Discuss the conflict that is occurring at General Hospital.
Conflict is a process in which one party (person or group) perceives that its interests are being opposed or negatively affected by another party (Hellriegel/Slocum, 2011). There are four primary levels of conflict: intrapersonal, interpersonal, intragroup, and intergroup (Hellriegel/Slocum, 2011). Intrapersonal conflict occurs within an individual and usually involves some form of goal, cognitive, or affective conflict (Hellriegel/Slocum, 2011). General Hospitals’ CEO Mike Hammer experiences intrapersonal approach-avoidance type conflict since he is trying to devise a master plan to cut costs, increase revenues, expand current services, and add new services.
Interpersonal conflict occurs when two or more individuals perceive that their attitudes, behaviors or preferred goal are in opposition (Hellriegel/Slocum, 2011). Once Hammer presented his ideas to Dr. Mark Williams, Director of Medicine an intrapersonal conflict was shown since he felt that all physicians act in the practice of good medicine and forcing them to adhere would make it harder to keep and attract new physicians.
Intragroup conflict refers to disputes among some or all of a group’s members, which affects a group’s dynamics and effectiveness (Hellriegel/Slocum, 2011). Although Marge Harding’s father and brother are medical doctors, she isn’t wowed by their positions, doesn’t mind challenging physicians, and views them as one dimensional. This represents an intragroup conflict.
Intergroup conflict refers to opposition, disagreements, and disputes between groups or teams (Hellriegel/Slocum, 2011). Dr. Williams and the rest of the attending physicians were against Dr. Boyers being fired and the possible legal liabilities for the EKG reports errors. Harding sent her assistant to the meeting to represent the fact that General Hospital should keep up with ongoing technology developments. The medical staff responded back by saying that if Harding didn’t speak on the matter that day they would send all new patients to low hospitals. This represented an intergroup conflict.
Discuss the conflict management styles that are evident in the case.
The forcing style refers to assertive and uncooperative behaviors and represents a win-lose approach (Hellriegel/Slocum, 2011). This is the conflict management style present in the General Hospital case. Hammer exerted this style when he tried to convince Dr. Williams, Director of Medicine, to get staff physicians to become more cost sensitive in their decision making. When the consultant he hired created a cost containment program the board of trustees disagreed. Once again Hammer went to Dr. Williams and tried to convince him to use the program as a platform for change, but he felt it would be a cultural change which was impossible.
The forcing style was also obviously used by Marge Harding since Hammer gave her full authority to make any changes she deemed necessary. As a result, she implemented computerized EKG interpretations and fired attending cardiologist Dr. James Boyer who had an excellent reputation and had barely missed work in 15 years. As a result numerous problems emerged such as late results, patient mix-ups, and misdiagnoses. This put General Hospital in potential legal trouble. To make matters worse, she went on vacation and placed her assistant John Williams in charge during the first week of the new computerized operation. John had absolutely no authority to discontinue the use of computerized EKGs.
The avoiding style refers to unassertiveness and uncooperative behaviors (Hellriegel/Slocum, 2011). This style was used when Dr. Williams became frustrated with the EKG problems and tried to discuss the matter with Mike Hammer. Instead of addressing the issue Hammer stated that he was quite busy and hoped that those directly involved would solve the situation. As CEO of the General Hospital he should have placed the EKG issues as a priority since this could place hospital’s reputation on the line.
Discuss how General Hospital could have used teams to address the cost reductions needed to stay competitive. A team is a small number of employees with complimentary competencies who are committed to common performance goals and working relationships for which they hold themselves mutually accountable (Hellriegel/Slocum, 2011). General Hospitals expected individuals to make cost cutting decisions. This topic is quite sensitive and it’s impossible to implement the best ways to do so without forming a proper team. An effective team knows why it exists, supports agreed upon guidelines/procedures, communicates openly and constructively, diagnoses its own processes and improves functioning, and develops a sense of freedom to be themselves while belonging to the team (Hellriegel/Slocum, 2011). General Hospitals’ “cost-cutting” team would have known its purpose of cutting costs while remaining competitive. Once procedures were put in place the team members would have supported the changes and been a great resource for explaining the importance to the remaining hospital staff. Creating a team would have warranted an open line of communication and introduced constructive criticism to certain ideas. This would have cause the entire team to be aware of all concerns with cutting costs and the most efficient ways to cut costs. A single group wouldn’t have been singled out like the physicians were. The overall functioning of General Hospital would have been improved since cutting the proper costs would have allowed the money to be spent on expanding current services and new services keep them in sync with the competition. Also the fact that the hospital utilized its asset of qualified staff to solve the cost cutting dilemma would have given them a sense of self worth and belonging to an organization that cares about their staff’s input.
