The company that I work for is CareOne at Valley, a senior care company. We are a sub-acute rehabilitation and long-term care center. We have about 150 employees working in our 8 departments: nursing, rehabilitation, dietary, environmental, recreation, social services, marketing and administration. Our mission is to define excellence within the health care community. We treat residents, their families and each other with respect, dignity and compassion. We strive to lead the industry by delivering superior clinical outcomes and exceptional care in exceptional settings.
Our vision to become New Jersey’s health care provider and employer of choice is supported by our ongoing commitment to achieving excellence, celebrating diversity, emphasizing education and promoting innovation (CareOne company website, n. d. ). Although our mission is to treat each other with respect, workplace hostilities can erupt for various reasons under almost any circumstances. According to Lanier (n. d. ), the term conflict refers to perceived incompatibilities resulting typically from some form of interference or opposition.
Conflict management, then, is the employment of strategies to correct these perceived differences in a positive manner. Some of the conflicts that can erupt in my workplace are a result of uneven distribution of the workload, misunderstanding of information or communication breakdown, personality clashes, and misinterpretation of duties or policies. Excessive workload causes stress on the staff which can make them more aggressive or unwilling to work together. This creates conflict among the staff; some people might even take it personal and feel that a particular coworker has issues with them.
A typical scenario at CareOne at Valley among the nursing staff is seeing them arguing with their supervisors about their work assignment, or about their coworkers taking too many breaks or being too slow. Misunderstanding of information or communication breakdown is another source of conflict in my workplace. People communicate in different ways. Some people require very little information to understand a subject, while others need more information and a clearer explanation in order to gather meaning. Faulty communication leads to misperceptions and misunderstandings that can lead to long-standing conflict (Lanier, n. d. ).
In addition, personality tensions are caused by differences in personality, attitudes, values, and beliefs. A personality conflict emerges when two people simply do not get along or do not view things similarly (Lanier, n. d. ). 150 employees means 150 different personalities, and although most of us have been part of the team for a considerate amount of time making us feel more comfortable with each other, tensions still arise. Conflicts may also surface when employees disagree about who has the responsibility for tasks and resources. For example, two employees can begin disputing responsibility over performing a specific job duty.
Managers and human resources professionals need to become proficient at workplace conflict negotiation to help maintain a professional atmosphere. According to Hellriegel and Slocum (2011), negotiation is a process in which two or more interdependent individuals or groups who perceive that they have both common and conflicting goals state and discuss proposals and preferences for specific terms of a possible agreement. The four core stages of negotiation include (1) assessing the situation, (2) establishing the process, (3) negotiating the agreement, and (4) implementing the agreement.
Two major negotiating strategies are distributive which focuses on win-lose outcomes, and integrative which focuses on win-win outcomes. In CareOne at Valley we always try to get a win-win outcome. However, we keep in mind that some conflicts cannot be resolved through the integrative negotiation strategy. In those situations, the best we can do is explain that there are differing points of view and then make and communicate a decision that ends the conflict most fairly and with company values in mind.
Our approach to achieve negotiation is always putting the parties involved at ease to obtain an objective statement of the problem; we listen with understanding and determine where each person stands on the issue. In the nursing department we have been able to settle uneven distribution of the workload conflicts using an integrative negotiation strategy.
It started with some of the nursing assistants complaining that they felt stuck with the most tedious duties such as collect specimens, turn and position patients, and patient ransfer, while their coworkers will always take on the easiest tasks like passing snacks and updating their daily books. With the integrative strategy we were able to create a schedule that gives our nursing assistants a chance to take turns at the different daily duties. We assessed the situation, determined compromise, created an action plan and implemented it. But, when the staff complained of uneven distribution of the workload due to personnel reduction a win-win outcome was not possible. The sub-acute units are usually staffed with 2 nurses for every shift.
When our overall census is below our budget, we cannot afford to have the same staff. Nevertheless, the nurses give us a hard time when they have to work alone. We still engaged in active listening, and suggested alternatives to reduce their workload such as delegating tasks to the unit clerk and nursing assistants. In this type of negotiation, the management goals (reduce labor hours) are in direct conflict with the staff. Awareness and understanding probably are the most important means for dealing with win-lose ploys by the other party (Hellriegel & Slocum, 2011).
