Conflict Is Inevitable in Healthcare
Wherever people collaborate under pressure, conflict arises. HIM departments experience conflict over workload distribution, policy interpretation, and interdepartmental disagreements about documentation requirements. RHIA candidates must know established conflict management frameworks.
The Thomas-Kilmann Conflict Model
This widely taught model describes five conflict-handling styles based on two dimensions: assertiveness and cooperativeness.
- Competing: high assertiveness, low cooperation, useful in emergencies
- Accommodating: low assertiveness, high cooperation, useful when preserving relationships matters more than the issue
- Avoiding: low assertiveness, low cooperation, useful for trivial issues or when emotions need to cool
- Collaborating: high assertiveness, high cooperation, ideal for finding win-win solutions on important issues
- Compromising: moderate assertiveness and cooperation, useful when a quick, fair solution is needed
Choosing the Right Style
Effective leaders do not rely on a single style. They assess the situation, weighing the importance of the issue against the importance of the relationship, and select the style that fits.
Example Scenario
Two coders disagree about the correct code assignment for a complex case. A collaborating approach, bringing both coders together with a coding supervisor to review guidelines, produces a better long-term outcome than a manager simply dictating the answer.
Structured Conflict Resolution Steps
- Identify the underlying issue, not just the surface complaint
- Allow each party to explain their perspective without interruption
- Identify common goals both parties share
- Brainstorm solutions collaboratively
- Agree on a plan and follow up to confirm resolution
Difficult Conversations
Leaders should address conflict promptly rather than letting it fester. Delayed conflict resolution often escalates tension and damages team morale. Private, respectful conversations that focus on behavior and impact rather than personal attacks tend to be most effective.
Escalation and Mediation
When conflicts cannot be resolved directly, involving human resources or a neutral mediator may be necessary, particularly for conflicts involving policy violations or interpersonal harassment concerns.
Exam Tip
Memorize the five Thomas-Kilmann styles and their assertiveness and cooperativeness levels. Exam scenarios often ask which style is most appropriate for a described situation.