Conflict Management Training for Middle Managers in Health Care
Nursing Research on the Green
Terresa Bubbers, DM© and Becky Inglis, RN, MS - Gundersen Health System
- Background: Conflict in health care is a serious issue resulting in The Joint Commission (TJC) requiring hospitals to develop a conflict management system. The significant cost of conflict is identified in the daily use of management time in dealing with conflict. In addition, unresolved conflict leads to employee and patient safety issues, decreased morale, clinical errors, and toxic professional relationships. Managers identified spending up to 40% of their time on conflict. Researchers acknowledged managers lack the skills necessary to manage conflict effectively. The problem is that the health care industry has no long-term management program that affects the conflict management skills of middle managers.
- Significance: The significance of the study to the nursing profession is that conflict management skills of health care managers impact the environment that nurses work in and many managers in health care are nurses.
- Purpose/objective: The purpose the study was to determine whether an intensive 3-month conflict management training program influenced the manager’s conflict management skills.
- Methods/project: A quantitative field experiment research design plus repeated measures pretest and posttest for treatment group was conducted with 64 middle managers with five or more direct reports of a health care facility. The managers were randomized into the intervention (conflict coaching) group or the control group. Both groups completed the Conflict Dynamic Profile (CDP-I) pre and post study, measuring constructive and destructive behavior skills and hot buttons. The conflict coaching group then participated in a 4-hour conflict engagement workshop and was randomized to one of five conflict coaches. The intervention group then participated in 12-weeks of individualized conflict coaching. The conflict coaches filled out an Interprofessional Collaborator Assessment Rubric (ICAR) measuring conflict management skills with each face-to-face session.
- Results: There was no significant change in the constructive behavior skills of the intervention group when compared to the control group. There was a significant change in the destructive behavior skill of avoidance in the intervention group when compared to the control group. The constructive and destructive scores for the manager groups, pre-and post –study, scored much higher or lower respectively, than the national and international data. There was a significant change in the untrustworthy and hostile hot buttons in the intervention group compared to the control group. There was significant learning in the intervention group in all categories of the ICAR, demonstrating skill growth throughout the conflict coaching.
- Clinical implications: There was identified growth in the conflict management skills of the managers through the conflict coaching program.