Conflict situations and ways to resolve them in an organization. Conflict situations (CS) and ways to resolve them Chechenin Gennady Ionovich Doctor of Medicine

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1. What are the features of the team, what are its characteristic features?

The concept of a production team, despite the frequency of its use, is rather ambiguous. Most often people talk about a production team when (Homas, 1969; Schein, 1965; Rosenstiel, 1978):

1) there are a certain number of people who

2) for a long period of time they directly interact with each other and at the same time

3) adopt different standards and

4) united by the feeling of “we”

The specified criteria of a production team are at the same time its characteristics that can be ranked. So, for one team there may be a more or less developed sense of “we”, etc. Thus, the collective differs from other social entities (such as, for example, a queue in a store, a temporary concentration of people at a train station, a large political party) on the basis of ranking.

The peculiarity of production teams is that they operate in a specific context. Work teams are organizational units operating under certain structural and technological conditions. Features of interaction in a work group (for example, features of communication structure and distinctive norms) tend to reflect features of the entire organization. An important condition for the productivity of industrial interaction is group cohesion.

2.What is group cohesion?

Group cohesion refers to “the average attractiveness that a group enjoys among its members” (Irle, 1975). Greater cohesion is found in relatively small groups, which are quite difficult to join and which are organized on the basis of cooperation rather than competition.

The level of group cohesion has been shown to depend on the frequency of interpersonal contacts: with an increase in the number of contacts, the mutual sympathy of group members increases, which in turn stimulates the growth of contacts (Hofstaetter, 1967). This pattern, however, occurs only if, upon contact, people develop a feeling of similarity. Along with personal similarity, the similarity of the situation in which they find themselves is also important. This circumstance is especially significant if the situation is experienced as a “common fate” that group members experience together. The closeness of attitudes, opinions, values and behavior patterns among group members are among the factors that increase group cohesion. The purposes of unity are served by establishing group norms. The more cohesive the group, the stricter its norms and the better the group is at getting its members to follow them. It should be noted that norms can relate to different aspects of behavior.

4. What is the “social and psychological climate of the team”?

Social-psychological team climate is “a term used to describe the general opinion of members of an organization about how the organization (and/or subsystems within it) relates to its members and its external environment” (Jewell, 2001). Numerous studies of the socio-psychological climate have revealed the most important determinants of its formation. Researchers have identified management behavior, the size and age of the organization, its physical environment, work design features, and the types of rewards it offers employees as important factors in shaping the work climate (Schneider, Gunnarson, & Niles-Jolly, 1994). At the same time, the perception of the social and labor climate significantly depends on the nature of a person’s work, the team in which he works, and his personality (Hershberger, Lichtenstein & Knox, 1994). The deterioration of the socio-psychological climate, as a rule, is accompanied by a decrease in productivity at work and can lead to conflicts.

5. Define the concept of “conflict”.

The word “conflict” originates from the Latin conflictus – clash and is included in most European languages in almost unchanged form. In modern sociology, psychology and political science there are many definitions of this phenomenon. Without pretending to be complete, we will present some of them.

“Conflict is a perceived divergence of interests; the belief of the parties that their current aspirations cannot be realized at the same time" (Rubin, Pruitt & Kim, 2001)

“Conflict is a characteristic of interaction in which actions that cannot coexist in an unchanged form mutually determine and mutually change each other, requiring a special organization for this” (B.I. Khasan, 1996).

“Conflict is understood as the most acute way of resolving significant contradictions that arise in the process of interaction, which consists in the opposition of the subjects of the conflict and is usually accompanied by negative emotions” (Antsupov A.Ya., Shipilov A.I., 1992).

Analysis of these and other definitions shows that all definitions, while revealing individual aspects of a given phenomenon, cannot claim to be a complete definition. In addition, there is a sufficient variety of types of conflict - intrapersonal, interpersonal, intergroup and intragroup.

6. What are interpersonal conflicts?

In the context of our consideration, it is advisable to dwell on the most common type in medical practice - interpersonal conflicts. Well-known Russian conflict researcher N.V. Grishina (2002) gives this group the following definition: “An interpersonal conflict is a situation of confrontation between participants, perceived and experienced by them (or at least one of them) as a significant psychological problem that requires its resolution and causes activity of the parties aimed at overcoming the contradiction that has arisen. and resolving the situation in the interests of both or one of the parties.” According to this definition, motivational, cognitive and role conflicts are distinguished. Differences in the motivational, cognitive and role spheres of the conflicting parties can be considered as psychological factors in the formation of conflicts.

