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PERSONAL VIEW
Year : 2012  |  Volume : 25  |  Issue : 2  |  Page : 128-129

In the News! An Opinion - Unhealthy Conflict


Assoiate Editor, Education for Health

Date of Submission21-Oct-2012
Date of Acceptance23-Oct-2012
Date of Web Publication14-Nov-2012

Correspondence Address:
J van Dalen
Assoiate Editor, Education for Health

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1357-6283.103461


How to cite this article:
Dalen J v. In the News! An Opinion - Unhealthy Conflict. Educ Health 2012;25:128-9

How to cite this URL:
Dalen J v. In the News! An Opinion - Unhealthy Conflict. Educ Health [serial online] 2012 [cited 2020 Apr 10];25:128-9. Available from: http://www.educationforhealth.net/text.asp?2012/25/2/128/103461

In December 2011 a conflict between physicians at the Department of Pulmonology in a hospital in Amsterdam culminated with members filing formal complaints against one another. The hospital's reaction was to issue a speaking ban to the two individuals while the hospital quietly studied their conflict. As of August 2012 the investigation had not yielded its findings and the case became public, resulting in scandal. Patient safety was said to have been compromised by the original conflict and two of the three members of the Hospital's Board of Directors stepped down from their positions in the fallout. At the moment of writing (October 2012), the conflict has not been resolved, the volume of care for patients with pulmonary disease has fallen and health care is suffering because fewer lung operations can take place.

This is a dramatic and painful example of how important teamwork is for the quality of health care. Fortunately, most collaborations seem to go reasonably well and few conflicts escalate to this extent. However, the seemingly increasing number of conflicts that are made public calls for action in health professionals' education. Gratifyingly, health professions' educationalists have not waited for the news of conflicts to reach the newspapers. Many interventions have been carried out to prepare students and residents for teamwork.

In recent issues of Medical Education, a number of papers have appeared about conflicts within health care teams. Barrow [1] has attempted to explain the phenomenon of conflicts by noting the fairly recent adoption of teamwork approaches in health care. This has coincided with the shift in responsibilities among collaborating professions in areas that were previously treated as within the medical domain and the increasing professionalization of nonmedical health care workers. Moreover, Barrow notes that the responsibilities and codes of practices of collaborating professionals "do not address the issue of what might be the proper remit and domain of any professional group in a team in which its members are working." Within that fuzzy context it is difficult to provide clear guidelines on how best to address conflicts.

In an attempt to clarify this matter, Greer et al.[2] have distinguished task-process and relationship-associated conflicts. They present evidence that the latter two distract from effective teamwork. Task-conflict is seen to be generally negative for team functioning, but Greer et al. claim that under certain conditions their negative effects can be minimized. For this reason the three types of conflict should be distinguished. When they are not, there is a grave risk of disruption to the content of the task itself, the logistics under which the task must be accomplished and interpersonal relationships.

In a commentary in the same issue of Medical Education Kalishman et al.[3] stake a position even further and regard task-conflicts as inevitable and beneficial. It is because of these conflicts that we can really learn and advance our collaboration. They argue that conflicts can and ought to be used to develop collaborative health care teams. Conflicts are opportunities, if not the conditions, to move participants from operating principally within their own perspectives to integrate their languages and perspectives in order to resolve the challenge. Participants must "overtly clarify their motivations, values, and beliefs." It is well known from organizational and negotiation literature that true collaboration greatly benefits from sharing values and from pursuing common goals. The obvious and most important goal shared by all members of a health care team is to provide quality health care to patients and families.

How all of this can then be done is addressed by Gordon et al.[4] They reviewed the available literature to identify evidence-based recommendations for improving teamwork. They found five key themes: error; communication; teamwork and leadership; systems; and situational awareness. These issues can all be addressed through appropriate training of health professionals.

These studies and commentaries help point the way to reducing the danger of conflicts in health care teamwork. In view of the personal and institutional dramas and their costs described above, this area is ripe for improvement, for the betterment of health care.

 
  References Top

1.Barrow M. Conflict in context: Designing authentic teamwork education. Med Educ 2012;46:926-7.  Back to cited text no. 1
[PUBMED]    
2.Greer LL, Saygi O, Aaldering H, de Dreu CK. Conflict in medical teams: Opportunity or danger? Med Educ 2012;46:935-42.  Back to cited text no. 2
[PUBMED]    
3.Kalishman S, Stoddard H, O'Sullivan P. Don't manage the conflict: Transform it through collaboration. Med Educ 2012;46:930-2.  Back to cited text no. 3
[PUBMED]    
4.Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: A systematic review. Med Educ 2012;46:1042-54.  Back to cited text no. 4
[PUBMED]    




 

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