1. Mediation as an Option for Conflict Resolution Catholic Health East November 4, 2009 Philadelphia Mediation Group

2. 2 Presenter Introductions Kathryn Mariani, MAR is a mediator, trainer and consultant who has specializes in health care and aging. She works to establish national ethical standards and best practices in elder mediation. Nancy Neff Solnick, JD is a mediator, trainer and coach and a retired Certified Elder Law Attorney. She is one of the founders of the National Academy of Elder Law Attorneys.

3. 3 Session Objectives Distinguish facilitation from formal mediation View a videotaped facilitation demonstration Clarify roles in facilitation/mediation Examine ethical issues that arise in health care facilitation/mediation Identify the types of health care conflicts that may benefit from facilitation/mediation Consider how facilitation/mediation may be integrated into a health care facility

4. 4 Mediative Approach Progression First response – Active Listening – Assessment and referral Consultation with trained personnel – In-depth active listening – Assessment and possible referral Facilitated meeting with in-house facilitator Formal mediation with professional mediator

5. 5 Impact of Facilitation on Participants Expressed concerns and emotions Became calmer Gained greater clarity into their own opinions and desires Moved toward recognition of the other’s perspective Obtained information for decision-making Made decisions about how to proceed

6. 6 Attributes of the Facilitator/Mediator Calming presence Good listener Patient Respectful Impartial Non-judgmental

7. 7 Role of Facilitator/Mediator Orients parties to their own influence not that of the facilitator/mediator Supports the interaction between/among the participants Supports the emotional aspect of the conflict Helps parties identify and access necessary information Facilitates decision-making Assesses with the parties the need for additional conversations or process

8. 8 Who is the appropriate facilitator? How might your role affect your ability to be an effective facilitator? How are you perceived by the participants? Might you be able to facilitate if a resource person participates? Who else may be a more effective facilitator for this conflict? Viewed as neutral? trusted?

9. 9 Potential Participants Those Directly Involved in the Conflict Advocates Support Persons Others Invested in the Conflict Resource Persons

10. 10 Ethical Issues in Health Care Facilitation/Mediation Dual Roles Impartiality and Neutrality Confidentiality Self-Determination Sensitivity to Diversity Issues

11. 11 Potential Conflict Areas for Health Care Facilitation/Mediation Who gets to make medical and care decisions? Health Care Decisions Quality of Care Concerns End-of-Life Issues Discharge Issues Communication Issues Intra-Staff Conflicts

12. 12 How to Integrate A Mediative Approach into a Health Care Facility Gain support of administration and hospital community Educate and train staff Establish policies and procedures Create meeting spaces Establish relationships with outside professional mediators Monitor use and effectiveness of program