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5 Diamond Patient Safety Program
Decreasing Patient & Provider ConflictKeeping It Cool: Conflict Management
2008
•This presentation was collaboratively developed by the Mid-Atlantic Renal Coalition (MARC) and the ESRD Network of New England for the 5-Diamond Patient Safety Program.
The 5-Diamond Patient Safety Program is endorsed by the Renal Physicians Association (RPA) and American Nephrology Nurses’ Association (ANNA).
Keeping It C L!
Created by Renée Bova-Collis, MSW, LCSW
July 2007
Goal:To create an atmosphere that is both professional and comfortable for patients and staff.
Why Does MARC Have to Stick Their Nose in It?
• Subpart U regulations– Quality Improvement– Complaints and grievances
Network 5 Annual Complaint Comparison
0
10
20
30
40
50
60
Abus
/Dis
rO
ther
Tran
/Dis
cEn
viro
nPr
o Et
hics
Reim
/Fin
Staf
f Rel
Tran
sien
tTx
/Q
2003 n=902004 n=992005 n=1032006 n=143
Guided Imagery Exercise
Adapted From 2005 NKF Clinical Meetings Presentation by Rick Russo, LMSW
Common Triggers of Hostile Patient Behaviors• Ineffective Communication Skills• Frustration/Overwhelmed with Emotions• Perceived Disrespect/Belittlement• Perceived Loss of Control• FEAR
What is DPC?Decreasing Dialysis
Patient-Provider
Conflict
Create A Calm Environment
Open Yourself To Understanding Others
Need A Nonjudgmental Approach
Focus On The Issue
Look For Solutions
Implement Agreement
Continue To Communicate
Take Another Look
PROFESSIONALISM
Professional Code of Ethics
• Builds confidence• Accountability• Liability
Merriam-Webster dictionary:
Professionalism is a way of exhibiting a courteous, conscientious and generally businesslike manner in
the workplace.
“Most relationships don’t become screwed up because one person is doing it wrong. They become unhealthy because two people spin off each other.”
-Elizabeth B. Brown,
Living Successfully with Screwed-Up People
Relationships: Personal vs Professional
• Purpose
• Balance of Power
• Focus
Challenging situations are often the delayed result of
professional boundary violations.
Becoming Personally Involved
• Sharing that shifts FOCUS from pt to professional
• Lose ability to respond objectively
• React emotionally
Gifts• Unit policy against
giving/receiving of gifts
• Protects pts from feeling that they need to pay extra for quality
• Protects staff from feeling they need to give extra attention
Showing Favoritism
Showing that you favor one patient over another, or facilitate a patient favoring you over other staff•Creates expectation that it will be done again•Expectation that other staff will do the same
Dual Relationships
• Exchange of goods or services
Fishbowl Effect
Other Pitfalls:
• Flirtation• Inappropriate dress/language• Ordering/parenting• Having the last word• Threatening termination
Malpractice: Watch your Malpractice: Watch your tone of voicetone of voice
• Little to do with mistakes or skill• Personal level
-from Medical Economics www.memag.com Aug 18, 2006
Final Tips: How do you know if you are crossing a line?
• Allowed in other medical settings?
• Assist patient in care?• Can it be documented?• Willing to do for ALL
patients?
Document. Document. Document.
• Just the facts, Ma’am• What, Where, When,
Why, How, Who• If it’s not documented…
Healthcare workers are often nurturing and sensitive, thus
susceptible to the formation of intense personal relationships.