Case Study: Conflict Resolution at General Hospital

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Conflict Resolution at General Hospital

The conflict occurring at General Hospital can also be called substantive conflict, this occurs when the parties involved disagree on an issue. (Bacal, n.d., para. 4) The issue at hand is the ability of the physicians to cut costs. Hammer feels that there are simple ways to cut physician costs, just do it. However, physicians argue that to cut cost will cut the quality of care that is being provided to the patient. In most situations one would hope that there could be a median, unfortunately there was not one in this case study. The conflict arose from the fact that Hammer was not willing to view the cuts from the prospective of the physician, nor did he ask them for feedback on possible areas to make much needed cuts. Instead Hammer brought in a third party Marge Harding, whom by the reading had her own personalized conflicts with the medical profession and the character of the people that held these positions in any hospital.

Hammer's decision to bring in a third party did nothing but increase the conflict dynamic already in place at General Hospital. Now the conflict was not just the substantive conflict going on between Hammer and the physicians over cost cuts; now the new dynamic of a personalized conflict was introduced into what was already an out of hand situation. Marge Harding's personalized conflict is fuelled primarily by emotion and perceptions about someone else's personality, character or motives (her belief that physicians are one dimensional). When conflict is personalized and extreme each party acts as if the other is suspect as a person. Second, because personalized conflict is about emotion and not issues, problem solving almost never works, because neither party is really interested in solving a problem. Third, personalized conflicts almost always get worse over time, if they cannot be converted to substantive conflict. That is because each person expects problems, looks for them, finds them, and gets angrier. (Bacal, n.d., para. 8)

The conflict management styles in the case regarding General Hospital appear to be nonexistent. The management of conflict has three main dimensions: 1. The repertoire of formal and informal, autonomous and intervention based, procedures available for confronting and handling the conflict 2. The understandings and skills for recognizing and making sense of conflict, for imagining alternatives, and for communicating to pursue resolution, 3. The individual and community relationships context within which conflicts may emerge, feel, and be understood as problems by participants, and evolve, escalate, or de-escalate. (Bickmore, 2003, p. 4)

Hammer had no direct contact with the physicians once the cuts took place. In the case study he simply states that he hope that some type of resolution can be achieved by the parties that are directly involved. This action alone did not allow the physicians an opportunity to confront the issue nor make sense of what had been occurring with the new system in place. The next option was to go to the party that was directly involved with the implementation of the cuts that removed the physician from the Hospital that read the EKG's and replaced him with an auto reader that proved to be rather faulty as evidence by the case study. Instead of Marge Harding being available to the staff for questions, she sent her assistant whom had no authority what so ever to tell the staff that things were staying as is, no questions asked.

Had there been a proper form of conflict management in place and in use the majority of the issues that General Hospital had could have been resolved, or at least discussed to attempt to come up with methods or resolutions that could work for all parties involved. Instead this is a situation where no one is willing to communicate what is going on and receive much needed feedback and criticism. In the case study the situation is left to fester and grow worse developing additional issues that were never a factor before as time goes on. This situation calls for Dispute system design which is phrased to reflect an organization's effort to identify and improve the way it manages conflict. (Bingham & Nabatchi, 2003, p. 105)

Teams could have been utilized in various ways to address the necessary cost cuts for General Hospital. First, when people are placed on a team there is a sense of responsibility for not only oneself but also for the unit/team as a whole. Teams could have created a cohesive environment among employees in an effort to pull together and show how effective they could all be together.

Employees who understand management priorities and budgetary constraints can make better decisions concerning training issues, customer service problems, quality, product design, and work process improvements. For this strategy to be effective, workers should receive training in how to interpret and apply the information they receive. Information that addresses the operating results of the employees' team or unit will be more useful than overall corporate operating results. Although having employees see and understand the big picture is important, information related directly to their work will allow them to make necessary improvement to increase productivity, or it can serve as feedback for improvements already implemented. (Levine, 1995, p. 61)

Instead of terminating Dr. James Boyer, the physician solely responsible for interpreting EKG's they could have created a team with him as the lead. He could have taught a handful of the physicians of techs how to interpret the EKG's. In return these team members could each be appointed to a different area to interpret the EKG's for his or her area, which would free up Dr. Boyer to do other tasks around the hospital to help pick up the slack or even find new ways to utilize his services and/or abilities. Teams could have also been utilized for discussion and brainstorming groups to find effective ways to cut cost and still maintain what the physicians felt was a high level of quality care. Teams would also give a level of support and feedback lacking in the current format. Communication would be open as well as the opportunity for a cohesive and positive working environment.

The cooperative relationship building aspect of contracting and negotiation is just as much a management and policy process as personnel, planning, and budgeting in contemporary public-management. Public managers are accountable not only for policy outcomes, but also for the appropriateness of the relationships they create and support. They need interpersonal skills and behavioral knowledge as well as technical skills to build cooperative, long-term relationships as they negotiate agreements and arrange services. (Gooden, 2007)

Hammer simply needed to communicate with an open mind to the physicians regarding the necessary cuts. If he would have used the premise of give and take it would have been feasible to have a much more positive outcome. An effective method would have been to do some research and explain to the current staff what positive effects the cutbacks would have on current and future business, as well as the positive ways that the changes would have affected his or her job. It would have also been helpful to explain some of the outcomes if the necessary changes were not made and the negative effects that would have on the population being served, the Hospital, as well as the staff themselves.

It is possible that Hammer could have negotiated and had the doctors perhaps cut back on areas specific to each individual physician that he or she did not feel would negatively impact the quality of care provided. Another method would have been to try to find something that the staff wanted or give them a goal to work towards explaining that if they do A and B, then C. And D. are an option. On the other hand if A and B. do not work for them then it would be unfortunate to see E. And F. occur. Hammer needs six qualities to make negotiations work. He needs Rationality, Understanding, Communication, Reliability, Persuasion, and Acceptance. Even if the other party rejects the negotiator and his or her concerns as unworthy of consideration, the negotiator should accept the other party as worthy of consideration, care about them, and be open to learning from them. (Gooden, 2007)

The best strategy for Hammer would be an attempt at reconciliation. There has to be damage control for what he has done, and he has to correct his mistakes or at least find ways to make his decisions work in a positive manner. Only reconciliation can build mutual trust and provide mutual assurances for maintaining peace. Nevertheless, reconciliation is probably the most difficult condition because it asks for a deep cognitive change, a real change of beliefs, ideology, and emotions not only among the hierarchy but also among other parties involved. Both scholars and practitioners realize that although conflict resolution terminates a conflict, it does not necessarily stabilize the peace or prevent the emergence of a new conflict in the future.… [END OF PREVIEW]

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