Health workforce management


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Health workforce management

  1. 1. Health workforce management Dr. Rizwan S A, M.D.,
  2. 2. Health workforce management „The problem with people is that they're only human‟
  3. 3. Take home messages • • • • • • • People are not ‘things’ One person can’t do everything, team work is best Good leadership helps a team perform better Staff should be trained to attain highest standards Good communication will solve most problems Supervision is indispensable Conflicts will always arise, the trick is not to let them interfere with work CRHSP, AIIMS Dr. Rizwan S A 3
  4. 4. Health workforce management 1. Introduction 3. Leading a health team Leadership Sharing objectives Motivating 2. Health team 4. Organizing health team activities 5. Controlling & assessing work Job descriptions Controlling Norms & standards Coordinating Communicating Delegating Meetings Supervising Training Assessing Managing performance Records & reports Conflict resolution
  5. 5. References • On being in charge - WHO • RCH manual for medical officer - NIHFW • Epidemiology and management for health care for all - P V Sathe • World health report 2006 - WHO • Contemporary public health: policy, planning, management - J. P. Gupta • Managing health services - Nick Goodwin CRHSP, AIIMS Dr. Rizwan S A 5
  6. 6. Introduction - 1 • Public health workforce: people whose job is to protect and improve the health of their communities • 80% of health budget is spent on salaries and staff benefits, hence people matter more than things • Managing people is more complex than managing things • Things don’t think, answer back, are insensitive • People like to feel useful and appreciated and become discouraged when ignored or unjustly criticised CRHSP, AIIMS Dr. Rizwan S A 6
  7. 7. Introduction - 2 • To keep people satisfied at work, the work must be interesting and stimulating • Working conditions, relations among team members and between the community determine work satisfaction • Person in-charge of a health team should be sympathetic and helpful to the workers and maintain a relaxed and happy working atmosphere CRHSP, AIIMS Dr. Rizwan S A 7
  8. 8. Introduction - 3 • Better health care depends on efficient management, but management depends on people and good management can help a team work together harmoniously and efficiently • Five ways of achieving this – – – – – Setting and sharing objectives Encouraging good personal relations Distributing tasks Coordinating activities of the team Applying sound organizational principles CRHSP, AIIMS Dr. Rizwan S A 8
  9. 9. Health team - 1 • Health team: group of people sharing a common health goal and objectives determined by community needs, to the achievement of which each member contributes according to her competence and skill and in coordination with others • The team includes all those working together, even clerks, drivers, cleaners in addition to the technical staff • Health team exists for the community CRHSP, AIIMS Dr. Rizwan S A 9
  10. 10. Health team - 2 • No one person can acquire all the necessary skills and so people have to work together to get the work done • To work well as a team, the leader and other members need skills of leadership and organization „Behind an able man there are always other able men.‟ - Chinese proverb • Characteristics of teamwork – – – – Common binding purpose/goal Clear understanding of each other’s functions Pooling of knowledge Joint responsibility for the outcome CRHSP, AIIMS Dr. Rizwan S A 10
  11. 11. Leading a health team Leadership Setting and sharing objectives Motivating the team Delegating Supervision CRHSP, AIIMS Dr. Rizwan S A 11
  12. 12. Leadership • Ability of a manager to influence and induce subordinates to work with confidence and zeal for the achievement of organizational goals • Theories of leadership – Trait theory: Leaders are born, not made – Behavioural theory: Leadership depends on behaviour of the leader – Contingency theory: Leadership depends also on subordinates, the task, the workplace situation things right; „Management is doing leadership is doing the right things.‟ - Anon CRHSP, AIIMS Dr. Rizwan S A 12
  13. 13. Hersey and Blanchard's situational leadership theory Meri Marji - E.g. Government servant Kya? Kaise? Kab? Kyun?… Bhagwan barose! E.g. Intern CRHSP, AIIMS Mein hoon na!! Dr. Rizwan S A 13
  14. 14. Team & Leader CRHSP, AIIMS Dr. Rizwan S A 14
  15. 15. Example - 1 Problem Category Solution Intern keeps reading during Bhagwan peak OPD hours, Unable and barose! he is not interested, Unwilling E.g. Intern manages patients badly. Be firm and strictly monitor New lab tech in PHC, willing to work but does not know things Pair up with an experienced tech for few days, check progress, show support CRHSP, AIIMS Unable Kya? Kaise? butKab? Kyun?… Willing Dr. Rizwan S A 15
