R2RNot Logo
Resolution Resources
Blog Detail
Posted Jun 18 2015 9:03AM

Analyzing an organization’s past conflict is one of the best ways to reduce future incidents. Here are steps to do that and a case study of how it worked.


  1. Look for similarities among past conflicts.

Rather than focusing on the identity or intentions of a guilty party, begin by looking for circumstantial similarities among the past conflicts. Look closely to see if any of the organization’s actions or policies may be contributing to these disputes.

  1. Identify the conflict triggers.

Contributors to conflict can be political, procedural, structural, and/or personal. By regularly reviewing workplace disputes, it’s possible to discern operational or behavioral patterns occurring across a variety of conflicts, even in separate venues. Once they are identified, the circumstances can be altered to reduce or even eliminate the conflict.

  1. Evaluate the options.

Consider the options available for altering the circumstances so that it’s possible to achieve the desired result without the unintended consequence. Experiment with alternative policies or practices, carefully observing to see if one option works more effectively than others.


I used this comprehensive conflict assessment method for a community hospital.

Investigative Committee Formed

First I recommended they form a multidisciplinary committee to investigate the most frequently occurring conflicts within the institution. Based on my suggestions, the committee was comprised of: physicians, surgeons, patient care and charge nurses, and a designee from the senior leadership team.

Source of Conflict Identified

After just a few sessions, the committee concluded that the most common source of conflict was the after-hours phone calls between nursing units and on-call physicians.

Exceptions to the Conflict

In the course of their review, the committee discovered several nursing personnel and physicians that seemed to have very few conflicts resulting from their after-hour communications. So they examined how these personnel were able to consistently deal with the after-hours call without complications.

The Cause of Unintended Consequences

The committee also looked for policy or procedural issues that might have resulted in unintended consequences. They discovered that past insults had prompted a variety of defensive moves by both the nursing administration and the medical staff. The resulting actions and attitudes had intensified the sensitivity surrounding these calls, which did little to enhance effective communication.

Experimenting with Procedures

Based on their findings, committee members began experimenting with different after-hour call procedures, across a variety of in-patient units. They implemented a simple preparation protocol prior to each call to consistently gather data. The committee found this increased the effectiveness of the communication and greatly reduced the number of conflicts and on-call response delays.

Implementing New Protocol

The committee then shared their findings with the administrative, physician, and nursing leadership. Together, they agreed to change the old, more defensive policies and to implement the more effective protocol across all nursing units in the organization.

The Results

The hospital benefited from improved after-hours response, increased patient satisfaction, and better clinical outcomes. Additionally, the frustration levels among nurses and doctors dropped dramatically. The results were documented by a steep decline in the number of complaint calls to the Chief Medical Officer and Chief Nursing Officer, as well as declines in nursing transfer requests and turnover.


Determining whether there are organizational or operational contributors to conflict in your hospital or practice requires a careful examination of dispute patterns and contributors. It also requires that the senior leadership examine its own policies and practices, and be willing to remedy the unintended consequences of their actions. If you’re ready to reduce the conflict in your organization, contact us to help.