1. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Chapter 7 Power, Politics, and Conflict Management

2. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Objectives After completing this chapter, you will be able to: –Recognize what power is and how it is used within health care organizations –Describe and compare the major sources of power within health care organizations –Recognize the differences between managerial and professional sources of power within health care organizations

3. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Objectives (cont’d.) –Summarize the interrelationship between power and politics within organizational settings –Describe the demographic and contextual factors that affect how power is distributed within health care organizations –Classify the various conditions that give rise to power abuses in health care organizations

4. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Objectives (cont’d.) –Compare the different roles played by trust, fairness, and transparency in preventing power abuse in health care organizations –Distinguish between the different types of conflict and how they might be present in various health care organizations –Understanding how emotions affect individuals attempting to manage conflict

5. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Objectives (cont’d.) –Describe the various mistakes relating to how individuals think about negotiation and how they think about relationships –Identify the difference between interests and positions and describe why understanding that difference is critical in negotiation

6. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Objectives (cont’d.) –Compare the benefits of compromise, competition, and collaboration as three distinct strategies for negotiation –Describe the tactics to find a better solution, the tactics to acquire information, and the tactics to influence others

7. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Purpose Understand what power is, how and where to look for it, and how it plays out in health care organizations Focus on role of conflict management in managing role of both power and politics Stress important and necessary functions played by power and politics in getting organizations and workers to perform effectively

8. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. The Uses of Power in Organizations Determine key choices made at organizational level to guide strategy Influence actions of others Control, allocate, and redistribute resources within organizations Shape organizational cultures or competiveness

9. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. What is Power and Where Does It Come From? Power: control one group has over another’s behavior –Involves coercion (use of subtle influence dynamics to achieve desired goals) –Requires two or more parties interacting with each other on an ongoing basis –Three major sources of power within organization are structural, cultural, and knowledge-based

10. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Key Power Relationships in Health Care Organizations Physician-patient: –Traditionally, physicians held great authority over patients but trend is changing Physician-nurse: –Physicians exert direct influence over nursing work, pay, and employment status Physician-administrator: –Dual hierarchies create tensions; claim to power exist for both groups creating ambiguity

11. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. The Political Nature of Power Organizational politics: ongoing process of “managing influence” –Different coalitions of interests/influence vies for opportunity to achieve desired goals –Use of politics characterized by hidden nature –Notion of organizations as coalitions of different interests provides rationale for why politics becomes dominant mode of interaction

12. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. The Political Nature of Power (cont’d.) Health care organizations are very political because of several different, powerful stakeholder groups –Politics can be inefficient: requires individuals and groups to expend valuable time and resources for self-interests –Politics also plays positive, critical role in organizations: encourages groups and individuals to share power

13. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. How Power Stratifies: Personal and Contextual Influences Power stratification: different stakeholders have opportunities to access power based upon certain characteristics/circumstances –Demographic qualities, age and employment status are sources of power stratification –Size of organization influences power stratification –Controlling financial resources stratifies organizational power

14. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. The Abuse of Power in Health Care Organizations Power abuse: use of power in ways not generally acceptable, involves self-interest and not organization’s best interests Two main reasons for power abuse: –Advancement of personal ends at expense of customer, shareholder, or employee ends –Advancement of organizational ends; not always easy to discern

15. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. The Abuse of Power in Health Care Organizations (cont’d.) Abuse of power by managers elevates potential for negative fallout: –Loss of trust by employees towards managers when power is abused reduces potential for positive dynamics –Facilitators of abuse of power; uncertainty regarding goal achievement, centralized decision making, scarcity of rival coalitions, lack of reliance, complacency, pressure to make quick decisions

16. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Trust, Fairness, and Transparency in Preventing Power Abuse Steps to guard against abuse of power: –Structuring communication networks to create greater transparency –Using boards of directors and advisory groups as counterbalances to managerial authority –Creating strong code of ethics –Designing appropriate appraisal systems –Emphasizing personal integrity

17. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Power as a Key Source of Conflict Conflict associated with power and politics derives from two primary circumstances: –Parties have different perspectives, ideas, or agendas; intention to move them forward –Interdependent parties draw upon different sources for power, or have unequal access to power opportunities Conflict management: how parties approach, deal with, and resolve conflict

18. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Types of Conflict Task conflict: –Differences amongst parties in understanding and carrying out tasks –Challenge: understand individual viewpoints Relationship conflict: –Conflict regarding inherent characteristic of other party –Causes: i.e., interpersonal styles, personality –Challenge: navigate heightened emotions

19. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. The Negative Side of Emotions When individuals feel threatened, thinking becomes rigid or inflexible Result of heightened emotions produces decreased ability to cognitively process information, ideas, or possible solutions Emotional contagion occurs when emotions transmit from one party to another

20. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Common Mistakes in Thinking About Conflict Significant error negotiators make when approaching conflict, failing to plan or think through conflict before dealing with it Effective plan for negotiation: –Description of one’s own interests or needs –Possible positions or offers –Goals regarding specific positions for negotiation –Possible tactics to use in reaching goals

21. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Common Mistakes in Managing Relationships Not thinking about other party: –Reciprocity: tendency for others to exchange equal levels of goods and services Adding up personal not collective gain: –Cognitively active: act of being focused on all parties in negotiation Failing to trust: –Self-fulfilling prophecy: one’s beliefs influence another’s behavior to support that belief

22. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Key Conflict Management Strategies Conflict strategies marked by different approaches to value (combined benefits among all parties in negotiated agreement) Strategies most common for engaging another party and seeking resolution: –Compromising –Competing –Collaborating

23. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Tactics to Acquire More Information Do research: –Gather objective data Ask questions: –Specific way to uncover information in a negotiation about other party Find common ground: –Behaviors that help multiple parties find shared goals or interests

24. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Tactics to Find a Better Solution Add Issues Nonspecific Compensation Fraction / Unbundle Issues Logrolling Make a packaged offer Contingent Contracts

25. Copyright 2012 Delmar, a part of Cengage Learning. All Rights Reserved. Tactics to Influence the Other Party Make strong opening offer Use objective criteria Form a coalition Use BATNA / power of walk-away Plan concessions