In healthcare, cooperation is critical in order for patients to receive the best care possible. Although relationships between healthcare providers is normally positive, there are times when those relationships may be tense. There are many reasons why group dynamics in healthcare settings may seem off-balance and less than cooperative. In most cases, it is simply because one group in a healthcare setting is not aware of the difficulties faced by another. A doctor may not understand the day-to-day difficulties the nursing staff deals with while the nursing staff may not understand the difficulties of the dietary staff. It is up to those at the management level to address these group dynamics and create a positive working environment in order to provide patients with the best possible care available.
The first step in determining the best way to promote a positive working environment in healthcare is to understand intergroup dynamics. Social identity plays a part in how groups work together. Research has shown that people derive self-esteem from the social groups they identify most with. In addition, identification with a particular group facilitates consistent behavior among group members. Because it is instinct for people to compare their own group more favorably than others, it is not unusual for healthcare groups to see their own issues as more complex than others and value that group’s contributions over others. Socialization can also be a factor in how groups relate to each other in healthcare. Because healthcare workers are trained somewhat differently, they may have difficulty understanding the requirements of other groups. Nurses are socialized into the nursing role in a healthcare setting while radiologists are socialized into a different role. This can cause difficulty in cross-socialization.
Improving Group Dynamics
There are ways that management can improve group dynamics and create a more positive atmosphere. It is important to note that communication problems among staff are often the symptom of an underlying problem. One option to address group dynamic and communication problems is through cross-discipline training. During cross-discipline training, nurses are taught methods for raising concerns with doctors who may have a tendency to ignore those concerns. Doctors are given listening skillsets that allow them to not only hear when a nurse expresses concerns, but address those concerns in a timely manner.
It is important to remember that, in the healthcare setting, groups may work together as a team, but each group has their own tasks that must be carried out. Group dynamics in healthcare work when all members of each group understand that they are working toward the shared purpose of treating patients. Although this may seem obvious, it is sometimes so obvious it is overlooked. Management should encourage group leaders to keep the purpose at the forefront during all interactions by talking about how each group links together to achieve the goal of providing excellent healthcare to each patient. Creating an understanding between groups of how important their contributions are to the benefit of patients is critical in developing a more cooperative workplace.
Create a Plan
In order to have a cohesive, cooperative and positive workplace, management must have a plan, a strategy that is designed to promote patient service. The strategy should include elements that have been proven to show success in team building. The strategy should address tasks that must be performed by each group during patient care. Most organizations understand how to document services needed and performed during patient care, but including those services as part of a strategic plan can make healthcare operations run much more smoothly. One of the most important elements that must be included in a strategic plan is the needs of each individual within the healthcare facility. Many healthcare organizations use annual appraisals to reinforce employee behavior, but this may not be enough. People need their efforts acknowledged. They want their triumphs recognized and their struggles addressed. People need positive feedback when they perform well and constructive feedback when they should improve. Finally, team leadership needs to be part of the strategy. Conflict management, group dynamic training and diversity is critical to the success of any healthcare organization strategic plan.
How an organization handles conflict among staff members can demonstrate how cohesive and positive the workplace is. Conflict does not always manifest itself the same way throughout an organization. There are five identified styles of conflict management. Someone who is accommodating attempts to preserve harmony at all costs and may appear week or ineffective. Compromise is often a good way to resolve conflict, but this can lead to a reduction in patient care as staff feel as if they must make too many concessions to keep others happy. Avoidance describes those who will avoid conflict at all times. Many times, people who avoid conflict jeopardize patient care as they back down when someone of authority disagrees. Often this is combined with competition when someone of a higher rank forces an issue to resolution, even if that resolution is incorrect. The best type of conflict resolution is collaboration. This requires communication and discussion to come to a mutually agreeable solution such as an issue of patient safety that stretches resources. However, collaboration can be overused and management may spend significant time in lengthy discussions about trivial matters.
One of the best solutions to conflict is negotiation. Although it is similar to collaboration, negotiation allows each party to share their own needs and wants when it comes to patient care. It allows each person to voice concerns and make suggestions for how to resolve the dispute. It also allows power to be removed from the equation as most conflicts are more about power than the actual issue. This is especially true in a healthcare setting with its many different layers of responsibility. Negotiation also allows those involved in the conflict to develop their own solutions rather than involve management in every disagreement. In negotiation, no one “wins” and no one “loses,” so the patient benefits from increased levels of care.
Benefits of Conflict
Conflict in the healthcare setting is not without benefits. Conflict brings awareness to problems that may exist and can initiate organizational change. Successful management of conflict can improve morale and strengthen relationships among healthcare professionals. Failing to manage conflict, however, can have detrimental effects on an organization. There could be an atmosphere of misperceptions and bias with coworkers polarized due to unmanaged conflict. Issues may become blurred as the conflict moves away from the actual issue and differences could become magnified. Unmanaged conflict lowers morale, increases employee turnover and can damage meaningful professional relationships.
People develop their understanding of situations based on their experiences, background, education and situational specifics. These factors often create beliefs or positions on certain situations. Yet, when we want something, it is our interest that helps us achieve what we want. When we understand someone else’s interests, we often recognize ourselves in that person. Interest-based bargaining is can be used in negotiation as a way to address what creates one person’s desires. It allows the conflicting parties to step into each other’s shoes and develop an understanding of what motivates them to do what they do. It also allows each person to understand the other person’s values, something that is often at the core of conflict as they are hard to articulate. Helping staff develop the tools necessary to understand values and motivation can be an excellent way to manage conflict in a positive manner.
In the healthcare industry, the patient’s needs must come first. People who enter the field of healthcare do so because they want to help those who are sick or injured which is why it would seem obvious that the ultimate goal is to provide excellent patient service in a healthcare setting. Unfortunately, because group dynamics exist in all industries, especially in healthcare, conflict can arise between different groups as well as between individuals within each group. In order to fully address patient needs, management in a healthcare setting must address conflict resolution and group dynamics throughout their organization. With proper training, education and resources, healthcare staff can develop the skills necessary to work well together and manage conflict in the most positive way possible.