Making the most of conflict
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Association of Washington Public Hospital Districts. K & R Kuest & Robinson. MAKING THE MOST OF CONFLICT. K&R LLC. Association of Washington Public Hospital Districts. Kuest&Robinson LLC. Background: Ron Kuest, Principal (360)280-1513

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Association of


Public Hospital



Kuest & Robinson



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Association of


Public Hospital


Kuest&Robinson LLC

  • Background:

    • Ron Kuest, Principal


    • Lloyd Robinson, Principal


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  • 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.

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  • 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.

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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.

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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

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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)

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What is the Cost & Impact?


  • $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

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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

"Over 65% of performance problems result from strained relationships between employees, not from deficits in individual employee's skill or motivation."

Source: Dana, Dan, [online] The Dana Measure of Financial Cost of Organizational Conflict, 2001

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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

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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

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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

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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

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What Can Be Done?

  • Ways to address unproductive conflict and create a conflict competent workplace

    • Assess

    • Build

    • Resolve

    • Sustain

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What Can Be Done?


    • 1.  Understand the culture of your workplace.

    • 2. Know your vulnerable patient risk and cost/profit touch points affected by ` unresolved and unproductive conflict. 

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What Can Be Done?


    • 3.  Have an evidenced-based bias for action. 

    • 4.  Understand the basic causes. 

    • 5. Assess Conflict NowTM

    • 6. May 2010 Executive Retreat – Results of ACN

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What Can Be Done?


    • Conflict resolution skills training

    • Personality/communications skills building

    • Organizational and personal value-values clarification

    • Intergenerational valuing/appreciation

    • EEO and hospital policy training

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What Can Be Done?


    • Alternative internal dispute resolution processes

    • Facilitation and resolution

    • Mediation

    • Arbitration

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What Can Be Done?


    • 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)