Emergency Department Directors Academy Phase I Spring …...Conflict Management Skills DESCRIPTION...
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Emergency Department Directors Academy Phase I Spring 2020 Conflict Management Skills DESCRIPTION Callousness, anger, frustration, and tantrums are commonplace in the stressful environment of the emergency department. Many of our customers are in crisis. Everyone – emergency caregivers, private practitioners, patients and administrators – has needs that must be met. Explore what causes “communication breakdown.” Participants will discuss the origin of common ED conflicts and successful methods to resolve them. OBJECTIVES • Describe the common causes of conflict and the origins of stress in the ED environment. • Review ineffective individual responses to stress and conflict. • Define the necessary communication skills to effectively address conflict, such effective listening, eye contact, avoiding emotion, etc. • Describe the “Theory of Yes” and the concept of focusing on issues, rather than positions. • Design orientation checklists and materials. • Define and give examples of physician orientation plans. • Conflict Management Skills 2/3/2020, 8:15 AM - 9:30 AM FACULTY: Robert W. Strauss, Jr., MD, FACEP DISCLOSURE: (+) No significant financial relationships to disclose
Transcript of Emergency Department Directors Academy Phase I Spring …...Conflict Management Skills DESCRIPTION...
Emergency Department Directors Academy Phase I Spring 2020 Conflict Management Skills DESCRIPTION Callousness, anger, frustration, and tantrums are commonplace in the stressful environment of the emergency department. Many of our customers are in crisis. Everyone – emergency caregivers, private practitioners, patients and administrators – has needs that must be met. Explore what causes “communication breakdown.” Participants will discuss the origin of common ED conflicts and successful methods to resolve them. OBJECTIVES
• Describe the common causes of conflict and the origins of stress in the ED environment. • Review ineffective individual responses to stress and conflict. • Define the necessary communication skills to effectively address conflict, such effective listening, eye
contact, avoiding emotion, etc. • Describe the “Theory of Yes” and the concept of focusing on issues, rather than positions. • Design orientation checklists and materials. • Define and give examples of physician orientation plans. • Conflict Management Skills
2/3/2020, 8:15 AM - 9:30 AM FACULTY: Robert W. Strauss, Jr., MD, FACEP DISCLOSURE: (+) No significant financial relationships to disclose
DEFUSING LAND MINES:MANAGING CONFLICT EFFECTIVELY
Robert W Strauss, MD, FACEP Emergency Department Directors Academy
ACEP, Dallas – Spring 2020
ModeSitting
%10
AV Aids 40Participating 80
Stereotypical presentations involve sitting and listening without
participation. Effective learning involves multiple sensory modes.
RETENTION OF INFORMATION
CONFLICT OFTENRESULTS FROM INEFFECTIVE
COMMUNICATION
IS MORE THAN JUST THE WORDS
MEHREBIAN ON PERSUASION
Verbal Content
Vocal Expression
Visual Cues
100%
MEHREBIAN ON PERSUASION
We tend to overemphasize the content,
to convince them with the words.
If they’re not getting it,
perhaps … you’re not delivering it
VERBAL INCONGRUENCE
Ø The words don’t match the tone, posture and / or general demeanor of speaker.
Ø Examples:Ø The upset widowerØ The angry parentØ “I only hadda cupla behrs.”
VERBAL INCONGRUENCE
A personal tale
CONFLICT RESOLUTIONRULE #1
Observe the Activity
Listen to the Tone
HEALTHY OR UNHEALTHY
Ø Clear beginning and end
Ø When it’s over, it’s over
Ø It’s important
Ø Intensive –always
Ø Unknownpending
Ø Sense of crisisØ Your total
attention now isexpected
Ø Potentialdanger
• Emotional exhaustion 50%• Depersonalization 78%• Interferes with family 83%
• Occasionally• Frequently
50%33%
Survey of BC-EM
“WITH AGING, WE ARE LESS ABLE TO COPE WITH PHYSIOLGIC STRESS . . .MANY CAN NO LONGER COPE WITH FULL TIME PRACTICE.”
DENNIS WHITEHEAD, M.D.
“EVIDENCE OF SUBSTANTIAL SUBSTANCE ABUSE AMONG EMERGENCY PHYSICIANS.”
JEFF MARGULIES, M.D. ACEP WELLNESS COMM.
ORGANIZATIONAL CLIMATE
Ø Unequal status andpay;
Ø Authoritarian system (Captain of the ship!)
