Passivity- the goal is to appease and avoid conflict at all costs! Fail to express your thoughts/opinions Sarcastic Give in with resentment Remain silent Body language- “The Victim Stance”
Aggressive- the goal is to dominate and win! “This is what I think, what you think does not matter-you are uninformed” Often expression of feelings, thoughts in a way that is not wholly truthful, Usually done in an inappropriate and unprofessional manner Body language-clenched fists, crossed arms, glaring eyes, intrusive on personal space
Assertion Includes : Saying “yes” when indicated, but “no” when you mean “no”. – don’t be passive aggressive. Using “I” when not speaking for the team. Respectively defending your position, even if it provokes conflict.- you’re an advocate. Body language- Secure upright position in a relaxed manner, making eye contact, standing with open hands Making an assertive statement.
It is easy for personnel here to ask questions when they don’t understand. Pascal Metrics SAQ 2011
In this setting it is difficult to speak up. Pascal Metrics SAQ 2011
Disagreements in this work setting are resolved appropriately. Pascal Metrics SAQ 2011
In this work setting it is difficult to discuss errors. Pascal Metrics SAQ Keystone: Surgery 2011
Discussion 1.Why is it difficult to always be assertive? 2.What can you do to assure that your concerns are heard? 3.What can we do at the organizational level that will help you succeed at providing safe patient centered care?
Case Example 1 Central is placed in the PACU. The RN suggests an x-ray before the patient is transferred (that is policy). Physician Assistant states, “Get the x-ray on the inpatient floor” (violation of policy). The attending is paged but he does not return the page. RN is unsuccessful in getting x-ray taken in PACU and the inpatient floor delays. Meanwhile the patient suffers a pneumothorax requiring a chest tube.
Conflict-Handling Strategies Positive confrontation Compromising Win with some loss--win with some loss Goals are mutually exclusive; deadlock; conflict style differences Collaborating Win--win Complex, long-term issues; high interdependence Borkowski 2009
Discussion How will you implement a structured communication technique? Is the an opportunity to include multiple disciplines? What support do you need at the –unit level? –Hospital level? Armstrong Institute for Patient Safety and Quality 20
Questions? Armstrong Institute for Patient Safety and Quality 21