  16. 16. Example - 2 Problem Category Solution You are a new medical officer, you find that a Meri Marzi senior PHN does not do any Able - E.g. Government work. Sulks at you. but Unwilling servant Upon enquiry you find that…. Call her to your chamber, speak to her gently, discuss about a problem and ask for ideas, gain confidence A Resident with good Able public relations, knowledge Mein hoon and na!! and skill base, sincere in his Willing work, reliable Appreciate and provide occasional guidance CRHSP, AIIMS Dr. Rizwan S A 16
  17. 17. Setting and sharing objectives • People work well together when they agree with one another and take part in setting the objectives • People who are not involved in objective setting waste resources • People who are opposed to set objectives may obstruct work • Local objectives must be set in consultation with Community members, Health workers, Patients, Ministry of health CRHSP, AIIMS Dr. Rizwan S A 17
  18. 18. Motivating team members • Motivation is an inner impulse that induces a person to act in a certain way – Level 1: obtain the necessities of life – food, clothing, shelter, rest and safety – Level 2: satisfy social needs – companionship, love and position of respect – Level 3: personal satisfaction and pursue ideals • A leader should understand what encourages and what dissatisfies„Leaders must be close enough to relate to others, people at work but far enough ahead to motivate them.‟ - John C. Maxwell CRHSP, AIIMS Dr. Rizwan S A 18
  19. 19. Maslow’s need hierarchy theory Self actualisation needs Esteem needs Awards, promotions Social needs Team work, social events Security needs Job security, retirement benefits Physiological needs CRHSP, AIIMS Comprehensive health care Salary Dr. Rizwan S A 19
  20. 20. Causes of motivation • Achievement: wise leaders will help their workers achieve by giving clear instructions, suitable training and facilities • Recognition: leaders should be willing to praise when praise is due • The work itself: a good leader will try to keep dull, repetitive tasks to minimum and assure workers of the value of their work • Responsibility: a good leader tries to increase worker’s sense of responsibility rather than diminish it by criticisms • Advancement: a leader should encourage people to increase their skill and knowledge and train them for promotion • Self-improvement: leaders can help workers by challenging them with questions at work, help them themup whom it is due, giving high „Withhold not good from set to research, by quality supervision it is in the power of thine hand to do it.‟ when - Proverbs 3:27 CRHSP, AIIMS Dr. Rizwan S A 20
  21. 21. Causes of dissatisfaction • Inefficient administration: leaders who fail to pay salaries on time, to distribute supplies on time • Incompetent supervision: a supervisor who cannot help in a difficult diagnosis will lose respect • Poor personal relations: workers should be treated fairly, should be consulted about their work. • Poor leadership qualities: people respond to much better to example than to exhortation, without personal authority that comes from integrity, the authority of the position will not impress others • Low pay: absolute level is less important than relative level • Bad working conditions: a good leader ensures good working conditions and in its absence inspires by example CRHSP, AIIMS Dr. Rizwan S A 21
  22. 22. Delegating authority and responsibility • Delegation means giving another person the power to make decisions • Advantages – It saves time for other duties – Workers in the field must be able to make decisions – Saves long delays that occur when awaiting decisions from a distant authority – Allows workers to enjoy their work and become more skilful CRHSP, AIIMS Dr. Rizwan S A 22
  23. 23. Cons of delegation • If wrong decisions are made, work may suffer • A bad leader may pass on all the work to members with very little for himself to do • A leader may delegate work to people with insufficient experience „As a manager the important thing is not what happens when you are there, but what happens when you are not there.‟ - Anon CRHSP, AIIMS Dr. Rizwan S A 23
  24. 24. Rules for delegation of authority • Be clear about exactly what is delegated • Select the right person • Tell others about the delegation • Do not interfere unless asked to „Surround yourself with the best people you can find, delegate authority, • Give support as needed and monitorpolicy is being carried out.‟ and don't interfere as long as your progress - Ronald Reagan CRHSP, AIIMS Dr. Rizwan S A 24