7. What are the features of certain types of interpersonal conflicts?

Motivational reasons include conflicts of interest – situations affecting the goals, plans, aspirations, motives of the participants, which turn out to be incompatible or contradictory to each other. For example, a patient insists on determining his disability group and paying an appropriate monetary benefit, while the MSEC expert doctor is more likely to carry out rehabilitation measures. The interests of different parties contradict each other, however, perhaps the parties will still be able to find a way to resolve them jointly. A special type of conflict of interest concerns cases where they turn out to be incompatible. For example, several members of a hospital team simultaneously seek to occupy the position of chief physician of a clinic. Considering that we are talking about one full-time position, the impossibility of combining all intentions puts the parties to the conflict before an “either-or” choice.

The next group consists of conflicts caused by cognitive differences. Among this group, special mention should be made value conflicts – situations in which disagreements between participants are associated with their conflicting or incompatible ideas that have special meaning for them. It is known that the value system of any individual contains the most significant concepts for him. So, if we are talking about work, then the value will be what a person sees as the main meaning of his activity (is work for him a source of livelihood, an opportunity for self-realization). It should be noted that differences in values do not always lead to conflicts. The successful interaction in one team of people of different political and religious views is well known. However, conflict becomes inevitable when these differences affect the interaction of people or they begin to “encroach” on each other’s values. The most important feature of values is their active influence on the behavior of the individual (regulatory function). If the behavior of interaction participants is based on different dominant values, they can come into conflict with each other and cause conflicts. For example, the head of the department is concerned about statistical indicators (consumption of medications, the number of bed days spent by patients in the hospital), while the department doctor is more focused on the actual recovery of the patient.

Another common type of interpersonal conflict related to the activity sphere is role conflicts arising due to violation of norms or rules of interaction. Norms and rules are an integral part of joint interaction, without which it is impossible. They may be of an implicit, implied nature, for example, compliance with etiquette, or be the result of a special agreement, including one expressed in writing. However, in all cases, violation of generally accepted norms is fraught with disagreement and can lead to conflict between the participants in the interaction. Considering that medical teams are structures with a historically established clearly organized hierarchy of social relations, and the specifics of the professional sphere are concentrated on the “person-to-person” interaction, it is not surprising that role conflicts are perhaps the most acute in the medical environment. First of all, all kinds of violations of clinical subordination should be included here. It should be noted that the reasons for non-compliance with rules and regulations may be of a different nature. Violation of the rules in a team is possible due to insufficient familiarity with its rules and culture. Conscious violation of them indicates a desire to revise them.

8. What other conflicts occur in medical teams?

Less acute, however, no less common in medical teams are intergroup conflicts . In this regard, it is indicative that it was carried out under the leadership of N.V. Grishina’s study of several quite prosperous medical organizations. The work performed was based on studying the relationships between two categories of workers - nurses and doctors. All interviewed workers were satisfied with their professional activities and did not intend to change their place of work. The relationship between doctors and nurses was assessed as favorable by 66.6% of doctors and 73.2% of nurses. In addition to assessing the relationship in general, respondents were asked to separately assess the attitude of doctors towards nurses and nurses towards doctors. The following answer options were offered: “In general, doctors treat nurses kindly, with an understanding of the difficulties of their work and their contribution to the treatment process”; “Doctors could be more respectful of the work of nurses and take more into account the difficulties of their work”; “Doctors are often unkind to nurses and disdainful of their work.” The question of the attitude of nurses to doctors was identical. The results of the study showed that with a generally favorable assessment of the relationship, “we treat them kindly,” according to the overwhelming majority of surveyed doctors (76.5%) and nurses (81.4%), and “they could treat us.” be more respectful,” says most doctors and nurses. Thus, “we” are “kind” and “they” are “not respectful enough.”

9. How to deal with conflicts?

Speaking about the factors causing conflicts, one cannot help but touch upon the problem of eliminating them. The most important obstacle to constructive work with conflict is reluctance of the parties resolve it. Since conflict resolution presupposes that the parties reach agreement through dialogue, it is theoretically always possible (with different quality of agreements reached), except in cases where the parties themselves do not want this. The parties do not seek to resolve conflicts when they (or one of them) decide to sever the relationship or if maintaining the conflict relationship creates some advantages.

