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American health care organizations face unique challenges presented by crises and conflicts that pose risk to the attainment of the organizations goals (Borkowski, 2011). Conflicts arise out of stressful and emotional encounters and form a natural part of relationships. Conflicts are necessary for organizational growth depending on their management.
In hospitals, the unexpected is always arising and personnel are always dealing with life-and-death issues that require most immediate actions and there are no provisions second trials. Health care organizations are social systems that involve people interacting with each other to preserve the health and personal integrity of patients.
Damaging crises may befall hospitals at any time. Disasters like staff-related disgrace immediately put the specific hospital on the limelight. Crisis communication determines the impact of the crisis on a health care organization.
Crisis communication and response have a large significance in restoring the organizations status and their effectiveness depends on skills of the crisis communicators and their understanding of crisis management (Braun, Wlneman, Finn, Barbera, Schmaltz, & Loeb, 2006). The healthcare system is of particular concern when it comes to the concept of crisis communication because the lives of people are at stake.
In every case, crisis in health care organizations affects the physical, emotional or privacy aspects of an individuals life. This paper offers an in depth exploration of crisis communication and conflict management in health care organizations and adds a risk management aspect to the discussion.
Crisis Communication
No single professional group is consistently responsible for the hospitals preparedness to handle crises. It becomes problematic for community groups to define the suitable hospital contact. Crisis communication protocols deliver reliable communications and thwart concerned persons efforts of seeking care unnecessarily (Braun, Wlneman, Finn, Barbera, Schmaltz, & Loeb, 2006).
Halbesleben, Cox and Hall (2011) report that open communications in hospital settings show up inform of personnel speaking up and alerting others through sharing of pertinent issues usually referred to as red flags. When raised, red flags create alertness for every personnel on possible delays or other implication caused by the red flag.
Therefore, conflicts that may arise out of the misunderstanding that may ensue are limited. Miscommunication in hospital settings like theatre wards result to silo-effect working behavior for team members. In such cases, staffs fail to pass critical patient information to other staff by choosing to stay mum.
Overall, miscommunication leads to a higher probability of patient mishandling and contributes to patient crisis reports. Silo-effect mainly arises out of a lack of trust and communication among team members in the hospital or health facility (Halbesleben, Cox, & Hall, 2011).
In crisis communication approach, the communicators of the risk are supposed to use every device to move their audiences to take appropriate action (Lundgren & McMakin, 2009). In the case of a flood, messages from the communicators should cause the audience to vacate to higher ground and refrain from becoming obstacles to the work of rescue groups.
Crisis communication must be limited to the relevant information causing action and anything else is extraneous. Hospitals and health care institutions know what is best for their patients therefore; their crisis communicators should affirm the impression in their audience.
People are likely to respond when they only know the why reason of moving rather than the how and what reasons of moving (Lundgren & McMakin, 2009).
For an effective crisis communication, health care institutions adapt the following steps for developing messages involving infectious diseases crisis or other public health issues (Lundgren & McMakin, 2009): a description of the audiences reachable, which encompasses their relationship with to the crisis, as based on risk communication principles.
Secondly, the purpose of the message is articulated and finally the message delivery mechanism is noted, it include either the media or internet among others (Lundgren & McMakin, 2009).
When including the media in the crisis message delivery, a thematic explanation of the crisis comes out strongly than an episodic one. News media favors positioning the organization as the center of a crisis in causing it or acting on it. The media scrutinizes the organizations systems, policies and environments in relation to the cause of the crisis and its management.
Focus on individuals usually forms an insignificant part for news media such as focusing on an employee or other individuals like the CEO. Therefore, crisis communication managers of relevant health care organizations involved in the crisis take a special notice on how the media is likely to frame the issue (An, Gower, & Cho, 2011).
For crisis occurring inside health care organizations such as patient mishandling accusations, the media assigns blame for individual employees to the whole organizations responsibility unless, it is the top management who are responsible for the crisis. Crisis communicators need to factor in the media interpretation of their messages to benefit from a proper relaying by the news media (An, Gower, & Cho, 2011).