  25. 25. Styles of supervision • Autocratic: Do as I say! It tends to humiliate people and make them irresponsible • Anarchic: Do what you like! (jaise chal raha hai, vaise chalne do na! ya tumhari marzi!) • Democratic: Lets agree on what we are to do – helps people grow, to become responsible and show initiative CRHSP, AIIMS Dr. Rizwan S A 25
  26. 26. Can you tell? CRHSP, AIIMS Dr. Rizwan S A 26
  27. 27. Choice of supervision • Choice of supervision depends on – Job factors Complexity, difficulty of job, need for quick decisions, consistent results, creative work – Personnel factors Skill, reliability, experience of the workers, willingness to accept responsibility and make decisions CRHSP, AIIMS Dr. Rizwan S A 27
  28. 28. Adapting supervision styles • Good supervisors adapt styles according to needs • Democratic style – For work that requires creativity – With competent, reliable, experienced people and those who are willing to take responsibility • Authoritative style – For tasks that require coordination and consistency (dealing with large numbers of people) – For tasks such as emergency or controlling epidemic – Workers who have little understanding of the goals, have limited experience/skills and unreliable – Where staff can be closely supervised and controlled – Not suitable in rural health work where workers work in isolated health posts CRHSP, AIIMS Dr. Rizwan S A 28
  29. 29. Organising health-team activities Job descriptions Norms and standards Coordinating activities Communication Conducting meetings Training staff CRHSP, AIIMS Dr. Rizwan S A 29
  30. 30. • Distribution of tasks among members of the team is an important function • Work should be arranged in such a way that members use their individual skills and talents and there is no ‘overwork’ or ‘underwork’ • Job description is a means of helping to distribute tasks CRHSP, AIIMS Dr. Rizwan S A 30
  31. 31. Using job descriptions • A job description states – Objectives, activities and programmes of the post – Authority of the worker – Responsibilities of the worker • The purpose of job description is to define exactly to all members their work CRHSP, AIIMS Dr. Rizwan S A 31
  32. 32. Uses of clear job description • Clearly explains what each workers is expected to achieve • Prevents arguments between people, prevents gaps and overlaps • Can identify areas for training • Serve as a basis for evaluation • However they should be used flexibly, guidelines rather than too strictly or literally • Thus workers should be ready to help with one another’s work when necessary CRHSP, AIIMS Dr. Rizwan S A 32
  33. 33. Contents of job description CRHSP, AIIMS Dr. Rizwan S A 33
  34. 34. How to outline duties? • Training and tradition • Interpretation by the person who holds the job – it is very useful to ask workers to list their duties and discuss with them • Requirements of programme and services • Since rural health work keeps changing, supervisors should keep job description under constant review CRHSP, AIIMS Dr. Rizwan S A 34
  35. 35. Example of a job description CRHSP, AIIMS Dr. Rizwan S A 35
  36. 36. Using norms and standards • A job description does not say how much a health worker must do or how well • Norms and standards translate health objectives and targets of health teams to amounts of work and quality of care expected • They can be applied to work, performance, productivity and behaviour. E.g. no. of deliveries conducted by the ANM, birth complications rate, performance over time • Can be used to compare workers • However, workers cannot be regarded as machines with predetermined production mechanisms, they can set their own standards CRHSP, AIIMS Dr. Rizwan S A 36
  37. 37. Coordinating activities • It means bringing activities into proper relation with each other so as to ensure that everything is being done and no two people are trying to do the same job • Components – Distributing authority – Channels of communication – Arranging work so that right things are done in the right place, time, way and by the right people • A coordinated activity is orderly, harmonious, efficient and successful CRHSP, AIIMS Dr. Rizwan S A 37
  38. 38. Organizational principles to achieve coordination • Objective: group objective must contribute to overall objective • Definition: clearly defined tasks for groups • Command: clearly identified person in charge • Responsibility: person in charge • Authority: each person should have authority equal to responsibility • Span of control: person in charge should control not more than 6-10 people • Balance: activities of the groups should balance out CRHSP, AIIMS Dr. Rizwan S A 38
  39. 39. Checklist for coordination CRHSP, AIIMS Dr. Rizwan S A 39
