum

Enlightened Interests Ranking of ideas Examine the enlightened list What is agreed upon? Is it feasible? Ease of implementation? 6 Ease of Implementation Feasibility 3 2 1

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

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

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

Aligned Interests FairEquitable Meets the Test of Time Collaborative

Aligned Interests Record and Sign the Agreement Celebrate the Agreement

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

Action Steps To a multi-dimensional approach

Dimensions and Service Line Comparison 2009: 2013:

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

Thank You Scott Ellner, DO, MPH, FACS