As their former Staffing Coordinator, I used to try to explain to the staff that our managers are required to make decisions to stay in business, and that we all needed to stay flexible and find ways to make the best of any situation. Decision making is an everyday fact of life for each of us. Thoughtful decision making typically involves defining the problem, gathering information, identifying and assessing alternatives, and deciding what to do (Hellriegel & Slocum, 2011). Evidence-based management means managerial decision and organizational practices informed by the best available scientific evidence.
Refocusing management education on evidence promises improved managerial decision making and better organizational outcomes (Rousseau & McCarthy, 2007). Using evidence can help us make the right choices. According to Gomez (n. d. ), business that rely on evidence to inform their practices give themselves an advantage over those that simply put policies and procedures in place that executives think, but do not know, might be beneficial. Evidence-based management could be applied to CareOne at Valley by identifying the area we want to improve.
As a Staffing Coordinator of the nursing department, I have witnessed a high rate of employee turnover. Therefore, I would use the evidence-based management to identify the causes of staff turnover, and to determine steps to minimize it. To start an evidence-based management practice we have to gather evidence on the problem we are trying to solve or improve upon. Exit-interviews could help us control turnover. Through these interviews we can obtain information about what influenced the employee to leave the company, as well as what we are doing well and what we need to improve.
But, we cannot wait until an employee decides to terminate their employment with us to obtain this information and do something about it. We have to be proactive and really focus on employee satisfaction surveys and evaluations. We already do employee satisfaction surveys for all departments. Therefore, one-on-one evaluations could be a great resource to obtain the data that we need. Once the data is collected, we will have to review it and look for common threads. Employee surveys often contain valuable suggestions and insights that can be incorporated into solutions.
The key is to compare what has worked in the past and what the evidence is telling us. Perhaps, the staff is looking for better training and continued education, and not just a pay increase. Trade associations and journals may contain industry benchmarks and cases that we can review to further inform our practice (Gomez, n. d. ). This could be beneficial to create enough alternatives to minimize staff turnover. Before making the final decision on what changes we are going to take to improve our employee turnover rate, we should present our findings and solutions to our employees.
The idea is to be able to create retention and let them know we are actively listening during the employee satisfaction surveys and evaluations. The last step would be to put the new practices in place and evaluate them within the 6 months. According to Rousseau & McCarthy (2007), the success of evidence-based management lies in the hands of managers who must embrace the concept to make it work. Using research can take time, and “time is money”. Evidence-based management requires the capacity and willingness to search for and evaluate evidence.
Fundamentally, the ultimate support for evidence-based management is an evidence-based organizational culture whose values and norms promote informed decisions, evaluation, feedback, and reflection on their outcomes, and continued learning and updating regarding effective practice. Organizations must recognize that critical thinking and creative solutions to problems is imperative to enhance business potential. Today’s decision makers must use a variety of thinking styles, methodologies and creative processes.
Creative Thinking is thinking that shifts perception and perspectives to open up new pathways to explore, and when you take new pathways it is possible to discover new ideas that may lead to innovative outcomes (Jarrard, 2011). A creative alternative must be both novel and effective. Common blocks to creativity are found in three major categories: perceptual, cultural, and emotional. Perceptual blocks arise because of the ways in which we tend to perceive, define and examine the problems and decisions.
For example, fitting observations into a standard category or stereotype, or focusing too much on detail and not being able to reframe the decision in a broader context. The organizational culture may also hinder the production and recognition of creative alternatives. The natural tendency of organizations to routinize, decrease uncertainty, increase predictability, and centralize functions and controls can block creativity. Furthermore, our emotions can interfere with our ability to seek or identify truly creative alternatives.
It may be counterproductive not to consider a creative alternative just because you risk others thinking your idea is impossible or too “far out”, or because you fear making a mistake and the distrust of others (Liu, n. d. ). Decision-making is most powerful when combined with logical, intuitive and creative mental process. The stages of creative decision-making are preparation, concentration, incubation, illumination, and verification. The goal of the preparation stage is to gain a better understanding of the existing problem and the specific circumstances surrounding it.