  40. 40. Communication • Why is communication important? – Personal relations within a team are important and can be made worse by poor communication • Principles to maintain good communication – All members should be free to express their views – A message should be expressed clearly – The leader should ensure that the communication sent was received and executed – Conflict „The single biggestshould be managed in a is that will or disagreement problem in communication way achieve constructive results it has taken place.‟ the illusion that – G B Shaw CRHSP, AIIMS Dr. Rizwan S A 40
  41. 41. Managing space to assist communication • A big group is better divided into small groups of 6-7 • Table may hinder communication, esp. avoid long or U-shaped tables • Do not place tables in a way that emphasizes rank order unless there is a reason • Seating arrangements should reflect the purpose of meetings • Adapt seating arrangements to the purpose, not the purpose to the seating arrangements CRHSP, AIIMS Dr. Rizwan S A 41
  42. 42. Two people or one person & small group CRHSP, AIIMS Dr. Rizwan S A 42
  43. 43. Small group (5-10) CRHSP, AIIMS Dr. Rizwan S A 43
  44. 44. Large group (10-50) CRHSP, AIIMS Dr. Rizwan S A 44
  45. 45. Conducting meetings • Regular meetings of health teams are necessary, to make decisions on a new project, or educational activities • Preparing for a meeting – Purpose: Brief summary of what is to be achieved, agenda – Subject: Each person should have as much information as possible about the subject to be discussed – Type and size: Small or large, invited only or open, formal or informal – Place, time and duration – Who is convening and organizing – Announcements about the meeting CRHSP, AIIMS Dr. Rizwan S A 45
  46. 46. Excuse me Mr. Chairman, but before we close may we know why we came here? CRHSP, AIIMS Dr. Rizwan S A 46
  47. 47. A good meeting is successful communication • The success of a meeting depends on quality of communication • If the purpose was to pass on information or explain something, the speakers should ensure whether this has been successful (by questions and discussion) • It the purpose was to seek views, the chairman should summarize the views and obtain agreement • Quarrels and shouting are often due to poor communication, they „The most important thing in communication is can be minimised when people understandsaid.‟ other clearly to hear what isn't being each - Peter Drucker CRHSP, AIIMS Dr. Rizwan S A 47
  48. 48. Role of chairman • Keeps the meeting to its main purpose, gives everyone fair chance, controls timing, keeps order • 3 simple rules – No rudeness or personal remarks – Chairman must have absolute right to control the discussion, rule out irrelevant remarks and bring an end if necessary – Everyone should be stimulated to take equal part, discouraging talkative persons and stimulating hesitant persons CRHSP, AIIMS Dr. Rizwan S A 48
  49. 49. Controlling time in meetings • Questions and discussions should be kept to definite time limit • If decision cannot be reached within time limit, it is advisable to postpone the attempt, which gives more time to think and prepare CRHSP, AIIMS Dr. Rizwan S A 49
  50. 50. Committee meetings • A special type, a committee is a group of people appointed by another person or group for a special function • 2 types – Advisory committee: Advises somebody who has the power of decision – Executive committee: Has certain powers of decision on its own • Reasons for appointing a committee – Responsibility is shared – Reasonable range of knowledge and opinion consulted before decision is reached – Eliminate self-interest, bias and prejudice in decisions CRHSP, AIIMS Dr. Rizwan S A 50
  51. 51. Committee rules & procedures - 1 • Powers and duties: What are the responsibilities and what is their authority • Membership: Rules for appointing members, filling vacancies, coopting members • Voting rights • Arrangements for meetings: how often, who may call, advance notice • Procedure (how to conduct business): how decisions are reached, by majority or two-thirds or unanimously CRHSP, AIIMS Dr. Rizwan S A 51
  52. 52. Committee rules & procedures - 2 • Chairman – Appointed or elected – Convenes meeting, decides agenda, leads meeting, signs the ‘minutes’, calls members to speak, puts motions for voting and passes them as rejected or accepted • Secretary – Appointed or elected – Records main events, names of members present, visitors, those absent and their messages, exact wordings of decisions, summaries of discussions, date of next meeting CRHSP, AIIMS Dr. Rizwan S A 52
