2. ESRD Network 6 5 Diamond Patient Safety Program Decreasing Patient & Provider Conflict Keeping It Cool: Conflict Management 2008

3. Keeping It C L! Created by Renée Bova-Collis, MSW, LCSW July 2007

4. Goal: To create an atmosphere that is both professional and comfortable for patients and staff.

5. Why Does MARC Have to Stick Their Nose in It? Subpart U regulations –Quality Improvement –Complaints and grievances

6. Network 5 Annual Complaint Comparison

7. Guided Imagery Exercise Adapted From 2005 NKF Clinical Meetings Presentation by Rick Russo, LMSW

8. Common Triggers of Hostile Patient Behaviors Ineffective Communication Skills Frustration/Overwhelmed with Emotions Perceived Disrespect/Belittlement Perceived Loss of Control FEAR

9. What is DPC? D ecreasing Dialysis P atient-Provider C onflict

10. C reate A Calm Environment O pen Yourself To Understanding Others N eed A Nonjudgmental Approach F ocus On The Issue L ook For Solutions I mplement Agreement C ontinue To Communicate T ake Another Look

11. PROFESSIONALISM

12. Professional Code of Ethics Builds confidence Accountability Liability

13. Merriam-Webster dictionary: Professionalism is a way of exhibiting a courteous, conscientious and generally businesslike manner in the workplace.

14. “Most relationships don’t become screwed up because one person is doing it wrong. They become unhealthy because two people spin off each other.” -Elizabeth B. Brown, Living Successfully with Screwed-Up People

15. Relationships: Personal vs Professional Purpose Balance of Power Focus

16. Challenging situations are often the delayed result of professional boundary violations.

17. Becoming Personally Involved Sharing that shifts FOCUS from pt to professional Lose ability to respond objectively React emotionally

18. Gifts Unit policy against giving/receiving of gifts Protects pts from feeling that they need to pay extra for quality Protects staff from feeling they need to give extra attention

19. Showing Favoritism Showing that you favor one patient over another, or facilitate a patient favoring you over other staff Creates expectation that it will be done again Expectation that other staff will do the same

20. Dual Relationships Exchange of goods or services

21. Fishbowl Effect

22. Other Pitfalls: Flirtation Inappropriate dress/language Ordering/parenting Having the last word Threatening termination

23. Malpractice: Watch your tone of voice Little to do with mistakes or skill Personal level -from Medical Economics www.memag.com Aug 18, 2006www.memag.com

25. Final Tips: How do you know if you are crossing a line? Allowed in other medical settings? Assist patient in care? Can it be documented? Willing to do for ALL patients?

26. Document. Document. Document. Just the facts, Ma’am What, Where, When, Why, How, Who If it’s not documented…

27. Healthcare workers are often nurturing and sensitive, thus susceptible to the formation of intense personal relationships.