During crisis communication of a preventable crisis, health care organizations are likely to apportion blame on individuals to distract public attention from the root of the problem such as the organizational systems (An, Gower, & Cho, 2011). People assume a high level of controllability and intentionality for preventable crises and think that organizations should control or prevent them.
Therefore, despite a scapegoat approach by organizations to allocate blame to individuals, overall public opinion is for the organization to demonstrate a high degree of ethics and responsible behavior (An, Gower, & Cho, 2011).
Health care organization executives need to have a grasp of the structures and procedures that are present in their organization for managing crisis communication. They should be conversant with all crisis teams, internal and external crisis communication protocols and the compilation of emergency plans (Faustenhammer & Gossler, 2011).
During a crisis management, it is fundamental to ensure safety and survival of victims. In this stage, communication should be about explaining events in logical manners to shocked victims or employees immediately after the incident as it can yield negative results (Faustenhammer & Gossler, 2011).
Conflict Management
Conflicts arise out of stressful and emotional encounters and form a natural part of relationships. Conflicts are necessary for personal growth and organizational growth. In health care environments, individuals satisfied with the status quo who are opposed to new ideas and other people start conflicts (Harris & Roussel, 2010).
Effects of unresolved conflicts include, reduced productivity rates, increase in health care costs, lowering of staffs and patient morale and self-esteem, apathy increase, inappropriate responses and violence in extreme cases. Failure to manage conflict arises from passive behaviors, ineffective communication skills, apathy and pretending that the conflict is nonexistent or not worth solving. (Harris & Roussel, 2010)
Conflict needs proper management to protect health care safety and quality, Leadership group conflict in health care organization arises in accountabilities, policies, practices and procedures (Joint Commision Resources, 2009).
To manage conflicts individuals require skills necessary for organizational implementation of conflict management. Management of conflicts is possible without resolve of the conflicts. Conflict management aims at reducing the adverse effect of patient care and safety caused by conflict in the health care organization (Joint Commision Resources, 2009).
Executives of health care organizations face high levels of organizational conflict (Taylor & Taylor, 1994). Their management of conflict determines the realization of beneficial or destructive effects of conflicts on the organization and the people involved.
The organization structure of healthcare makes it difficult to measure organizational effectiveness by outcomes and this presents plenty of room for arguing on the right thing to do and how to do it (Taylor & Taylor, 1994).
In hospitals, the unexpected is always arising and personnel are always dealing with life-and-death issues that require most immediate actions and there are no second trials. These factors combine and intensify to create a built-in sense of rage or a constant management of crisis (Taylor & Taylor, 1994).
An effective conflict management begins with a diagnosis to determine if the conflict manifestation is real. Diagnosis determines the level of operation and the type of conflict. There are three types of health organization conflicts. First, there is goal conflict occurring when the desired states and outcomes for different parties are incompatible.
Secondly, there is cognitive conflict occurring when ideas or opinions are not compatible due to misunderstandings. For example, nurses thinking pharmacist are slow at providing prescriptions while the pharmacist seeing nurses as mistaken in their recommendations.
Lastly, affective conflict happens when feelings and emotions do not match up. These conflicts while appearing to be between persons are indeed real organizational conflicts because the individuals represent units and levels in contest over resources (Taylor & Taylor, 1994).
Dealing with conflicts requires that identification happen on the two dimensions: concern for self and concern for others. Concern for self depends on the assertiveness of the person in pursuing personal goals; on the other hand, concern for others depends on the person cooperativeness. Avoidance is an unassertive and uncooperative behavior used to stay out of conflicts or ignore disagreements by remaining neutral.
This conflict resolve method is incomplete and leaves a residue of feelings that are sure to impact future conflicts. Another conflict resolve method is forcing, which is an assertive and uncooperative reflection of win-lose attitude. This method assists individuals to achieve their goals but regular use breeds fear and hatred.