  53. 53. Committee rules & procedures - 3 • Order of business – Chairman calls meeting to order (announces names of absentees and their apologies, introduces new members, recognises guests) – Secretary reads previous meeting’s minutes – Members propose additions/corrections to minutes – After all modifications, chairman moves to approve minutes, voting takes place and approved – Discussion proceeds according to agenda items and decision made on each item CRHSP, AIIMS Dr. Rizwan S A 53
  54. 54. Training staff • Human resources are the most expensive form of health resource, hence they should have high standards of performance • Purpose of training – – – – To improve competence Maintain a positive attitude towards work To reduce sense of inadequacy To ensure that community gets quality care CRHSP, AIIMS Dr. Rizwan S A 54
  55. 55. Training strategies • Continuing education – A system that gives opportunity to continue learning, both for personal career and benefit of health services – Help to adapt performance to new developments – Still inadequate in many countries, carried out in piecemeal • In-service training – – – – – Is associated with supervision, service and problem related Concerned with local needs Deals with training needs as they arise Deals with problem solving in health care Training focussed on priority health problems CRHSP, AIIMS Dr. Rizwan S A 55
  56. 56. Training process Training need analysis Training objectives Training delivery What are the training needs for this person and/or job? Objective should be measurable and observable Techniques include onthe-jobtraining, action learning CRHSP, AIIMS Dr. Rizwan S A Training evaluation Measure reaction, learning, behavior, and results 56
  57. 57. Assessing training needs • Task analysis  A detailed analysis of a job to identify the skills required, so that an appropriate training program can be instituted • Competency analysis  Careful study of competency level to identify a deficiency and then correct it with a training program, or some other development intervention. CRHSP, AIIMS Dr. Rizwan S A 57
  58. 58. Competency analysis Current competency level of the employee Competency Gap Competency Assessment CRHSP, AIIMS Dr. Rizwan S A Required competency level for certain position Training and Development Program 58
  59. 59. Assuring competence of health teams • Selection and recruitment • Assessing competence and performance • In service training approaches • Relating the training system to health care „A good manager is a man who isn‟t worried about his own career but rather the careers of subordinates‟ – H.S.M. Burns CRHSP, AIIMS Dr. Rizwan S A 59
  60. 60. The educational process • Defining learning objectives • Setting criteria and designing methods for assessing achievement • Selecting learning methods • Organizing learning experiences • Providing conditions in which active learning can take place • Developing and using training resources • Reinforcing learning experience with supportive supervision • Evaluation management consists of showing average people „Good how to do the work of superior people‟ – John D. Rockefeller CRHSP, AIIMS Dr. Rizwan S A 60
  61. 61. Steps in educational process „The art of choosing men is not nearly so difficult as the art of enabling the chosen ones to attain their full worth.‟ - Napoleon Bonaparte CRHSP, AIIMS Dr. Rizwan S A 61
  62. 62. Controlling and assessing work Controlling and maintaining work standards Assessing performance Records and reports Dealing with problems & conflicts CRHSP, AIIMS Dr. Rizwan S A 62
  63. 63. • After the objectives and duties of a health team have been defined and team members carefully selected, trained and instructed, control measures can be devised to ensure that the team’s work programme proceeds as expected and maintain expected amount and quality of work CRHSP, AIIMS Dr. Rizwan S A 63
  64. 64. Controlling and maintaining work standards • Necessity – To ensure that work is done according to the objectives and within the allotted time and resources – To enable supervisors to identify deficiencies in workers' abilities and arrange for proper training – To enable supervisors to recognize and reward good work and recommend for promotion – To ensure that resources are adequate and properly used – To enable identification of causes of work deficiencies • Good control should be – Timely, Simple, Minimal, Flexible CRHSP, AIIMS Dr. Rizwan S A 64
  65. 65. Methods of control in a team • Instructions – Must be clear enough to be understood by all concerned – Must be practicable and within the capacity of those meant to carry them out – Adequate resources to carry them out – Must be stated in a way that results can be easily assessed • Work schedule – Shows what a worker/team is to do and when – They let the supervisor know what team is doing what on a particular day and time and enables individuals to make the best use of time CRHSP, AIIMS Dr. Rizwan S A 65
