Liz Forbat1, Jean Simons2, Charlotte Sayer3, Megan Davies3, Sarah Barclay4. 1. Australian Catholic University and Calvary Health Care, Canberra, Australian Capital Territory, Australia. 2. Lullaby Trust, London, UK. 3. Evelina London Children's Hospital, St Thomas' Hospital, London, UK. 4. Medical Mediation Foundation, London, UK.
Abstract
BACKGROUND: Conflict is a recognised component of healthcare. Disagreements about treatment protocols, treatment aims and poor communication are recognised warning signs. Conflict management strategies can be used to prevent escalation, but are not a routine component of clinical training. OBJECTIVE: To report the findings from a novel training intervention, aimed at enabling paediatric staff to identify and understand the warning signs of conflict, and to implement conflict resolution strategies. DESIGN AND SETTING: Self-report measures were taken at baseline, immediately after the training and at 6 months. Questionnaires recorded quantitative and qualitative feedback on the experience of training, and the ability to recognise and de-escalate conflict. The training was provided in a tertiary teaching paediatric hospital in England over 18 months, commencing in June 2013. INTERVENTION: A 4-h training course on identifying, understanding and managing conflict was provided to staff. RESULTS: Baseline data were collected from all 711 staff trained, and 6-month follow-up data were collected for 313 of those staff (44%). The training was successful in equipping staff to recognise and de-escalate conflict. Six months after the training, 57% of respondents had experienced conflict, of whom 91% reported that the training had enabled them to de-escalate the conflict. Learning was retained at 6 months with staff more able than at baseline recognising conflict triggers (Fischer's exact test, p=0.001) and managing conflict situations (Pearson's χ2 test, p=0.001). CONCLUSIONS: This training has the potential to reduce substantially the human and economic costs of conflicts for healthcare providers, healthcare staff, patients and relatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: Conflict is a recognised component of healthcare. Disagreements about treatment protocols, treatment aims and poor communication are recognised warning signs. Conflict management strategies can be used to prevent escalation, but are not a routine component of clinical training. OBJECTIVE: To report the findings from a novel training intervention, aimed at enabling paediatric staff to identify and understand the warning signs of conflict, and to implement conflict resolution strategies. DESIGN AND SETTING: Self-report measures were taken at baseline, immediately after the training and at 6 months. Questionnaires recorded quantitative and qualitative feedback on the experience of training, and the ability to recognise and de-escalate conflict. The training was provided in a tertiary teaching paediatric hospital in England over 18 months, commencing in June 2013. INTERVENTION: A 4-h training course on identifying, understanding and managing conflict was provided to staff. RESULTS: Baseline data were collected from all 711 staff trained, and 6-month follow-up data were collected for 313 of those staff (44%). The training was successful in equipping staff to recognise and de-escalate conflict. Six months after the training, 57% of respondents had experienced conflict, of whom 91% reported that the training had enabled them to de-escalate the conflict. Learning was retained at 6 months with staff more able than at baseline recognising conflict triggers (Fischer's exact test, p=0.001) and managing conflict situations (Pearson's χ2 test, p=0.001). CONCLUSIONS: This training has the potential to reduce substantially the human and economic costs of conflicts for healthcare providers, healthcare staff, patients and relatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Entities:
Keywords:
Health services research; conflict; paediatrics; training
Authors: Oscar Lyons; Liz Forbat; Esse Menson; Julia C Chisholm; Kate Pryde; Siobhan Conlin; Victoria Felton; Susanne Ingle; Celia McKenzie; Rohana Ramachandran; Charlotte Sayer; Carly Snowball; Emma Strachan-Gadsby; Natasha Tisovszky; Sarah Barclay Journal: BMJ Paediatr Open Date: 2021-11-26