CONFLICT RESOLUTION AT GENERAL HOSPITAL

Strayer University Organizational Behavior (Bus 520)
28 November 2011
Discuss the conflict that is occurring at General Hospital.

Conflict is defined as a process in which one party perceives that its interests are being opposed or negatively affected by another party (Hellriegel & Slocum, 2011). Conflict occurs daily, whether it happens between two or more individuals or between two competing groups. How a person or group responds to such conflict can make or break an organization. Healthy internal competition can exist, such as teams trying to come up with the next great solution to a problem, but all too often people treat colleagues as adversaries which hurts the organization as a whole (Miller, 2010). In the case of General Hospital, the two major parties at odds are the CEO Mike Hammer and his administrative staff, representing the business side of health care, and the Director of Medicine Dr. Mark Williams, who represents the medical staff. The conflict at General Hospital stemmed from the fact that the hospital was losing money and was having a hard time competing with a nearby hospital. Mr. Hammer, who believed physicians were primarily responsible for cost overruns at hospitals, was unable to convince Dr. Williams, nor the Board of Trustees, to adhere to any cost containment measures or solutions. Frustrated at the doctors’ refusal to engage in responsible fiscal measures, he decided to take an authoritative approach and delegated total authority to Marge Harding, his Chief Operating Officer, to engage in cost cutting measures directed at physician tasks. The two administrators adopted a “good cop-bad cop” strategy against the doctors where Ms. Harding would rather ruthlessly effect budgetary cuts without informing Mr. Hammer so as to give him plausible deniability. The ever ambitious Ms. Harding, who enjoyed confronting and challenging doctors, saw this as an opportunity to achieve her personal goals of obtaining a CEO position within five years. The first measure taken by Harding was to computerize and outsource the interpretation of EKG readings. This task had been accomplished by resident Dr. James Boyer, a respected physician with an unblemished record. By doing this, the hospital would save $100,000 in doctor’s salary over the next three years and provide nearly instantaneous results (Hellriegel & Slocum, 2011). Soon after implementation, problems with EKG analysis began to arise, prompting doctors to question the absence of Dr. Boyer and why they were not consulted prior to his termination. Before catching a plane for vacation, Ms. Harding had sent Dr. Boyer a letter relieving him from his duties and informing him to apply for another position within the hospital. This action enraged the physician staff who demanded a meeting with Ms. Harding who just avoided the issue altogether. The physicians, led by Dr. Williams, issued an ultimatum to Ms. Harding that she meet with them or they will admit their patients to other hospitals. In whole, all the issues among the parties exhibited the traits of Intergroup Conflict. Intergroup conflict results when groups within an organization develop attitudes toward each other founded on distrust, selfishness, and an inability to listen or respect the opposing point of view. The only sense of collaboration, or common agreement, was the good cop-bad cop strategy of Mr. Hammer and Ms. Harding.
Discuss the conflict management styles that are evident in the case.

Upon acknowledgment of the hospital’s financial difficulties, Mr. Hammer attempted the collaborating style for conflict management by pointing out wasteful practices and suggesting doctors adhere to a cost containment program. His efforts fell short due to the physicians’ unwillingness to compromise. Doctors felt and convinced the Board of Trustees that a cost containment program was culturally unfeasible and would impact the hospital’s ability to retain quality doctors. Dr. Williams’ forcing style of conflict management just solidified Mr. Hammer’s perception that doctors do not care about costs associated with running a hospital. Seeing that collaboration (win-win) or compromise (give-take) styles proved fruitless, Mr. Hammer reverted to a forcing style (win-lose), basically stating his way was the way it was going to be. When using a forcing style, the person in position of authority makes a decision regarding the conflict without regard to how others feel about the situation. In order to enact his point of view, Mr. Hammer tasked COO, Marge Harding, to choose a task physicians perform that can be done at less cost and implement the change. This style would not be best for those who are trying to motivate employees. A leader should seek positive input from his staff and at least listen to their concerns. The forcing style will tend to alienate those who are affected by the decision and make them feel as if their thoughts and feelings are unimportant. Finally, when the physicians complained about Ms. Harding firing Dr. Boyer to implement the new EKG system, Hammer and Harding used the avoiding approach. Using this method, Hammer would completely ignore the conflict or issue at hand. Furthermore, Hammer would not take any steps to eliminate the conflict or issue. Like the accommodating conflict management style, which the boss just gives into every demand, avoiding can be very harmful to a business. Employees will perceive the person of authority as someone who either does not care or someone who will not hold them accountable for lack of work ethic or poor performance. Either way, substandard work will result.
Discuss how General Hospital could have used teams to address the cost reductions needed to stay competitive.