Generalizing the psychological principles of working with conflicts, N.V. Grishina points out that the task of practical assistance from a psychologist is to initiate and organize dialogue as the most constructive form of resolving a conflict with oneself or other people. In this case, there are different approaches - psychotherapeutic work (helping an individual work with himself) and psychological counseling (helping a person dialogue with others). According to the three main directions in psychology, three main directions of conflict resolution have developed.

Levels of conflict in medicine

Conflicts in medicine, as well as in other industries, occur at three levels of contradictions (high, medium and low):

1. Health system - society;

2. Health care institutions (administration) – medical personnel;

3. Medical personnel – patients (and their relatives).

The above diagram reveals the so-called vertical conflicts, the subjects of which occupy different social positions, ranks and have different strengths.

There are also horizontal conflicts in the healthcare system:

1. At the “SOCIETY” level, contradictions and conflicts may arise regarding the health policy pursued in society between the main part of citizens (civil society) on the one hand, and the highest governing structures (authorities) on the other.

2. At the “ADMINISTRATION” level, both vertical conflicts are possible between different levels of management structures, and horizontal ones - for example, between different medical institutions.

3. At the level of “DOCTOR”, “PATIENT”, horizontal conflicts arise: doctor-doctor, patient-patient.

Contradictions that give rise to conflicts

in the healthcare system

At the “SOCIETY – HEALTH” level

1. Lack of a holistic and consistent concept for healthcare development.

2. Insufficient financial and logistical support for the healthcare system. It has objective (the economy is in decline, lack of resources) and subjective (short-sighted, irresponsible state policy) reasons.

3. The scarcity of allocated funds leads to such negative consequences as:

· Social and labor conflicts, strikes, rallies, picketing;

· Closure of local hospitals;

· Lack of funds for medicines and equipment;

· Dissatisfaction of medical personnel with the level of remuneration for their work. This forces people to look for additional income, which reduces the quality of work.

Conflicts in the doctor-patient system

The essence of conflicts in the doctor-patient system lies in the clash of opinions, views, ideas, interests, points of view and expectations of the participants in the interaction.

Stand out objective, subjective And unrealistic conflicts.

Objective conflicts caused by dissatisfaction with what was promised, unfair distribution of any responsibilities, advantages and aimed at achieving specific results.

Examples include:

1. The doctor’s promise to the patient of a complete cure, but as a result of the peculiarities of the course of the disease, permanent loss of ability to work occurred;

2. Poor performance of one’s duties (postoperative complications due to the fault of a medical worker, untimely rounds);

3. Refusal to hospitalize the patient or untimely hospitalization.

4. Untimely execution of operations, procedures, etc.

5. Placement in a ward with a dying patient.

6. Requirement for the purchase of medicines.

7. Demand for remuneration for work performed.

Subjective conflicts. This type of conflict is often associated with a discrepancy between the patient's expectations and reality.

The reason may be an inappropriate understanding of the proper behavior of medical personnel (rudeness, discourtesy), procedures (irregularity, unpunctuality, negligence), sanitary and hygienic conditions in the hospital (dirt, noise, smell), incorrect diagnosis or incorrect prescription of therapy.

Unrealistic conflicts have as their goal the open expression of accumulated negative emotions, grievances, hostility - when acute conflict interaction becomes not a means of achieving a specific result, but an end in itself.

This conflict is often caused by the patient’s biased attitude towards the medical service in general or towards an individual doctor in particular.

Not all patients who turn to a doctor are inclined to cooperate with him and believe that the doctor wants and can help them. Such patients are not ready to establish cooperation during treatment. Practice shows that many of them look at the doctor’s attempts to establish a trusting relationship with them as a disguised desire to get a “guinea pig”. Primary care physicians feel similar skepticism, with some patients seeing a “barrier” preventing them from receiving “real” care. The requirement to quickly refer them to a specialist, often even before completing the medical history, is a clear hint at the patient’s lack of desire to establish interaction with the doctor. Sometimes this is expressed openly: “I don’t like going to doctors,” “Medicines are harmful,” or even: “I don’t trust doctors.”

