1. MAKING THE MOST OF CONFLICT K&R LLC K & R Kuest & Robinson K & R Kuest & Robinson 1 Association of Washington Public Hospital Districts

2. Kuest&Robinson LLC  Background:  Ron Kuest, Principal rdkuest@comcast.net (360)280-1513  Lloyd Robinson, Principal robinson2002wa@aol.com (206)406-4604 2 Association of Washington Public Hospital Districts

3. Definitions  Conflict: A disagreement at work when the individuals involved believe there is a threat to their needs, interests or concerns. These disagreements often involve misunderstandings or misperceptions of facts, are often emotional and affect many aspects of work. 3

4. Definitions  Unproductive conflict: Conflict among individuals that interferes with safe and productive work.  Productive conflict: Disagreements in a safe environment marked by trust, openness, respect and mutuality.  Conflict competency: The ability to engage in disagreements and tension with others and produce results of the effort while building trust and amity. 4

5. Life Process of a Conflict Working together— both sides realize a new order is necessary for economic/ organizational survival. Cost/losses are huge at this point. 5 Beginning --a difference of opinion, view or belief Early Growth-- no method or skills to deal with dispute. Hostility is expressed. Deadlock-- two sides at war. A mutually hurting stalemate waiting to break out into violence. Looking for a way out-- to cut losses or gain time to rebuild. Both parties become open to negotiation and mediation. Settling dispute or resolving conflict-- both sides too weak to continue to fight. Open to resolution but so much hurt is on the table.

6. Why is This Important?  85% of employees have to deal with conflict in some way in their working lives.  Conflict at the senior level is found in many organizations and can have a significant cultural impact on the organization. Source: OPP Study 2008 6

7. Why is This Important? "Unresolved conflict represents the largest reducible cost in many businesses, yet it remains largely unrecognized." (Dana, Daniel (1999). Measuring the Financial Cost of Organizational Conflict. MTI Publications and Slaikev, K. and Hasson, R. (1998). Controlling the Cost of Conflict. Jossey- Bass) 7

8. What is the Cost & Impact? BY THE NUMBERS  $700,000: is the average jury award in wrongful termination  80,000: number of discrimination charges filed annually with the Equal Employment Opportunity Commission  $38,000: average claim paid on a sexual harassment case  15,500: number of sexual harassment cases filed annually  70: percent of jury trials in which employees win  55: percent of claims in which damages are awarded  $6.4: the average amount, in millions, of punitive damages awarded in racial discrimination cases  $2.7: average amount, in millions, of punitive damages awarded in employment cases 8

9. What are the Potential Impacts of Conflict?  Excessive employee turnover  Loss of efficiency and effectiveness  Disputes, grievances and litigation  Stress, frustration and low morale  Damaged labor relations  Sick leave and disability claims  Damaged community/patient/physician relations 9

10. Conflict in a Hospital Setting  Question: What does conflict look like in a hospital setting?  CEO differences of focus and priorities with: Commissioners, Doctors, Employees, Community  Tension between mission and margin  Greater workloads by everyone with diminishing and/or inadequate resources  Doctors are looking for more compensation for services 10

11. Conflict-Joint Commission’s View  “Conflict commonly occurs even in well- functioning organizations and can be productive for organizations. However, conflict among [leadership groups] with regard to accountabilities, policies, practices, and procedures that is not managed effectively by the organization has the potential to threaten health care safety and quality.” The Joint Commission 2009, Leadership Chapter 11

12. Conflict-Joint Commission’s View  “Further, it is important that organizations identify an individual skilled in managing conflict who can help the organization implement its conflict management process.”  “Conflict management skills can be acquired through various means, including experience, education, and training.” The Joint Commission 2009, Leadership Chapter 12

13. What are the Impacts?  Question: What are the impacts of unproductive conflict in a hospital setting?  Wasted time (who pays?)  Momentum killer  Labor disputes/litigation  Costs good people (leave, won’t come, burn out)  Slows strategic planning  Loss of the time margin  Patients feel the stress, anxiety, “edginess”  Patients have less attention/time 13

14. What Can Be Done?  Ways to address unproductive conflict and create a conflict competent workplace  Assess  Build  Resolve  Sustain 14

15. What Can Be Done?  ASSESS  1. Understand the culture of your workplace.  2. Know your vulnerable patient risk and cost/profit touch points affected by ` unresolved and unproductive conflict. 15

16. What Can Be Done?  ASSESS  3. Have an evidenced-based bias for action.  4. Understand the basic causes.  5. Assess Conflict Now TM  6. May 2010 Executive Retreat – Results of ACN 16

17. What Can Be Done?  BUILD  Conflict resolution skills training  Personality/communications skills building  Organizational and personal value-values clarification  Intergenerational valuing/appreciation  EEO and hospital policy training 17

18. What Can Be Done?  RESOLVE  Alternative internal dispute resolution processes  Facilitation and resolution  Mediation  Arbitration 18

19. What Can Be Done?  SUSTAIN Look at how the organization communicates. Build intentional conflict competency skills into the orientation/training process at every level in the organization. Be alert to how staff routinely deals with tension. Utilize an EAP (employee assistance program) 19

20. Questions? 20