The Wagging Tail

We all have disagreements in the work place, and disagreements can become conflicts that interfere with our ability to accomplish our work when emotions become involved. These emotions often stem from primitive feelings of fight or flight and that is why they seem so vexing to resolve. The key to resolving conflict is to recognize emotions, ours and theirs, create safety and focus on mutual benefit.

Here’s an example situation: I want to have Pets checked in quickly; Jane* wants to ask a lot of questions during registration at the front desk. Emotions of conflict could build with my co-workers when I apply an underlying negative meaning to a given situation. For instance, “Jane takes forever checking in Pets even though she knows it slows my work down. Jane doesn’t respect my role.” Now, not only am I behind in my work, from my perspective, but my co-worker is insulting me! If this conflict has gone on a while, with me grumbling about “we sure could speed things up around here” with Jane in earshot, I should assume that Jane now has emotions about this, too.

To have a conversation about this conflict that will bring a positive resolution, it’s a good idea to follow these simple guidelines:

• Signpost the difficulty of the upcoming conversation
  Signposting is telling your co-worker to emotionally prepare for a difficult discussion. This prevents a feeling that they have been ambushed and leads to more openness.
• Attend to the relationship
  For your co-worker to consider meeting you halfway there needs to be some good will in the relationship. Your co-worker is more likely to work with you if they sense you want to get along with them, not assert your ideas over theirs.
• Speak to emotions
  There is nothing so powerful in a relationship as feeling like a colleague is trying to understand what it feels like, from the co-worker’s perspective.
• Focus on mutual benefit
  You want to enlist the co-worker in a project that will benefit both of you in your work.

Signpost difficulty: “Jane, I know this may be hard to discuss, and I think it’s important.”

Attend to the relationship: I have to have integrity without attachment. I need to focus myself on resolving the problem so that we can both accomplish our work. I need to let go of wanting to win.

Speak to emotions: Focus on empathy. “You want to make sure we have complete information before we start caring for the Pet.”

Focus on mutual benefit: “I want to talk to you about our differences on how to get Pets cared for when they come to our hospital. We both want efficient and effective Pet care. I want to understand why you see things the way you do and share with you my perspective and feelings.”

This approach often helps to ease conflict and develop constructive problem solving. It is not always easy to do, especially when you feel angry or upset. One additional benefit is that, when I use this approach, I feel that, whether or not I am successful with the co-worker, I have conducted myself with integrity.

How do these conversations go in your office? What have you found useful in talking to your co-workers about conflict?

Some additional articles about resolving conflicts:

• http://www.essortment.com/all/coworkerconflic_rbhc.htm
• http://cars.unm.edu/PDFs/resources/Resolving_Coworker_Conflicts.pdf

*sample situation not intended to reflect on any actual persons

Do veterinarians practice evidence-based veterinary medicine? In the human medical profession, evidence-based medicine (EBM) has become established and clinicians have accessible EBM tools to support clinical decision-making.

What exactly does EBM mean to a practitioner? EBM is the conscientious and implicit effort to apply current best research evidence to medical decision-making. EBM should enhance clinical expertise in concert with consideration of patient needs and client circumstances.

For veterinarians, EBM is gaining momentum, but it is not widely employed in clinical practice. In addition to published research evidence, veterinarians still rely heavily upon textbooks, anecdotes, faculty expertise, and peer consultations. Depending on the clinical question, these may be the only resources to utilize, but they are often inadequate, outdated, and unproductive. Why has veterinary medicine been slower to adopt the practice of EBM? Is it because there is less rigorous, controlled research conducted and published in the peer-reviewed literature? These challenges create a gap between new knowledge and the practice of EBM in veterinary medicine.

How can the veterinary profession close the knowledge-to-practice gap? The gap represents a barrier to high quality care for individual patients. Where can veterinarians go to get evidence-based, synthesized information? Who teaches veterinarians how to incorporate it into clinical settings? The US Preventative Services Task Force (USPSTF) is well-known for providing physicians with recommendations and guidelines based on research evidence. According to their website, the USPSTF is “An independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services.”

Could similar guidelines for preventive care and screening be developed for veterinarians? These guidelines would support the most efficacious screening for optimal pet care. The BARK (Banfield Applied Research and Knowledge) team is using Banfield’s large database to generate new knowledge, in addition to critically appraising existing knowledge from a variety of sources, to create preventive care and screening guidelines for the common diseases of middle-aged and senior pets.

Next month, BARK’s Research Medical Advisor Associate, Patrick Shearer, BVMS, PhD, will talk about periodontal disease. Please join us, post your comments, and engage in a discussion about what we know about the disease and how as veterinarians we can promote the highest quality evidence-based dental care for the pets that we see.

