Negotiation and Conflict Management

1. Types of Negotiation

Healthcare is a highly complex scenario in which the need to make decisions among groups of passionate, smart people with differing views can generate conflict. Organizations must find a way to allow diverse ideas and opinions to be generated in a culture of psychological safety while facilitating discussion dedicated to gaining a genuine agreement about matters of importance.

There are five types of negotiation that occur among individuals and groups, according to Kenneth Thomas:

• Avoidance: One party avoids interaction, leaving opinions and concerns left unsaid that could lead to disagreements and problems in the future.
• Accommodation: One party concedes to the other to avoid conflict.
• Competition: Both parties want to win and begin to haggle, resulting in one party being the winner and the other the loser.
• Compromise: Give and take occurs between the parties, with each group giving up something to reach an agreement.
• Collaboration: Both parties work together to find a mutually agreeable solution and maintain working relationships and achieve win-win results. This type of negotiation fosters innovative and creative thinking that leads to new opportunities that benefit both parties.

2. Collaborative Negotiation

Healthcare teams should adopt collaborative negotiation at every possible opportunity. This is the only negotiation approach that produces workable solutions that manage resources, provides the best options for patients, and preserves relationships between parties.

The hallmarks of collaborative negotiation are appreciative inquiry and self-reflection, which allow facilitators to draw out the underlying impetus behind participants’ positions. It creates an opportunity to gain insights and perspective that others may not have thought of, and it can generate better decisions. Self-reflection occurs when each participant tries to understand what desires they bring to the table. When emotions run high during meetings, it is necessary to re-center the discussion to the central issue to bring people back to the task at hand and focus on why this decision is important. Another option is to take a break and let people have a few minutes to digest the information and center themselves for further discussion.

Collaborative negotiation can be challenging, but it is worth the effort and will lead to inventive solutions to problems that keep everyone’s best interests at heart. It will also further establish a just culture and a safety culture; it must permeate into everything you do for you to establish a high reliability organization.

Authored by Cindy Ebner, MSN, RN, CPHRM, FASHRM

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