As hospital and health system leaders position their organization for future reimbursement models, it is vital to consider that properly managed conflict has been identified as the #1 cost containment strategy available to effective leaders. Unresolved and mismanaged conflict leads to hidden agendas, lack of timely communication and reduced collaboration resulting in patient care mistakes, increased turnover and lost opportunities.
W. Edwards Deming, known as the Father of the Quality Evolution, said “it’s impossible to predict the long-term consequences of poor quality.” The same can be said of unresolved conflict.
Costs related to mismanaged conflict include:
- Increased management activities – Managers spend more than 25% of their time working on reducing conflict.
- Poor decision-making due to poor communication
- Less efficient workload – workload is restructured to accommodate employees in conflict.
- ‘Presenteeism’ – a term that describes a person who “retires on the job.” They intend on leaving the job, but don’t. They have lower commitment to their job and reduced moral. It’s estimated that presenteeism may be as much as three times that of absenteeism (WarrenShepel (online), Health & Wellness Research Database, 2005).
- Absenteeism due to stress-related illness and the desire to avoid the conflict
- Employee replacement costs including termination costs, recruitment and effective onboarding time – the national average of voluntary resignations due to unresolved conflict is 65%
- Litigation and dealing with grievances
Why conflict isn’t addressed?
- General discomfort with emotions related to conflict – just hope it will go away
- Fear that intervention will assume responsibility for the resolution
- Most hospital leaders and physicians have not had the benefit of in-depth conflict resolution training
- Lack of establish protocols for resolving conflicts within the organization
- Inability to acknowledge the existence of conflict when present
Avoiding conflict isn’t an option. The Joint Commission recognizes the value of teamwork and mandates the development of a conflict resolution process in order to provide high quality patient care through collaborative working relationships. Clearly, managers and leaders must resolve conflict and channel the outcome to positively impact the work environment. This may seem obvious to most – but not always easy to implement without ongoing leadership development and the involvement by neutral facilitators. Effective leaders know what they are prepared to handle and when they need support.
In a recent case, the hospital Executive Committee took immediate action when they received an email from a Director of Nursing detailing another explosive interaction with a disruptive senior physician. The nurse manager followed protocol by contacting Human Resources and formally reporting the incident. In the formal report and in the email she expressed her anger and frustration because she and her staff regularly experienced verbally abusive interactions with this physician and others in the hospital. In the email, she mentioned taking legal action against the physician and the hospital system if the behavior didn’t stop. The EC acted swiftly by personally reaching out to the Director of Nursing, seeking advice from the hospital attorney and contracting with a conflict coach consultant.
The consultants began a two-coach conflict resolution process with the physician and the Director of Nursing. The conflict coach worked on the underlying issues to extract the root cause and found answers that an insider could not find through discussion and investigation.
As a result, a harassment suit never materialized; the physician and the Director or Nursing came to a greater understanding of each other and made a commitment to work together as a team. Both continued their work with the coaches and modeled the way for others who were dealing with stress related anger and broken trust. Organizationally, the leadership development program was expanded to include emotional intelligence, conflict resolution and stress management. The conflict resolution process took about two months and the executive leadership coaching continued for another six months.
A significant cost benefit from the hospital’s financial investment of working with a conflict coach consultant – aside from resolving the conflict with an independent outsider’s perspective –included the long-term leader development approach for a model for growth and sustainability.
What can leaders do to reduce the cost of conflict?
- Increase self-awareness the conflict warning signs
- Become aware of people’s passive / aggressive behaviors
- Take responsibility for personal and professional leadership development
- Ask for help through a mediator, ombudsman or conflict coach
- Develop others
- Act swiftly – the cost of delay has a unpredictable cultural impact
Alyson Lyon, MBA is an Executive Leadership Coach, Educator, Business Consultant and one of the founding partners of Higher View Coaching & Consulting LLC specializing in conflict resolution – litigation avoidance, leadership development, managing relationships and team dynamics. For more information, contact her at firstname.lastname@example.org.