• Each month thereafter, the BARK team will blog about topics such as:
• EBM and evidence dissemination initiatives in the profession
• Strategies to best apply evidence in clinical settings
• Current and future research initiatives at Banfield

Let us know if you have ideas about questions or topics that are of interest to you, especially in relationship to evidence-based medicine and getting new knowledge to our patients!

Further Reading: Click on the links below for two articles on EBM that recently appeared in the Banfield Journal. The current edition of the Banfield Journal can always be viewed online at www.banfield.net/banfield-journal.

• Banfield Journal May-June 2009
• Banfield Journal July-Aug 2009

No way around it. If you’re part of the workforce, occasional disagreements and problems between co-workers are inevitable. And although differences of opinion will always be a part of human interactions, we know that the more effectively we can communicate our thoughts to each other, the less conflict we experience. And the less conflict we experience in the work environment, the more productive we will be.

During my research into conflict resolution and practice management, I came upon numerous and useful resources that I’d like to share with you. I could list all the great ideas that I found useful, but I find that the two I list below are the best. Not only are these initiatives innovative, they are practical and easy to implement.

Anticipate problems and prepare. Reduce the likelihood of disagreements by instating a Principles of Mutual Respect Policy (PMRP). In a non-threatening manner, this document can provide clear expectations, define desired behavior, and more importantly, acknowledges that every team member is important and the practice is dedicated to open communication and treating everyone with respect. Brenda Tassava, CVPM, has an excellent example that she implements as director of operations for the Broad Ripple Animal Clinic and Wellness Center in Indianapolis, Ind.

Distribute and discuss the PMRP at your next internal meeting and, on an on-going basis, make sure all new team members receive a copy.

Get out and eat some lunch. My second favorite idea comes from Florence Sanford, CVPM, practice manager at Nassau Veterinary Clinic in Nassau, N.Y., and she describes it as “When our team’s resolution skills aren’t enough to manage conflicts, I’ve sent feuding team members out to lunch together with $25 to talk out their issues. Neither person is welcome back unless there’s a truce. This has happened four times in 15 years and each conflict resolved. Some feuding team members even became good friends.”

I’m convinced this idea of removing quarreling co-workers works because I have done the same thing with my husband on those rare occasions when we continue to revisit the same disagreements with no resolution in sight. I take him out to dinner and discuss the issue. I know I am much better at communicating when I am “in public” and he is much more receptive to hearing my concerns. There’s something about sitting in a neutral place and sharing a meal that can allay bad feelings and open our minds to understanding others.

Each of us has unique life experiences, personalities and perspectives that shape the way we interact with our world and, consequently, impacts the way in which we communicate. Keeping these differences in mind, it’s easy to see how problems and animosity among colleagues can occur. Communicating expectations up front and listening to each other over a roast beef sandwich, might be what your team needs to work through bad feelings and improve team member relations.

References

http://veterinaryteam.dvm360.com/firstline/Communication+Strategies/Bring-peace-back-to-your-practice/ArticleStandard/Article/detail/529606

http://veterinaryteam.dvm360.com/firstline/Veterinary+team/4-ways-to-keep-the-peace-at-your-practice/ArticleStandard/Article/detail/642323?contextCategoryId=37267

Several weeks ago, I showed up early at the hospital on my “day off” for some paperwork.

I first noticed that the rest of the hospital also seemed to be closed when operating hours had already started. All of the exam room doors were closed, lights were off, no one was at the front desk and a pile of trash in front of the counter.

I was a little upset. I imagined clients, both potential and current, walking the other way so I went about picking up trash, opening exam rooms and turning on the lights. My receptionist walked out of the treatment room a moment later and greeted me enthusiastically while helping me finish opening everything up. She also explained that a team member had called in sick, which was why she had to go in the back to help secure a Pet and could not set up shop right away. She assured me she had only been gone for a few moments.

Before I left the store, I gathered the team to discuss the situation in order to avoid this from happening in the future. We discussed how my team did not prioritize the hospital’s appearance with the rest of their duties, and while much of the reason was that the team was distracted with other morning tasks, we all knew that we could do better.

We discussed the importance of first impressions, consistency, friendliness and overall exceptional service. Everyone understood that we needed to put certain protocols in place to prevent this from happening in the future. Amongst other things, we decided that, as a team, we should walk around the counter to make sure the hospital front looks clean. Because whether we’re seeing a new or an established client, saying “I’m so sorry about the mess” with an excuse just doesn’t cut it. While an established client might still continue to come to our hospital because we have solidified a positive first impression and they know that this situation is not typical, a new client’s first impression would most definitely be a negative one.

As I departed my hospital a few minutes later, I felt much better. Not only did I make sure to prevent a problem that is easy to fix, but I effectively communicated the needs of my hospital to the rest of the team. While I had not expected the need to communicate something that I thought was so simple to the rest of my team, I took this as a good learning opportunity on interacting with my team as well as stressing the importance of first impressions to clients.