From the Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California.
Anesth Analg. 2019 Oct;129(4):1109-1117. doi: 10.1213/ANE.0000000000003991.
Effective communication is essential in today's health care environment, and poor communication can lead to conflict among health care providers. Differences in cultures and beliefs can further incite conflict among health care team members, families, and patients. Pediatric patient care has a higher potential for conflict because decision-making responsibilities are shared among patients, parents/guardians, and clinicians. It is important to understand the phases and types of conflict because each conflict situation requires a different approach to optimize management. Equally important is an understanding of styles used by individuals to manage conflict. The Thomas-Kilmann Conflict Mode Instrument and the Dutch Test for Conflict Handling are 2 validated tools used to assess conflict management styles. The different styles include competing/forcing, collaborating/problem solving, compromising, avoiding, and yielding/accommodating. A successful physician should be able to identify the phases and types of conflict to use the conflict management approach most suitable for the given conflict.There are several techniques for managing conflict in the pediatric operating room. Acknowledging and managing one's own emotions during conflict is a pivotal first step toward diffusing the situation. Active listening is an important communication skill that improves team dynamics. Aligning the interests of the parties involved in conflict will encourage collaborative problem solving. Cultural competency training can improve communication and conflict management skills. Effective conflict management through formal education of all perioperative team members can lead to improved communication and teamwork and better patient outcomes.
有效的沟通在当今的医疗保健环境中至关重要，而不良的沟通可能会导致医疗保健提供者之间产生冲突。文化和信仰的差异会进一步加剧医疗团队成员、家属和患者之间的冲突。儿科患者护理更容易产生冲突，因为决策责任由患者、父母/监护人以及临床医生共同承担。了解冲突的阶段和类型很重要，因为每种冲突情况都需要不同的方法来优化管理。同样重要的是了解个人用于管理冲突的风格。托马斯-基尔曼冲突模式量表和荷兰冲突处理测试是两种经过验证的工具，用于评估冲突管理风格。不同的风格包括竞争/强制、合作/解决问题、妥协、回避和让步/包容。一个成功的医生应该能够识别冲突的阶段和类型，然后采用最适合给定冲突的冲突管理方法。儿科手术室有几种管理冲突的技术。在冲突中承认和管理自己的情绪是化解局面的关键第一步。积极倾听是一种重要的沟通技巧，可以改善团队动态。协调冲突各方的利益将鼓励合作解决问题。文化能力培训可以提高沟通和冲突管理技巧。通过对所有围手术期团队成员进行正式的冲突管理教育，可以提高沟通和团队合作能力，改善患者结局。
