HCS 131 Week 3 Collaboration Through Conflict Example

The Operating Room Schedule Everyone Fights Over: Turning a Conflict Between Surgery Schedulers and Clinic Staff Into Collaboration

[Student Name]

University of Phoenix

HCS/131: Business Communications Skills for Health Care Professionals

Week 3 Assignment

[Instructor Name]

[Date]

The hospital, departments and people are composites written for a model paper.

At 3:40 on a Thursday afternoon, an orthopedic clinic's office manager called the hospital's surgery scheduling office to insist that a patient be added to the next morning's operating room schedule. The scheduler explained that the day was full. The office manager said the surgeon had been promised the slot and asked for the scheduler's supervisor. The call ended with the office manager hanging up and the scheduler, three months into the job, crying at her desk. Calls like this had happened every week for months. This paper analyzes the conflict and describes how the two departments turned it into collaboration.

The Pattern Behind the Call

The hospital has eight operating rooms shared by six surgical groups. Each group has block time, reserved hours on certain days. Schedulers post the next day's schedule at noon. Clinics often call after noon to add cases, move cases between rooms or ask for another group's unused time. There was no written rule for how late a case could be added or who decided. Schedulers answered each call as it came, and whoever pushed hardest usually got the time.

Sources of the Conflict

Three sources drove the conflict. Operating room time is scarce and valuable, so every minute is contested. The rules were unclear, which meant every request became a negotiation. And each side answered to someone else: schedulers to the perioperative director, who wanted rooms to start on time, and clinic staff to surgeons, who wanted their patients done this week. Neither side was acting in bad faith; each was doing what its own boss rewarded, and the gap between those two sets of rewards was where the conflict lived.

The Styles Each Side Used

Thomas (1992) plotted conflict behavior on a grid. One side of the grid measures assertiveness, the drive to get one's own needs met; the other measures cooperativeness, the drive to meet the other party's needs. Five modes follow from the grid: avoiding, accommodating, competing, compromising and collaborating. The clinic office manager was competing: highly assertive and low in cooperation, escalating to supervisors to win the slot. The schedulers began by accommodating, squeezing cases in to keep the peace, which caused late starts the next morning. After repeated confrontations they shifted to avoiding, letting calls go to voicemail after 3:00. Neither pattern solved anything; accommodation created delays and avoidance created more angry calls.

Positions and Interests

Fisher et al. (2011) advised negotiators to focus on interests, the needs behind a demand, rather than positions, the demand itself. The clinic's position was "add this case tomorrow." Its interests were a patient with a fracture who needed surgery within a few days and a surgeon who did not want to cancel clinic appointments to operate on a weekend. The schedulers' position was "the schedule is closed." Their interests were rooms starting on time, staff not kept late and fair treatment of all six groups. Laid side by side, the interests did not conflict: everyone wanted urgent patients treated promptly within a predictable schedule.

A Facilitated Meeting

The perioperative director and the clinic's practice administrator agreed to a 60-minute meeting with two schedulers, the clinic office manager and a surgeon, facilitated by the hospital's patient access director, who had no stake in the outcome. Brett and Goldberg (2017) suggest that team disagreements go better when people separate the problem from their relationship and agree on the facts before arguing about solutions. The facilitator followed that order. First, each side described the problem from its own view without interruption. Second, the group reviewed three months of data on late add-ons: 41 requests, 29 granted and 17 first cases that started late. Third, the group listed interests on a whiteboard. Only then did it discuss options.

The Agreement

The group agreed on three rules. Add-on requests for the next day close at 1:00 p.m., an hour after the schedule posts. Cases the surgeon marks as urgent, such as fractures that need repair within 48 hours, go to a daily urgent slot held open in one room until 2:00 p.m., after which unused time is released to all groups. Any exception requires a direct conversation between the surgeon and the anesthesia director, not a call to a scheduler. The rules were written into a one-page policy, emailed to all six surgical groups and reviewed at the next surgical services committee.

Communicating the Change

How the agreement was shared mattered as much as its content. Each clinic received the policy by email and a call from the perioperative director. Schedulers received a script for declining a late request politely and pointing to the urgent slot. The clinic office manager called the scheduler from the Thursday incident to apologize, which the facilitator had suggested but not required.

Results After Three Months

Add-on requests after 1:00 p.m. fell from about 14 a month to 3. Late first-case starts linked to add-ons fell from 17 in the prior quarter to 5. The urgent slot was used on most weekdays. Schedulers reported in a short survey that calls from clinics were calmer, and no scheduler has left the department since the change.

What the Schedulers Learned

The newer schedulers said the most useful change was not the rule itself but permission to say no with a reason. Before the meeting, declining a request felt personal and risky. After it, a scheduler could say, "Next-day add-ons close at one; if this is urgent, the surgeon can use the urgent slot," and the conversation stayed about the rule. Conflict that once landed on the most junior person in the chain now had a process to go through.

Lessons for Managers

Three lessons stand out. Look for the structure under a personal conflict. Bring data so the discussion rests on facts rather than memories. And write the agreement down, with an owner, so the next person in the job inherits a rule instead of a fight.

Conclusion

A weekly argument over operating room time looked like a clash between difficult people. It was really a clash between unclear rules and competing pressures. By naming styles, separating positions from interests and meeting with a neutral facilitator, the two departments collaborated on a rule that served patients, surgeons and schedulers alike.

References

Brett, J., & Goldberg, S. B. (2017). How to handle a disagreement on your team. Harvard Business Review Digital Articles, 2-6.

Fisher, R., Ury, W., & Patton, B. (2011). Getting to yes: Negotiating agreement without giving in (3rd ed.). Penguin Books.

Thomas, K. W. (1992). Conflict and conflict management: Reflections and update. Journal of Organizational Behavior, 13(3), 265-274. https://doi.org/10.1002/job.4030130307