Recognizing a patient who is skeptical of doctors is usually not difficult, but avoiding his negative or defensive reaction is much more difficult. However, it is important to be able to distinguish such people from others and not try to convince them with words. Most likely, they will be more impressed not by words, but by actions. In such cases, as in many other potentially conflictual situations, it is useful to let the patient know that he has been listened to carefully. Sometimes simple remarks like: “I am listening to you carefully,” or “I will advise you something, but, of course, you will decide for yourself” help to get around the sharp corners and let him relax.

A special category consists of patients with goals other than treatment. They seek to use their trusting relationship with the doctor for purposes that have nothing to do with treatment. Such patients, unlike the previous ones, usually seem inclined to fruitful cooperation, grateful and completely trust the doctor. In fact, those of them who are especially zealous in praise are more likely than others to come into conflict with the doctor. There are two types of situations in which patients seek destructive interactions with the doctor.

Firstly, these are cases when the patient, through his words and actions, tries to persuade the doctor to take his side against other family members: “Please explain this to my wife,” “It’s because of him that I’m depressed.” In this situation, the doctor becomes a weapon that the patient uses against his loved ones. The patient can directly ask the doctor to intervene in a domestic conflict. Such requests should be regarded as a signal warning of danger: the trusting relationships established during treatment can be used by the patient to achieve goals that are far from treatment.

The second type of situation in which a doctor’s trust may be abused is when the disease promises the patient certain benefits. In other words, the painful state brings some benefit, and as a result he strives to maintain it. Increased attention from others, less responsibility and certain privileges provided by law can be beneficial. A person wants to be sick, and he uses his relationship with a doctor to obtain “official confirmation” of his condition.

So, it is important to be able to recognize patients who use their relationship with their doctor for extraneous purposes: they can easily be confused with people who truly strive for fruitful cooperation in the treatment process. Both of these types of destructive patient-doctor interactions are characterized by the fact that the patient's behavior changes little over time, and the doctor often experiences frustration and a feeling of helplessness. The physician must be constantly vigilant in such situations, otherwise his trust will be abused.

Finally, another rare type of people, those who are not inclined to establish fruitful cooperation with a doctor can be called “litigious”. Despite the fact that patients with an initial intention to file a lawsuit are extremely rare, the doctor must be able to recognize them. Serious errors in diagnosis and treatment are fraught with a lawsuit, even if a completely trusting relationship has been established between the doctor and the patient, but it is important to emphasize that most lawsuits are caused by conflicting relationships.

It should be noted that the effective prevention of lawsuits due to improper treatment requires special attention by the doctor to establish a fruitful interaction with the patient, and this rule applies to all people, regardless of whether they have a noticeable tendency to litigiousness or not. And, most importantly, follow the advice of lawyers - extremely clear documentation.

Patients with whom it is difficult to establish mutual understanding during the treatment process, despite a mutual desire for it, may be of different types, but usually these are people whose personality does not arouse our interest. However, the doctor should not allow himself such subjectivity. Patients with whom difficulties often arise in establishing cooperation can be divided into the following types: persistent and demanding, sticky, chronically dissatisfied.

Instinctly demanding they know how to justify their most senseless demands. Viscous use medical care so intensively that they cause irritation and frustration. Chronically dissatisfied harass and often plunge doctors into despair by constantly informing them of the ineffectiveness of the treatment being used.

2.1. Levels of conflict in medicine

Conflicts in medicine, as well as in other industries, occur at three levels of contradictions (high, medium and low):

1. Health system - society;

2. Health care institutions (administration) – medical personnel;

3. Medical personnel – patients (and their relatives).

The above diagram reveals the so-called vertical conflicts, the subjects of which occupy different social positions, ranks and have different strengths.

There are also horizontal conflicts in the healthcare system:

3. At the level of “DOCTOR”, “PATIENT”, horizontal conflicts arise: doctor-doctor, patient-patient.

2.2. Contradictions that give rise to conflicts

in the healthcare system

At the “SOCIETY – HEALTH” level

1. Lack of a holistic and consistent concept for healthcare development.

3. The scarcity of allocated funds leads to such negative consequences as:

· Social and labor conflicts, strikes, rallies, picketing;

· Closure of local hospitals;

· Lack of funds for medicines and equipment;

· Dissatisfaction of medical personnel with the level of remuneration for their work. This forces people to look for additional income, which reduces the quality of work.

