Workplace conflicts and disputes are common, especially in the clinical practice industry, and pediatric care is no exception. In the management of care, conflict resolution and leadership disagreements are critical. Organizations incur considerable expenses due to conflicts, which include poor patient satisfaction, dysfunctional teamwork, and more significant employee turnover and retention, among other things. However, when conflict resolution skills are accepted and educated, the results include increased productivity, improved teamwork, increased employee/patient happiness, and lower turnover and retention, to name a few. As a result, the article below provides an overview of alternative resolution strategies/conflict management concepts, conflict phases and types, conflict management tactics, and professional integrity in the pediatric operating room.
Conflict in healthcare is defined by a lack of communication which is the leading cause of intraoperative errors. For example, in the pediatric care unit, when the patient needs long-term care, conflict occurs mainly between the parents and the care team due to differences in the religious and cultural beliefs of the parents. Due to the difference in knowledge, the caregivers should inform the parents about the treatment method to avoid dehumanization and stigmatization. Though it may not be a regular part of clinical training, conflict management strategies can help prevent worsening and competing, partnering or collaborating, compromising or avoiding, and accommodating from the Thomas-Kilmann conflict mode instrument (Forbat et al., 2017). The stated conflict style depends on the degree of either assertiveness or cooperativeness. The Dutch Test for conflict handling describes the five major conflict management strategies: forcing, problem-solving, avoiding, and yielding. The Dutch test and the Thomas- Kilmann approaches analyze conflict management among health workers. It is critical in the pediatric operating room to control one’s emotions during a conflict to calm the atmosphere.
On the other hand, active listening is an excellent way to improve team dynamics. To foster collaborative issue solving, the interests of the parties involved in the conflict should be aligned. Formal education for all perioperative team members promotes better communication, teamwork, and patient outcomes. Conflict at children’s hospitals is frequently caused by a breakdown in communication between parents and the clinical team about the treatment method chosen (Sinskey et al., 2019). By resolving interpersonal and organizational difficulties that impede team functionality, seamless communication across the nursing team promotes excellent patient care.
Conflict resolution is linked to better patient outcomes and the well-being of families and employees. After learning about the four stages of the conflict, finding a solution is simple (Forbat et al., 2017). The first phase is characterized by competition and frustration among the parties concerned. In the second phase, the concerned parties are assigned to the conflict’s cause. It happens quickly, causing misunderstandings and hastening the dispute. The third is a behavioral response to the conflict’s root cause. The final phase entails the outcome of the behavioral response, which could, for example, divert a physician’s attention away from their primary task of caring for a critically ill child.
Following the phases, it is crucial to examine the three types of conflict. Task conflict, interpersonal conflict, and process conflict are examples of these. The first relates to the conflict that arises due to the task’s content. Because it synergistically allows for problem-solving, this conflict can effectively improve team performance. Personality clashes, such as differences in goals, values, or distinct cultures, cause relationship problems. Disagreement about how to do a task is a process conflict that, if left unresolved, can harm the team’s performance.
Competing is a fundamental conflict management style typical in emergencies with high stakes and necessary decisive action. For instance, a post-tonsillectomy patient who needs an emergent operation may trigger his parents to be adamantly present for induction in the operating room. In such a case, the doctors may deny their request for the sake of the patient’s safety. The best course of action is to use conflict resolution strategies, including emotional recognition and management, active listening, and interest alignment. Accommodating may be more appropriate when preserving the relationship than the more critical issue to the other person. A patient may want to wait for the return of his parents, who steps away before an urgent operational need. In this case, the surgeon must accommodate the child’s request. Avoiding is another technique, and it is applicable when the issue is inconsequential compared to the task in concern—for example, ignoring a child’s emotions and inducing the child to anesthesia.
Compromising is crucial in times of infeasible collaboration where each party must contribute to achieving conflict resolution. When dealing with a patient with high chances of developing complications from general anesthesia due to cardiac disease, the doctors may agree to opt for less invasive and shorter surgery to minimize the risk (Sinskey et al., 2019). Conflict management techniques include acknowledgment and management of emotion, which help in effectively leading an interdisciplinary team, coordinating care with other health care workers, and changing the patients’ perspectives in the pediatric operating room.
Active listening is another technique that establishes a good patient-doctor relationship hence increasing patient satisfaction. Actively listening translates to valuing the opinion and feelings of the patient. Alignment of interest entails focusing on the interest of the parties in need of a solution. The main types of interest include substantive, procedural, and psychological. Substantive refers to the tangible outcome and benefit from solving the conflict. The procedural analyzes the preference for the conflict resolution process and the psychological focuses on emotions arising from conflict resolution. Conflict management education using either case studies or training by having training workshop series is essential for every pediatric operating team.
Reference
Forbat, L., Simons, J., Sayer, C., Davies, M., Barclay, S (2017). Training pediatric healthcare staff in recognizing, understanding, and managing conflict with patients and families: findings from a survey on immediate 6-month impact. Archives of Disease in Childhood, 102 (3): 250-254
Sinskey, J., Chang J., Shibata, G., Infosino, A., Rouine-Rapp, K. (2019). Applying conflict management strategies to the pediatric operating room. Anesthesia and Analgesia 129 (4): 1109-1117.