Thirdly, accommodating is a cooperative but unassertive method often referred to as lose-win strategy. Collaborating is a highly cooperative and assertive win-win method. Collaborating managers see conflicts as natural and leading creative solutions, when handled properly. Compromising is an intermediate cooperative and assertive method with a give and take approach (Taylor & Taylor, 1994).
Risk Management, Experience and Training
Health care organizations seek ways to identify and reduce risks threatening their existence (Caroll, 2009). Health care risk management began to emerge after the malpractice crisis of mid-1970s as hospitals and related entities faced a crisis characterized by a speedy rise in claims cost, insurance premiums and saw an exit of several medical professional liability insurers.
As a result, the American Society for Healthcare Risk Management (ASHRM) came into existence in 1980 (Caroll, 2009). Risk management on health care organization considers an unnumbered complex legal, regulatory, politics, business and financial risks facing the organizations.
Now risk management is moving to embrace more strategic orientations and professional risk managers are morphing into chief risk officers. Their new roles now demand a detail examination of their career factors such as higher education, business, financial and technical skills as risk management returns to the realm of patient safety (Caroll, 2009).
Risk management strategies are a mix of techniques aimed at preventing or reducing potential losses and preservation of the organizations assets. They encompass a set of written policies and procedures that promise uniformity and consistency of the program with greatly boosts communication between the affected parties and the program (Caroll, 2009).
Risk management professionals have to be very visible in the organization because they rely on feedback and cooperation from fellow organization members.to remain visible, they communicate, educate and raise consciousness to nurture an awareness of risk management (Caroll, 2009).
Risk professionals have to be insiders who get information of impeding crises and organizational conflicts early in the due diligence process, so that they effectively advice senior management on risk implications of new business arrangements. Risk implications are of high priority but executives who are not in agreement with risk management matters and specific indemnity requirements overlooked them (Caroll, 2009).
Conclusion
For health care organizations effectiveness in goal achievement, personnel ought to share a vision of what they are striving to achieve. There also needs to be ways to recognize and resolve conflicts before they escalate. Members of any organization need to have ways of keeping conflict to a minimum. Solving problems caused by conflict prevent major obstacles from affecting a health care organization.
Hospital preparedness to handle crisis, is not dependent on a sole discipline group. Hospitals need to a crisis communication protocol to manage effectively concerns and anxiety from crisis-affected persons.
References
An, S., Gower, K. K., and Cho, S. H. (2011). The level of responsibility and crisis response strategies of the media. Journal of Communication Management, 15(1), 70-83.
Borkowski, N. (2011). Organizational Behavior in Health Care (2nd ed.). Sadbury: Jones and Barlett Publishers.
Braun, B. I., Wlneman, N. V., Finn, N. L., Barbera, J. A., Schmaltz, S. P., and Loeb, J. M. (2006). Integrating Hospitals into Community Emergency Preparedness Planning. Annals of Internal Medicine, 144, 799-811.
Caroll, R. (Ed.). (2009). Risk Management Handbook for Health Care Organizations. San Francisco, CA: Jossey-Bass.
Faustenhammer, A., and Gossler, M. (2011). Preparing for the next crisis: what can organizations do to prepare managers for uncertain future? Business Strategy Series, 12(2), 51-55.
Halbesleben, J. R., Cox, K., and Hall, L. (2011). transfer of crew resource management training, a qualitative study of comminication and decision making in two intensive care units. Leadership in Health Services, 24(1), 19-28.
Harris, J. L., and Roussel, L. (2010). Initiating and sustaining the clinical nurse leader role: a practical guide. Sadbury MA: jones and Barlett Publishers.
Joint Commision Resources. (2009). Portable Accreditation Manual for Critical Access Hospitals 2009: Camcah. Oakbrook Terrace: Joint Commision Resources.
Lundgren, R. E., and McMakin, A. H. (2009). Risk communication: a handbook for communicating environmental, safety, and health risks (4th ed.). Hoboken, NJ: John Wiley and Sons.
Taylor, R. J., and Taylor, S. B. (1994). The AUPHA manual of health services management. Gaithersburg: Aspen Publishers, Inc.
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