Is
the problem disagreement over treatment plan?
Who should have the final say? Whose
opinion carries the most weight? Ultimately,
each team member should be asked to identify the conflict/problem as he or she
sees it, in their own words, without fear of immediate criticism (both the task
and process leaders should be able to facilitate this).
Conflicts can occur simply over misunderstanding what the problem or task
at hand is; or they may occur due to discipline specific variations in approach
and/or treatment of a patient problem (for example, the team dietician may
prefer to have a dental evaluation and present an anorexic patient with life
long favorite foods, rather than begin an appetite stimulant, antidepressant or
canned high calorie dietary supplements as desired by the MD/PA/NP).
Conflicts can also arise from a variety of other reasons. The important
point here is to figure out what exactly the conflict or problem is stemming
from.
The difficult process item for team members here may simply be listening to each other without criticism and interruption. One procedural rule during conflict resolution might be to hold all questions and comments until the team member is finished speaking, at which point questions of clarification might be asked by other team members.
Back
Proceed to Generate Solutions
Once
all team members are on the “same page” regarding the basis of the conflict
or problem, solutions can be generated. All team members should be encouraged to participate in this.
Ideally solutions will be broad enough to encompass most, if not all,
viewpoints. This allows “buy in” from team members. In the example above, regarding the anorexic older patient,
perhaps a longitudinal solution will work-first the dietician’s suggestions
are tried for a defined period of time, and then other action items suggested
the MD/PA or NP might be tried.
Here team members may struggle with consensus building, but if the team has agreed that decisions will be made by consensus, it is important not to allow more vocal, aggressive or traditional “leaders” have the final say.
Back
Proceed to Apply Solutions
Once a consensus or decision has been reached, team members should follow through on any “action items” they have agreed to be responsible for. If timing is a priority in the sequence of various action items, this needs to be made clear and agreed upon at the time of assignment.
Back
Proceed to Evaluation Solutions
Old Business is usually the first order of business at most formal meetings. It is important to follow up and review the effectiveness of team generated solutions/conflict resolution as it relates to patient care and team growth. Were more problematic areas generated? Was resolution complete? If the conflict revolved around patient care issues, what is the status of the patient at present (as well as the next proposed course of action)?