Describe how Hammer can use negotiation skills to get buy-in for the cost reductions.
Currently, Hammer is using distributive negotiations which involve traditional win-lose situations in which one party’s gain is the other’s loss (Hellriegel/Slocum, 2011). This type of negotiation includes four strategies: I want it all, time, good cop/bad cop, and ultimatums (Hellriegel/Slocum, 2011). Perhaps introducing a mediator would have helped resolved the cost reduction conflict. A mediator’s job is to ensure mutual motivation, achieve a balance of power, and coordinate confrontation efforts, promote openness in dialogue, and maintain an optimum level of tension (Hellriegel/Slocum, 2011).
Since Marge Harding was COO of General Hospital she sided more with the CEO and should have been included in the mediation. The two parties would have been clear: hospital administration vs. the medical staff. Mutual motivation could have been achieved by identifying incentives for hospital administration and the medical staff.
A balance of power could have been achieved by establishing trust between the two parties. When Hammer brought in Harding he gave her total power over implementing cost reduction. Harding was fairly new to General Hospital and although she may have been qualified for the position she was not qualified enough to make cost cutting decisions without first communicating with medical staff and therefore she lost their trust.
Confrontation efforts would have been kept to a minimum with a mediator since any changes implemented would have been explained to both parties involved. There wouldn’t have been any sudden surprises like the firing of attending cardiologist Dr. Boyer and replacing him with the computerized ECG system. By promoting an open dialogue the mediator could have gotten the medical staff and hospital administration to say what they feel and perhaps gain an understanding of each other’s concerns. Hammer felt a need to reduce costs since General Hospital could lose its accreditation and survivability. He also felt that physicians were a major factor in the inability of hospitals to regulate costs. The medical staff felt that their actions were out of “the practice of good medicine.” They felt that forcing them to make cost cuts was a cultural change and could cause difficulty keeping and attracting talented physicians. A mediator would have brought both sets of concerns to the table.
Lastly, a mediator would have also kept tension levels low between parties. The exchange of words between the physicians and Harding would have never happened because both parties would have known what changes to expect because of the mediation. In the event that something didn’t work out as desired both parties would have addressed the issue in a more civilized manner.
Recommend a strategy for Hammer to resolve the problem. Now that General Hospital is truly in shambles he needs to rectify the problem by introducing principled negotiations which are prescribed ways in which parties should negotiate to resolve disputes. There are four principles of principles of principled negotiations: separate the people from the problem, focus on interests not positions, invent options for mutual gain, and insist on using objective criteria. Instead of attacking each other Harding and the medical staff could separate the people from the problem by understanding each other’s side. Perhaps an immediate solution to the EKG problem would be to give Dr. Boyer his position back. If Dr. Boyer is not willing to comeback then a suitable replacement should be found. Maybe slowly introducing the computerized EKG system would work better. This would give Dr. Boyer more time to find a replacement position hopefully at General Hospital. This way both parties are satisfied with the outcome.
Obviously costs have to be cut in order for General Hospital to survive. Hammer should gain an understanding that the physicians probably feel threatened since he feels they struggle with cutting costs. I’m quite sure both parties want to see General Hospital rise above the issues it’s facing. So in actuality the two parties aren’t in as much opposition as it seems. Physicians shouldn’t be the only ones singled out. I think analyzing every single department will determine more ways to cut costs and save General Hospital.
To achieve mutual gain for hospital administration and medical staff should create new solutions that create a win-win situation. One answer isn’t always a solution. I think Hammer felt that giving Harding total control over cutting costs was the only solution to fixing the problem. I think that he should have created a team of in-house experts to determine efficient ways to cut costs. This way the largest possible amounts of options are created to solve the problem in a way that is a mutual gain for everyone.
In order to use objective criteria Hammer should look at other hospitals that faced similar situation. He should looks at hospitals who survived and those who took a hit. By researching both sides of the spectrum he gets to see what ideas were successful and which ideas fell short.
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