2.3. Conflicts in the doctor-patient system

The essence of conflicts in the doctor-patient system lies in the clash of opinions, views, ideas, interests, points of view and expectations of the participants in the interaction.

Stand out objective, subjective And unrealistic conflicts.

Objective conflicts caused by dissatisfaction with what was promised, unfair distribution of any responsibilities, advantages and aimed at achieving specific results.

Examples include:

1. The doctor’s promise to the patient of a complete cure, but as a result of the peculiarities of the course of the disease, permanent loss of ability to work occurred;

2. Poor performance of one’s duties (postoperative complications due to the fault of a medical worker, untimely rounds);

3. Refusal to hospitalize the patient or untimely hospitalization.

4. Untimely execution of operations, procedures, etc.

5. Placement in a ward with a dying patient.

6. Requirement for the purchase of medicines.

7. Demand for remuneration for work performed.

Subjective conflicts. This type of conflict is often associated with a discrepancy between the patient's expectations and reality.

This conflict is often caused by the patient’s biased attitude towards the medical service in general or towards an individual doctor in particular.

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Introduction

The work of a doctor is a special type of professional activity, characterized by a state of constant psychological readiness, emotional involvement in the problems of patients related to their health, in almost any situation involving active interpersonal interaction. Thus, conflict potential is an objective pattern of functioning of a healthcare institution and is characterized by the presence of three groups of organizational conflicts:

2) emotional (problems of power, balance of formal and informal relationships, approval; high level of conflict in business communication between doctors and patients);

All these manifestations determine the phenomenon of dysfunctional conflict. The causes of dysfunctional conflict are associated with incompatible differences in the value and motivational characteristics of various employees and their groups. To form a comprehensive program for the prevention of destructive conflicts, it is necessary to optimize the organizational culture of the institution. Optimizing the organizational culture of an institution begins with diagnosing the moral and psychological climate and formulating organizational conditions that provide socially and psychologically favorable conditions for the implementation of the organizational strategy.

Organizational culture is a set of behavior patterns that are acquired by an organization in the process of adaptation to the external environment and internal integration, which have shown their effectiveness and are shared by the majority of members of the organization. Stress is a nonspecific (general) reaction of the body to an impact (physical or psychological) that disrupts its homeostasis, as well as the corresponding state of the nervous system of the body (or the body as a whole).

One of the indicators of the effectiveness of organizational culture is the degree of conflict. The stronger and more positive the organization's culture, the lower the value of this indicator. In the process of developing organizational culture, HR specialists need to diagnose the degree of conflict and stress factors in the organizational environment. Organizational conflict increases the level of social tension and seriously aggravates social and labor relations. To solve problems of conflict management in an organization, a manager needs to learn to identify conflict and map organizational conflict. Prevention and management of conflicts in an institution are one of the most important areas in the professional activity of the head of a medical institution. The satisfaction of employees and the attractiveness of work for them directly depend on the socio-psychological climate in the work team. In turn, scientists consider the general level of conflict and organizational stress to be one of the most important indicators of the favorableness of the socio-psychological climate. The head of a medical institution needs to have information that allows him to objectively assess the level of stress and conflict in the organizational environment.

1. Objectives and system of program activities for conflict management in medical institutions

1.1 Relevance of the project topic

The main goal of a manager at any level is to establish effective teamwork among employees. However, sometimes difficult relationships develop in a team, which not only interfere with successful interaction, but also provoke conflict situations. If a person is not at peace with himself, a problem arises in the relationship between him and other people, and in this case, with employees. So-called work conflicts can have a negative impact on the entire work process.

Managing an organization is impossible without conflict management, so the topic of conflict management is relevant for the head of any organization. And for effective management it is necessary to study the types, levels, essence of conflicts, as well as find and put into practice the most optimal ways to resolve controversial situations.