Teamwork and cooperation are essential in an organization which strives to be effective and efficient. The best teamwork comes from a diverse group sharing a vision or goal, in that leaders and members are all committed to the same objectives and understand their roles in achieving those objectives. Diversity plays a key role in determining team failure or success as long standing research shows that when solving complex, non-routine problems, groups are more effective when they are composed of people who have a variety of skills, knowledge, and perspective (Sawyer, 2007). With diversity comes a certain amount of friction between participants but this conflict keeps the team focused on ways to solve the problem vice fall into the group think trap and hence be non-productive. A team composed of doctors, accountants, nurses, and chief administrators, each with their own perspective of the situation would be effective in conducting cost analysis and ways to avoid inherent bankruptcy. Each team member should be able to communicate well with other members of the team both individually, and as a group. As a team member presents data, other team member must exercise active listening in hopes they may learn something for other team members. For example, if a nurse explains that the nurse to patient ratio on the burn ward is excessive, then administrators can adjust manning levels accordingly. This may be a cost saving measure that other members of the group may not have realized. One person’s comment might inspire someone else to think of a new idea. As previously stated, the team concept will work when all participants share a common goal. This is why the team should be composed of volunteers, when possible. When a person cares about the overall topic, in this case, the financial well being of the hospital from which they receive their paychecks, they are more inclined to compromise to ensure their personal needs are met. Everyone would give up a little something for the better good. Despite the best of communications, nothing drives results better than the facts themselves. A team’s primary mission would be in fact finding. Administrators present financial data while doctors justify the need for those expenses. Of course this will cause friction but at least a dialogue will be created. Certainly a doctor is wise enough to see how costs accumulate just as well as an accountant may understand the need for certain medical procedures. A true analysis of the data presented to the group brings about a more refined focus. The EKG issue can be examined by all parties and a resolution agreed upon. The rationale for either side must be support by the facts and nothing but the facts.
Describe how Hammer can use negotiation skills to get buy-in for the cost reductions.

Webster’s dictionary defines negotiation as the act of conferring with another to settle a matter or dispute (P. 230). This process can relate to individuals or competing groups who have a combined interest. While each party involved in the conflict seeks to gain something, all must be prepared to settle differences peacefully and agree to compromise to resolve the matter. The aim of any negotiation is to find a solution that is acceptable to both parties, and leaves both parties feeling that they’ve won, in some way, after the event. There are several styles of negotiation, depending on circumstances, but in this case, Mr. Hammer and Dr. Williams should use the principled approach. With this strategy, both parties can identify common ground and express themselves openly knowing that each side may have to give a little. Their focus should be on what is best for the hospital instead of whatever personal gain they can glean. A principled negotiation has several steps that ensure success. First, the parties should set personalities aside and work together to find a solution. Mr. Hammer should lose the notion that physicians don’t care about costs and Dr. Williams should understand that hospital administrators are not out to diminish patient care. Second step is would be to focus on the needs of the patient (and their insurance companies) in providing a quality health service at a reasonable cost. Dr. Williams could re-think some of the wasteful procedures that may or may not be needed. The third phase is to together come up with possible solutions to the problem and weigh the pros and cons of each. Respect toward each other can be displayed here as a solution one may bring to the table may not be in the others liking. Still, generate a list and discuss them one by one making the effort to not dismiss that solution until all evidence is presented. The fourth aspect and in my opinion, the most important, would be to just stick to the facts and make a mutual decision based upon those alone. Being objective to the problem at hand will force one to arrive at a solution, even though it is not exactly what neither really wants. Leadership is about making the hard choices for the good of the organization. Any negotiation is, in itself, adversarial but given the proper mind set going into it will result in problem resolution. The careful exploration of your position and the other person’s position, with the goal of finding a mutually acceptable compromise that gives you both as much of what you want as possible. People’s positions are rarely as fundamentally opposed as they may initially appear, once ego and pride have been separated from the equation.
Recommend a strategy for Hammer to resolve the problem. Provide a rationale for the recommendation.

Mike Hammer cannot brush off the physician’s team. Instead, he should explain the Hospital’s real situation. A manager who” just does” without explanation is using an authoritarian approach and therefore cannot be seen as a true leader. An effective leader should be an expert in communication. By definition, communication is an exchange of thoughts, ideas, and feedback (Lloyd, 2008). This was certainly not taking place. Even though renovations are in order, this should be a process which evaluates any and all cost reduction purposes for all the areas, not only addressed to physicians’ salaries. Also, the physicians who would like to stay at the General Hospital should understand the situation of this organization. With selfishness and arrogance, no one would get any benefit. The “good cop – bad cop” strategy is totally ridiculous in a professional environment that approach is inappropriate. A manager cannot threat people as a way of negotiate about any situation. Marge Harding should change her approach as well. I believe she is more focused on her long term career expectations, instead of the Hospital’s goals. That fact disqualifies her as an unbiased manager. The EKG interpretation system should have been reviewed before being implemented. This fiasco proved the lack of knowledge of those who suggested this alternative procedure as a solution, instead of focus on the service the hospital is supposed to provide. The option here is to bring back Dr. Boyer who will perform his previous duties while a review of EKG reading is conducted. Dr. Boyer may be given other tasks while a shared protocol for reading is developed. Hospitals have always regarded themselves as a place to heal sick people. One thing that should be realized is that they operate more like a hotel, a building full of rooms that need to be filled everyday. Hospitals can only fill a room by having a doctor send a patient to them (Wall, 2011). This trend is changing as Medicare and Medicaid is pursuing a program that would bundle payments for some hospital procedures, leaving doctors and hospitals to decide who gets what. Given this information, Hammer should try to negotiate long term contract agreements with doctors, and split any proceeds that savings in efficiency would produce.

References
Hellriegel, D., & Slocum, J.W. (2011) Organizational Behavior, 13th edition, Mason OH: Cengage Learning
Lloyd, H.C. (2008). Am I The Leader I Need To Be? Atlantic City, NJ: Raphel Marketing.
Miller, J. G. (2010). Outstanding! 47 Ways to Make Your Organization Exceptional. New York, NY: Penguin Group.

Sawyer, R.K. (2007). Group Genius: The Creative Power of Collaboration. New York, NY: Basic Books.

Merriam-Webster. (2008). Webster’s Dictionary. Springfield, MA: Federal Street Press.

Wall, J. K. “Stitching Health Care Together.” Indianapolis Business Journal. 28 Sep. 2009:A1

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