Relationship-based conflict

Relationship-based conflict involves a fundamental and intractable difference between two individuals and is probably most commonly seen between staff members within a department. The conflict might be quite heated or quietly insidious, and outwardly manifested through harassing, bullying, gossiping or denigrating behaviours.

Values-based conflict

This is seen in a clash of values between the organisation and the staff. Commonly, the organisation’s ‘lived’ values will be at odds with its ‘espoused’ values, which causes friction with staff. Conflict concerning values can occur when staff feels the organisation is not true to its stated values or deviates from the reason they decided to join the organisation in the first place.

Interest-based conflict

Interest-based conflict may be seen when different professional groups in an organisation have conflict over a common issue. While there may be mutual commitment to the overall aims of the organisation, there remains conflict based on a shared interest. This might be seen, for example, if nursing and medical staff identify a different solution or approach to the same problem. The conflict arises when each professional group is unwilling to move from their stated or professional position.

Structure-driven conflict

Structure-driven conflict happens when inequities in the system cause discordance between groups. It may be a result of inadequate or unfair polices, rules, practices or protocols, or of contextual or organisational factors that inhibit cooperative professional relationships (Malloch & Porter-O’Grady, 2005). This may be seen in the unequal treatment of different groups within a health system or hospital, when one group receives favourable treatment in terms of services, pay increases or privileges over other clinical groups that are working under the same conditions in the same organisation.

Data-based conflict

Differences of opinion can be based on the use of data to support a given argument or point of view. Data may be used or manipulated to support a position, and this may be the source of conflict between groups. Alternatively, one group may be given more access to data than another group, or one group may not be given the same information to assist in a decision-making process.

Is all conflict bad?

While it is often thought that all conflict is inherently bad and that organisations should always be peaceful and harmonious, conflict can in fact be functional, as well as dysfunctional. Parkin (2009) claims that functional conflict focuses on disagreements about content and issues of tasks, with their surrounding decisions, opinions, ideas and points of view. In the right surroundings and with the correct management, functional conflict can actually energise groups and improve team performance. According to Parkin, functional conflict can increase understandings of alternative and multiple views, stimulate questioning and effective use of information, improve the evaluation of alternatives and enhance critical thinking.

Functional conflict can be achieved only when there is mutual respect for all parties involved, maturity among the team members and open and honest communication throughout – not when teams are in turmoil or are harbouring dysfunctional, unresolved conflict. Heifetz, Grashow and Linsky (2009) go further, by suggesting that managers can orchestrate functional conflict to achieve real, not superficial, harmony within teams.

Management of conflict

Most people dislike dealing with conflict or actively avoid it, because it is often heated, takes considerable emotional capital and is confronting. Human nature, through the ‘fight or flight’ mechanism, either encourages people to run away from conflict or, when cornered, compels them to fight.

Managers often avoid dealing with conflict, hoping that it will self-rectify, disappear or calm down. Unfortunately, failure to adequately address and actively manage conflict can lead to its escalation. Health managers need the correct tools and approaches to adequately address and manage conflict. Just as one type of fire extinguisher will not extinguish every type of fire, so one single approach to conflict resolution will not manage every type of conflict, and health managers need to develop a suite of methods to deal with the range of conflicts they will face. Lencioni (2005) claims that avoiding conflict is one of the main types of team dysfunctions, and that a fundamental requirement of managers is to address and deal with conflict.

Katz and Flynn (2013) suggest that leaders and employees give different definitions of conflict and have varying opinions on the effectiveness of the systems in place. There is also little awareness of the tools and strategies available to mitigate conflict in the workplace. It is therefore critical that health managers have open conversations with staff to discuss conflicts that detract from the team’s performance and how to adequately address them.

Health managers need to be in a position to actively deal with or ‘call’ conflict when they see it. By making it explicit within the team that the manager will address conflict, the team effectively gives permission for conflict management and resolution to occur. Openly discussing conflict also demonstrates to the team that dealing with conflict is another management function, like staffing and budgeting. This active approach can take the mystique and stress out of managing conflict at a local level.

While it is important to consider the health manager’s role in managing and dealing with conflict, there is also an important leadership function in conflict resolution, in preventing and dealing with conflict situations as they arise. Demonstrating strong leadership is as important as developing sound management strategies to deal with conflict. Healthcare workers at any level can demonstrate leadership and effect positive strategies to prevent conflict from occurring or escalating.

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