  66. 66. How many of you have gone thru this? CRHSP, AIIMS Dr. Rizwan S A 66
  67. 67. Visits by supervisors • In supervision nothing beats a direct visit, esp. for rural health • Personal visits assures workers that the team leader is someone to whom they can turn for help whenever they need • Provides an opportunity for exchange of ideas and in-service training • Each visit should have a definite purpose and long enough to complete that purpose • Should ask – What targets they are aiming at and whether they consider them practicable • It is helpful to have a checklist • Surprise visits are not good practice, it suggests that the supervisor „A desk is a dangerous place from which to view the world.‟ does not trust the workers, they should be encouraged to prepare for - John Le Caré the visit CRHSP, AIIMS Dr. Rizwan S A 67
  68. 68. “My supervisor knows that I am here and that what I do is important enough for a regular visit to review my work” CRHSP, AIIMS Dr. Rizwan S A 68
  69. 69. Assessing work performance • Based on clear statement of objectives, that are relevant, feasible, measurable and agreed by the workers • Determine the level of achievement by the team • Purpose of assessment is to help discover the strengths and weaknesses of workers and the potential for growth and further training needs • Assessment should be continuous • Supervisor must help workers to respond to helpful criticism and improve performance • The immediate supervisor who sees the health worker most often is the best person to make the assessment • A checklist is very useful CRHSP, AIIMS Dr. Rizwan S A 69
  70. 70. Sample checklist for assessment CRHSP, AIIMS Dr. Rizwan S A 70
  71. 71. Finding work deficiencies • There are several reasons, many are not workers’ faults – – – – – – – Insufficient training Insufficient resources Lack of clear job description, instructions Lack of reward, promotion Team members not working well Supervisor not encouraging enough Personal worries CRHSP, AIIMS Dr. Rizwan S A 71
  72. 72. Why performance appraisal? • Appraisal provide information upon which promotion and salary decision can be made • Appraisal provide an opportunity for a manager and his/her subordinates to sit down and review the subordinate’s workrelated behavior, and then develop a plan for corrective action • Appraisal provide a good opportunity to review the person’s career plans in light of his/her exhibited strengths and weaknesses CRHSP, AIIMS Dr. Rizwan S A 72
  73. 73. Performance management cycle - 1 Performance planning (Setting Performance Targets) Feed back Regular review and Monitoring Corrective Action  Training & development Plan  Salary/Bonus adjustment  Career development CRHSP, AIIMS Performance appraisal and evaluation Dr. Rizwan S A 73
  74. 74. Performance management cycle - 2 Defining performance targets Defining the performance standards means making sure that you and your subordinate agree on his/her duties and targets that you expect Appraising performance Appraising performance means comparing your subordinate’s actual performance to the standard/targets set in step one Providing feedback for development Providing feedback means discussing plans for any development that is required CRHSP, AIIMS Dr. Rizwan S A 74
  75. 75. Problems in performance appraisal Lack of standard Poor feedback to employee Poor measures of performance Irrelevant or subjective standards Negative communication Failure to apply evaluation data CRHSP, AIIMS Dr. Rizwan S A 75
  76. 76. Performance appraisal element - 1 Performance appraisal elements has two main categories Competencies: It represents soft or qualitative aspects of performance (process) Performance Result: Hard or quantitative aspects of performance (result) CRHSP, AIIMS Dr. Rizwan S A 76
  77. 77. Performance appraisal element - 2 Competencies score Overall score Performance score Will determine the employee’s career movement, and also the reward to be earned CRHSP, AIIMS Dr. Rizwan S A 77
  78. 78. Records - 1 • Consist of information kept in the health unit about the work of the unit, health conditions of the community, individual patients and administrative matters • Records should be accurate, accessible, available when needed and contain useful information • Records are an administration’s memory, they help supervisor to  Learn what is taking place, make effective decisions, assess progress towards goals CRHSP, AIIMS Dr. Rizwan S A 78
