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Friday, September 30, 2011

Resolving Conflicts

I just finished a week in a class focusing on leadership skills. I found one of the presentations especially valuable to my current work, and with the permission of the instructor, am sharing some of that content with you.

The session I'm referring to was on Conflict Management, and referred to five different approaches to managing conflicts.  One of the conflicts that I'm presently trying to "manage", has to do with disconnects between ONC's S&I Framework, HIT Standards Committee, HL7 and IHE.  Now, for me to say that I'm managing this conflict would seem rather arrogant.  The point is not that its my responsibility to "manage" it, so much as it is my goal to do what I can to ensure that the current situation improves.

Before I explain my main point, I want to give you a little bit of background that I got from the class.  As I mentioned, there are five different approaches to conflict resolution that were addressed in the class.  These are shown in the diagram below (which is my depiction of what the instructor showed us):

Each of the five techniques has two different properties that help you determine when they are effective.  One has to do with the stakes or risk inherent in the situation.  The other has to do with the importance of the relationship.  This shows up on the two axes of the image.  High cooperation is important when when the relationship is important, lower when there is less importance in the relationship.  High competition is present when the stakes or risk are high, lower when the risks or stakes aren't as important.  I've tried to shade the graph to show that there is a continuum, and that the different techniques really identify different places in this continuum.
TechniqueStakes/RiskRelationship
AvoidanceNot HighNot Important
AccommodationNot HighImportant
CompromiseModerateSomewhat Important
CompeteHighNot Important
CollaborateHighImportant

Looking at these three techniques, and evaluating national HIT Standards needs along with the important of the relationship between these national groups (ONC and HIT Standards FACA), and HL7 and IHE, it's pretty easy to assert:

  1. The stakes are very high for everybody.
  2. From the HL7 and IHE perspective, it's very clear that the relationship between ONC and the HIT Standards committee is very important.
  3. I would hope that the national groups (ONC and the HIT Standards Committee) would feel the same way about the importance of the relationship.
If we are all agreed on that, then it becomes very clear what ONC, IHE, and HL7 must do, and that is collaborate.  I believe that these collaborations are beginning to take place.  If you look for example at the work done by IHE for updating XDS Metadata to support Direct, and from HL7, where they are continuing with the CDA Consolidation effort, I see some effective efforts at collaboration.  But, I still want to see more. 

There's another way to look at the five techniques.  We can, for each party, look at "What's In It for Me" (WIIFM).  If we look at each of these conflicts as a game, there are different kinds of games being played, with different outcomes.

Avoid is I don't care and you lose.  Accommodate is I don't care and you win.  Compromise is we both care, and both win some and lose some.  Compete is we both care, and I win and you lose.  None of these are ideal outcomes when the risk is high and the relationship matters.  Collaboration is the only technique that allows both parties to win.

Let's all win.

   -- Keith

P.S.  I speak about IHE and HL7 and ONC and HIT FACA, but I realize that those aren't the only parties in this game, they are simply the parties that I usually interact with.  I'll reiterate, we all need to win, and we all need to collaborate. 

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