Ø Limited resources;Ø Malpractice fears.
PROPERLY REORDER THE 4 CS
Ø CostØ ConvenienceØ CareØ Caring
CONVENIENCE
ØWhat we want: Attention now!Ø How long will you wait?Ø When people have a choice
about their emergency care,they will choose byconvenience. The most important satisfier is …
CARING
Ø It’s not the level of careby which we’re judged.
Ø We run out of time, get stressed and take shortcuts
“We’ve got to kiss ‘em when they come in,
kiss ‘em when they leave, and touch them
every twenty minutes.”
Marshall Segal
AN ENVIRONMENT OF STRESS?
Ø Dissatisfied patientsØ Poor communicationØ Uncontrolled work environmentØ Expectations v. RealityØ Chaos
WE RESPOND TO STRESS BY HABIT, PATTERNS OF BEHAVIOR LEARNED AS CHILDREN
When under stress,we revert to an individually consistent personality style
Conflict Resolution Rule #2
Abraham Maslow
What makes us human is the time between impulse and action.
MASTERING YOUR OWN MIND KATHERINE ELLISON
For most of us, the lag time between provocation, impulse and action is shorter than a heartbeat—just a quarter of a second between the trigger event and the response of the amygdala. In that fraction of a second, our emotions have time to swamp our judgment—and often do.
What is your personal cue?
What is your individual manifestation of stress?
Mistake behavior
Do we learn from our mistakes?
Do you?
LUCY: DO YOU THINK ANYBODY EVER REALLY CHANGES?
LINUS: I’VE CHANGED A LOT IN THE LAST YEAR.
LUCY: I MEAN FOR THE BETTER.
CHARLES M. SCHULZ
CONFLICT RESOLUTIONRULE #3
Mistakes Reinforce
Mistake Behavior
”It takes 18 months to two years to change a
behavior . . . And you’ve really got to want to.”
Harles Cone
CHANGING“STRESS TOLERANCE LEVEL” A PERSONAL TALE
FOUR STAGES OF LEARNING
2.
1. UnConscious InCompetence
Conscious InCompetence
3. Conscious
4. UnConscious
Competence
Competence
”You and I will more readily make a change when we believe it will
make things easier.”
CONFLICT RESOLUTIONRULE #4
CONFLICT RESOLUTIONRULE #5
You can’t control anyone,
except, maybe . . . . . yourself.
CONFLICT RESOLUTIONRULE #5A
The most difficult people
don’t realize that they are
the “trigger men.”
CONFLICT RESOLUTION RESOLVING CONFLICTS
RESPONDING TO EMOTIONWITHOUT EMOTION
While it is tempting to fight fire
with fire, hot interpersonal andtense conflicts can frequently be effectively managed with . . .
“TO MAKE ONESELF UNDERSTANDABLE TO PEOPLE, ONE MUST FIRST SPEAK TO THEIR EYES.”
NAPOLEON
THE WORST OFFENSES
Ø Loss of control: Screaming is a form of (and one step short of direct) violence.
Ø Public humiliation is the worst insult.
THE THEORY OF
“YES”
RESOLVING DIFFICULT SITUATIONS TECHNIQUES TO TAKE HOME
Ø SilenceØ Eye CommunicationØ Theory of “Yes”Ø Gordon Technique
GORDON TECHNIQUE
When . . . . . . . . . . . .
I feel . . . . . . . . . . . . .
Because . . . . . . . . .
ACKNOWLEDGE AND VALIDATE
Ø Blaming blamers à escalates
Ø Placating, the common response, does not lead toresolution
Ø Acknowledgement andvalidation is consistentlysuccessful as a first step inresolving discord
FOCUS ON INTERESTS, NOT POSITIONS.
GETTING TO YES
FISHER AND URY
RESOLVING DIFFICULT SITUATIONS TECHNIQUES TO TAKE HOME
Ø SilenceØ Eye CommunicationØ Theory of “Yes”Ø Gordon TechniqueØ Acknowledge and ValidateØ Focus on IssuesØ Giving Feedback
WHAT IS ACCEPTABLE?
If I inadvertently do something that really irritates you, I’d like you to let me know by:
WHAT IS ACCEPTABLE?
If I do something that really pleases you, I’d like
you to let me know by:
“THE SKILL TO DOCOMES FROM THEDOING.”
CICERO