  79. 79. Records - 2 • Before asking health workers to make records, supervisors should ask themselves following questions – – – – – – Will this information be used? What part will it play decision making and evaluation? Can this be accurately collected? Will it be accessible? Reasonable cost? Only because of routine? • Supervisors should make sure that the workers understand the reasons for collecting the information required „The problem is people don't keep good records. • Special forms are often better records, they'd save money.‟ standardized used to record information in a If people kept manner and save time - David Mellem CRHSP, AIIMS Dr. Rizwan S A 79
  80. 80. Reports • The information communicated to other levels of health service, is an important management tool for influencing future actions • Reporting forms are often standardized and distributed in advance • Workers should be trained to prepare reports according to instructions • Copies should be made and one retained as record CRHSP, AIIMS Dr. Rizwan S A 80
  81. 81. Dealing with problems and conflicts • Solving staff’s personal problems – Personal worries are varied and may interfere with work, a good supervisor tries to understand those problems – A worker who feels that a supervisor does not care and is unsympathetic may feel resentful and angry and affect quality of work „The quality of our lives depends not on whether or not we have conflicts, but on how we respond to them.‟ -Tom Crum CRHSP, AIIMS Dr. Rizwan S A 81
  82. 82. Dealing with disputes - 1 • The commonest cause of dispute is confusion, caused by people having different ideas about what is to be done and how it is to be done • It can be minimised by – Frequent meetings of members – Allowing people to express views openly and letting the whole group decide what should be done – Sharing agreed objectives – Clear and detailed job descriptions – Clear instructions and procedures to follow – Distributing tasks fairly – Creating work schedules and distribute work fairly • Common cause of argument is jealousy and favouritism „People are disturbed not by things, • A supervisor must be just and viewand never of them.‟staff in public but by the fair they take criticise – Epictetus CRHSP, AIIMS Dr. Rizwan S A 82
  83. 83. Dealing with disputes - 2 • Conflict is simply a recognition of and expression of difference • Traditional view – All conflicts are harmful – Indication of management failure • Behavioural school of thought – Conflicts are logical as people differ – Not always detrimental; could be constructive • Types of conflict – Functional: enhances and benefits the organization's performance „Conflict harms or hinders combat is optional.‟ – Dysfunctional: is inevitable, but the achievement of organizational goals - Max Lucado CRHSP, AIIMS Dr. Rizwan S A 83
  84. 84. Settling disputes - 1 • Reasons for dysfunctional conflicts – – – – Unclear job descriptions Aggressive nature of individuals Poor communication Task interdependence • Conflict resolution – – – – Clear job descriptions Closely related jobs to be assigned to same group/ individual Improved„Every personal communication between inter fight is on some level a fight differing „angles of vision‟ illuminating Better understanding of self and others the same truth.‟ CRHSP, AIIMS – M K Gandhi Dr. Rizwan S A 84
  85. 85. „A good manager doesn‟t try to eliminate conflict; he tries to keep it from wasting the energies of his people.’ – Robert Townsend CRHSP, AIIMS Dr. Rizwan S A 85
  86. 86. Settling disputes - 2 • A serious argument can affect morale and performance of whole team • Must be stopped quickly and reconciled • People involved should be interviewed separately and all facts made known • All efforts should be made to discover the true cause of argument • People involved should be asked separately on how to resolve the argument and whether they are willing to be reconciled • If a solution can be found that is acceptable to all concerned, productive and friendly relations can be re-established • If not, the best solution is to persuade them to „agree to differ‟ – to „He who has learned to disagree without being disagreeable has acknowledge the differences in valuable secret of astop arguing about discovered the most their views but to diplomat.‟ them - Robert Estabrook CRHSP, AIIMS Dr. Rizwan S A 86
  87. 87. Take home messages • • • • • • • People are not ‘things’ One person can’t do everything, team work is best Good leadership helps a team perform better Staff should be trained to attain highest standards Good communication will solve most problems Supervision is indispensable Conflicts will always arise, the trick is not to let them interfere with work CRHSP, AIIMS Dr. Rizwan S A 87
  88. 88. Thank you! CRHSP, AIIMS Dr. Rizwan S A 88
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