There is an opinion that conflict should be avoided whenever possible or resolved immediately as soon as it arises. However, it should be borne in mind that conflict, along with problems, can also bring benefits to the organization. It is believed that if there are no conflicts in an organization or work collective, then something is wrong there. There are no conflict-free organizations in life: it is important that the conflict is not destructive. The organizer’s task is to design a constructive, solvable conflict. To benefit from it, you need an open, non-hostile, supportive environment. If such an environment exists, then the organization only gets better from the presence of conflicts, since the diversity of points of view provides additional information and helps to identify more alternatives or problems. However, one should not discount the fact that individual, most often interpersonal, conflicts are destructive. A specialist should also know about this, since joint activities involve people who differ in their professional preparedness, life experience, individual character traits and temperament, etc. These differences inevitably leave their mark on assessments and opinions on issues that are significant for the individual and the organization, and sometimes give rise to confrontation, which, as a rule, is accompanied by emotional excitement and often develops into conflict. In some cases, clashes of assessments and opinions go so far that the interests of the cause recede into the background: all the thoughts of those in conflict are aimed at struggle, which becomes an end in itself, which negatively affects the development of the organization. It is these problems that determine the relevance of the topic of this project.

Conflicts are an integral element of the development of social systems. Being an irreducible type of social relations, conflict interaction is to a certain extent determined by the nature of the organization of the social system in which it arises and develops. Conflicts in medical institutions are an indicator of problems that have not yet been resolved by reforms carried out in the health care system.

The issue of conflicts in healthcare during the formation of a market economy has not been sufficiently studied in domestic sociology. It becomes an objective necessity to study the motives and causes of conflict processes in medical institutions in connection with their negative impact on the quality of medical care provided to the patient. The issue of creating an effective technology for managing conflict processes in medical institutions, including their prediction, identification, reduction and resolution, is relevant.

The sociology of medicine has a sufficient set of methods that make it possible to comprehensively analyze issues of conflict interaction in healthcare, thereby actively influencing the development strategy of the industry. Medical and sociological monitoring makes it possible to timely identify areas of tension (latently existing contradictions) inevitable during the period of reforms, assess the significance of innovations for society, study the social frustrations of the medical worker and the patient, their impact on the treatment process and the psychological climate in medical institutions and, ultimately , on the state of public health.

The object of study of the project is the professional activities of employees of medical institutions.

The subject of the project's research is conflict situations that arise in the process of providing medical care in medical institutions.

1.2 Project goal and objectives

The goal of our project is to develop practical recommendations for managing conflict situations in medical institutions based on a study of their causes, conditions of occurrence, content and social consequences.

To achieve the goal, the following tasks were solved:

b identification of patterns of emergence and development of conflict situations in medical institutions in the context of reforming the country’s healthcare system;

b sociological characteristics of participants in conflicts in medical institutions;

b assessment of the consequences of interpersonal conflicts in medical institutions on the quality and efficiency of medical care for the population;

ь development of a classification of conflicts in medical institutions;

Expected effect of the project: adaptation of the proposed practical recommendations in medical institutions for the purpose of effective conflict management and their prevention.

1.3 Characteristics of the situation

Health is a basic need and an inalienable human right. This value setting is a socio-psychological guideline that determines the motivational behavior of individuals, social groups and society as a whole, which is reflected in the social policy of the state. The reform of the state healthcare system has been going on for more than 10 years, but contrary to expectations, it is accompanied by an increase in contradictions and conflict potential in healthcare institutions, a decrease in the degree of satisfaction of patients and doctors with the quality of medical care provided, which are the main criteria for the validity and correctness of the chosen direction of reform, which indicates trouble in this socially significant sphere.

Despite the fact that conflict is an inevitable phenomenon in the life of society, the collective and each person, ensuring progress and their progressive development, conflict situations in medical institutions are assessed by participants and outside observers of these processes as undesirable, requiring immediate resolution. The stress that arises in subjects of conflict interaction complicates interpersonal communication, reduces the effectiveness of treatment, negatively affects the psychophysiological state of medical workers, and increases social tension among providers and recipients of medical services.

Conflicts in medical institutions are only superficially local in nature. Functionally, they are closely related to those processes and contradictions that constitute the main content of social changes in society. Levels of conflicts in medicine, as well as in other industries, occur at three levels of contradictions (high, medium and low): Health care system - society; Health care institutions (administration) - medical personnel; Medical personnel - patients (and their relatives).

Medical workers are currently in a difficult socio-professional situation. Their social adaptation in society is extremely difficult. Due to insufficient funding for the industry and the inability to provide patients with medical care using modern medical technologies and in accordance with high standards of its provision, the emotional background decreases, a state of internal anxiety and professional dissatisfaction is maintained. Low wages for employees of medical institutions reduce the motivation to perform their professional duties well. Often, social and everyday problems are extrapolated by the parties to the conflict to the process of interpersonal communication, which contributes to the growth of conflict in medical institutions.