This step focus on gathering information and facts that are relevant to making a decision. Quality is more important that quantity when gathering information. Too much information can confuse and complicate the decision making process (Bednarz, 2011). During the concentration stage a list of specific advantages, disadvantages and interesting aspects for each alternative should be shared, discussed and recorded. The incubation stage involves exploring different paths toward new alternatives.
A successful incubation stage yields fresh ideas and new ways of thinking about the nature of an issue or a problem and alternative solutions (Hellriegel & Slocum, 2011). The illumination stage is the instant of becoming aware of a new candidate solution, and the verification stage involves evaluating the solution’s effectiveness. There are numerous creativity methods. Edward De Bono, Alex Osborn and Michael Michalko are some of the pioneers of creative thinking. The best approach we should follow at CareOne at Valley when making decisions is De Bono’s Lateral thinking.
In his book Six Thinking Hats, De Bono created this technique that forces you to move outside your habitual thinking style, and helps you to get a more rounded view of a situation. Each “Thinking Hat” is a different style of thinking. The White Hat makes you focus on the data available; the Red Hat obliges you to look at problems using intuition, gut reaction, and emotion; using the Black Hat thinking allows you to consider all the bad points of the decision; the Yellow Hat helps you to think positively; the Green Hat stands for creativity; and the Blue Hat stands for process control.
At CareOne at Valley, the Six Thinking Hats technique could be of great use when deciding if we should expand into a second floor during the scheduled renovations. The decision of renovating the sub-acute units has already been made. A year ago, we renovated a few rooms with the idea of selling these rooms as suites. Lately, we have experienced a great demand for these “suites” which is why we decided to invest in renovating the rest of the rooms. But, should we also expand into a second floor?
We know we had a steady demand with the first suites, if we convert the rest of the rooms shouldn’t we expect a greater demand? Looking at the problem with the white hat, we can analyze the data we have. We can examine our admissions trending and our lost referrals due to the unavailability of these suites. With the red hat thinking, we can have some individuals excited about the idea of more appealing rooms, and others not so excited because it means more work. Using the black hat thinking, we consider the possibility of not being able to sell those extra rooms.
Expanding into a second floor means needing more admissions to maintain a good occupancy rate. On the other hand, with the yellow hat we can project abundance of admissions, more marketing, and great success. We already have a great reputation, we are a Medicare-rated 5 star facility, expanding seems like right move. With the green hat thinking, we might consider creating an Assisted Living unit. We will still be expanding, and at the same time targeting a different market which can make it more feasible to maintain our occupancy rate.
The blue hat is usually used by the meeting’s administrator to keep other members of the team switching to the different styles of thinking. The environmental factors that affect the organizational design of CareOne at Valley are our suppliers, competitors, customers and our employees – distributors – since they are the ones who have direct access to customers. Our suppliers involve U. S. Foods, Phoenix Textile, Gulf South, Partners Pharmacy, and W. B. Mason, Aero ambulance, and Mobilex X-ray services to name a few. These are some of the relationships we have developed to obtain materials for our daily operations.
Our competitors are the other skilled nursing facilities in the area that drive CareOne at Valley to deliver superior clinical outcomes and exceptional care in exceptional settings. Our customers are our residents and patients. They are our reason to want to be the best at what we do. According to Hellriegel & Slocum (2011), distributors are the various organizations that help other organizations deliver and sell its products. Our employees are our distributors; they are the ones that deliver our product, superior care, to our customers.
Customers and employees are the most important people for CareOne at Valley. They are the resource upon which the success of our business depends. CareOne at Valley pursues a differentiation strategy. This strategy is based on providing customers with something unique that makes the organization’s product or service distinctive from its competition (Hellriegel & Slocum, 2011). We are one of the few five star Medicare-rated facilities for two consecutive years, going on our third year in February 2013. Only 10 percent of nursing and rehabilitation centers in the U. S. receive such distinction.
Annual health inspections, staffing levels and quality measures determine each facility’s rating. Quality measures include ten important aspects of care, such as how well the nursing home helps residents retain their ability to dress and eat, and how the facility prevents and treats skin ulcers. “Our Five-Star Quality Rating is a testament to the commitment and quality of care that our team provides every day. Everyone on our team works diligently to provide exceptional care with the utmost compassion and dedication”, said Caryn Edelbach our Licensed Nursing Home Administrator back in 2011.