Conflict ManagementConflict Management

Susan Bostwick MDSusan Bostwick MDWeill Medical College of Cornell UniversityWeill Medical College of Cornell University

David Keller MDDavid Keller MDUMass Memorial Children’s Medical CenterUMass Memorial Children’s Medical Center

Thanks to Aaron Friedman MD, Hasbro Children’s HospitalThanks to Aaron Friedman MD, Hasbro Children’s Hospital

Conflict is…Conflict is…The interaction of

interdependent people who perceive incompatible goals and interference from each other in achieving those goals.

-Hoeker & Wilmot

Take Home MessageTake Home Message• Conflict is:

InevitableNecessaryUseful

Today’s GoalsToday’s GoalsDefine Conflict and its propertiesUnderstand multiple approaches

to conflict management Reflect on your own approach to

conflictUnderstand tools that may be

used in conflict situations

What is conflictWhat is conflict• Pair-Share• Define the characteristics of

conflict

What is Conflict?What is Conflict?Conflict is not…• Sign of a bad

relationship • Negative

experience• Mistake • Struggle

between right and wrong

Conflict is…• Perceived

difference needs, values and

goals • Part of a

relationship• Consequence of

growth change

Examples of ConflictExamples of Conflict• Generational change:

Housestaff clash with primary care providers• Technology driven change:

Upgrading to electronic medical records• Change in scope of practice:

Should we admit to the hospitalists?• Something just isn’t fair:

What about our salaries?• Others

Advantages of ConflictAdvantages of Conflict• Diffuse more serious conflicts• Stimulate search for new facts

or solutions • Enhance relationships • Increase cohesiveness

Conflict should be managed not eliminated

Disavantages of ConflictDisavantages of Conflict• Time consuming • Disrupts progress/ problem

solving• Detracts from job at hand • Keeps people apart; if unresolved • Poor quality, lowers productivity• Reduces team effectiveness

Types of ConflictTypes of Conflict

Intrapersonal Interpersonal

Intragroup Intergroup

Sources of ConflictSources of Conflict

• Fear• Dishonesty • Boundaries• Negligence• Need to be right• Miscommunicatio

n

• Mishandling conflict in the past

• Hidden agenda• Revenge• Fighting the

“last war”

Small Group WorkSmall Group Work• Take 5 minutes to

read the “case study” at your table and discuss the nature of the conflict presented

• REPORT OUT: What is the type and source of the conflict?

Conflict ManagementConflict ManagementThe use of strategies

and tactics to move parties toward resolution or at least containment of a dispute that avoids further escalation and relationship destruction.

-Aschenbrenner

Conflict Management 1Conflict Management 1• Identify critical information

Whose problem is this?What is the situation?Issues, history, players, stake holders

Conflict Management 2Conflict Management 2• What organizational factors are

present? Policy/procedure, culture, working

conditions What personal factors do I need to

acknowledge? Personal issues, conflict resolution style,

what pushes my buttons

Conflict Management 3Conflict Management 3• Personal inventory

What role does my behavior play in the dynamic?

What situational elements am I willing/able to change?

What are my resource constraints? What matters to me --

• winning?• The relationship?, • specific outcome?

Conflict Management 4Conflict Management 4• Increase my effectiveness

Acknowledge my own feelings!!If not purely interpersonal –separate

the problem and the peopleFocus on interests – not positionsGenerate solution optionsConsider measurable outcomesRecognize successful conflict

management

Conflict ManagementConflict Management

Tailor your conflict management strategies to match situations with peers, supervisors or those that report to you.

Conflict Management: Conflict Management: PeersPeers

• Shared interest/goals• Non competitive approaches• Solve this without involving

others• Set the ground rules early • Consider humor• Cultivate relationships at all

times, not just during conflict

Conflict Management: Conflict Management: SuperiorsSuperiors

• Present relevant data accurately/concisely

• Be explicit about what you want • Be explicit about yourself• Link your goal to their values/goals• Acknowledge the constraints in their

positions • Understand organizational culture• Don’t expect gratitude or approval • Don’t cause them to lose face

Conflict Management: Conflict Management: SubordinatesSubordinates

• Match actions and words• Assume they know more about you

than you think • Be explicit about expectations and

consequences • Give and accept feedback in private• Deal fairly and objectively with poor

performance• Listen, learn [boomerang questions]• Be a coach not a player

Small Group WorkSmall Group Work• Back to your case. In

15 minutes, discuss: Whose problem is this? What is the power

dynamic? Who are the stake

holders? What organizational

factors are present?• REPORT OUT: Give us

the bullets in 1 minute.

Styles of ConflictStyles of ConflictSuccessful leaders

know their own preferred style of handling conflict, but vary their style to meet the needs of the situation..

Styles of conflictStyles of conflict

High

Low

Competition Collaborate

Compromise

Avoidance AccommodateLow High

Cooperativeness

AvoidanceAvoidance• “You don’t have a dog in this fight”• Cool down needed• No chance for success• Turn the other cheekDisadvantages

Missed opportunity to clarify issue Increases power differential Coward/pushover label Overused in healthcare

CompetitionCompetition• True zero sum game • Time constraints• “Opponent's” only styleDisadvantages

Sets power wins patternIncreases power differentialNot helpful in personal relationshipsNo ownership in the solution

AccomodationAccomodation• Issue more important to the other

party • Graceful exit strategy • Value the relationship • Competition getting no whereDisadvantages

You are a fixer/enabler Doormat Increase power differential

CompromiseCompromise• Issue and relationship important • Need temporary or expedient

“fix”• Collaboration falters Disadvantages

Focus on position/solution not issuesLose-lose rather than win-win May miss a systems solution

CollaborationCollaboration• Need to build support for implementation• Addressing complex problems• Change needed for the solution• Allows focus on goals, issues, values not positions or demands Disadvantages

Time consuming Both parties need to listen and learn Willingness to change Needs planning and team building

Communication SkillsCommunication Skills• LISTEN, LISTEN, LISTEN• Respect• Cultivate trust • Stay clear, concise, positive • Recognize body language• Use “I” statements not “you” statements (avoid blame)• Articulate your needs• Acknowledge others’ needs • LISTEN, LISTEN, LISTEN

Small Group WorkSmall Group Work• Back to your case. In

15 minutes, discuss: Discuss the pros and

cons of each approach to your conflict.

• REPORT OUT: Give us the bullets in 1 minute.

Styles of ConflictStyles of Conflict• To proactively

manage conflict, choose the collaborative approach whenever possible.

Successful Conflict Successful Conflict ManagementManagement

• Reconsider your definitions of conflict • Know your preferred style• Vary your style based on situation • Tailor your approach based on

involved parties• Proactively manage conflict –

anticipate • Communication – LISTEN