At the same time, with the financing of hospitals and clinics inadequate to real expenses, a search is underway for new forms of organization and remuneration of medical workers. The intensification of the work of doctors in the context of the introduction of the “final result” limits the time of communication between the doctor and the patient, leads to the formalization of the treatment process, which is also manifested by an increase in the number of conflicts.

Identification of conflict situations, study of the causes of occurrence, dynamics of processes of conflict interaction and their consequences, as well as the development of adequate social technology for conflict management in medical institutions, during the period of reforms in the industry, will not only allow timely identification of problem areas of ongoing reforms and adapt them to realities practical healthcare, but also influence the quality of medical care provided to patients, public health, and reduce the severity of social contradictions.

The transitional society in today's Russia has become an arena of deep contradictions in all spheres of life. The radical reorganization of economic relations led to rapid social differentiation and sharp polarization of views of the country's population. The healthcare system, as a branch of the national economy, is no exception, experiencing all the economic and psychological problems of modern society.

In the extremely difficult conditions of reforming the healthcare system, the humanity of the mission and professional ethics require the medical worker to fulfill his professional duty, but accumulated contradictions and psycho-emotional stress in the process of providing medical care can at any time lead to a conflict situation.

Even a minimal conflict in the case where one of its parties is a sick person will have negative consequences, since it will indirectly affect the health of its participants.

Conflict in medical institutions, being an extreme case of aggravated contradictions, requires modern identification, quick and effective intervention in order to minimize its negative consequences. To do this, it is necessary to clearly understand the patterns of occurrence and the dynamics of development of conflict interaction, that is, be able to predict it, and therefore prevent it. It is necessary to promptly determine its functions and possible consequences, as well as choose the optimal regulatory tactics.

Conflict management in such a socially significant area as the provision of medical care will improve the quality of medical services provided and optimize the process of restoring the health of patients.

For medical workers (despite the high degree of adaptation to the profession), in conditions of socio-psychological discomfort during the formation of market relations in the state and the implementation of reforms in healthcare, it is typical to have latent ongoing intrapersonal conflicts that complicate communication and reduce its constructiveness in the systems “head of institution - doctor", "doctor - doctor", "doctor - patient".

Severe personal anxiety is interconnected with a high level of reactive anxiety in a certain group of medical personnel of medical institutions and objectively increases the conflict level of interpersonal communication in professional settings.

The reforms carried out in the healthcare system have a destabilizing effect on the socio-psychological climate in medical institutions and, in the process of ongoing transformations, the number of medical workers who receive satisfaction from their work is decreasing.

The introduction of a system of remuneration for medical workers based on the “final result”, with economically unjustified low prices for medical services in the compulsory health insurance system, leads to a reduction in the time of patient appointments, a deterioration in the quality of medical care for the population, and an increase in the number of complaints and conflicts in the “doctor-patient” system. and reduces the level of patient satisfaction with the care provided to them in medical institutions.

Causes and types of conflict situations.

Analysis of the state of practical medicine indicates an increase in the number of conflict situations between a medical institution and a patient, between a doctor and a patient. The medical staff of a medical institution is in a constant state of risk of conflicts, which can be divided into two groups: conflicts that occur as a result of medical errors, and conflicts that arise due to the personal characteristics of the doctor and the patient.

Objective reasons for medical errors include:

* inconsistency of individual postulates, as a result of which the diagnosis of the disease and its treatment change;

* imperfection of medical equipment and applied technologies;

* insufficiently clear organization of the work of the medical institution.

Subjective causes of medical errors:

* lack of sufficient experience as a doctor;

* failure of the doctor to improve his knowledge;

* errors related to communication.

These subjective causes of medical errors, as well as the personal characteristics of some patients, are the causes of conflicts in which the purely medical actions of the doctor are secondary and not of decisive importance. Even if the doctor did everything correctly from a medical point of view, legal and psychological errors in interaction with the patient can lead to serious consequences for the doctor and the entire medical institution.

Most often, doctors in their practice encounter interpersonal conflicts. Interpersonal conflict is a conflict between two, less often three or more individuals (where everyone is “for himself”). Interpersonal conflicts can be vertical, in which the subjects of the conflict stand at different steps of the hierarchical ladder, therefore, have different rights and powers, and horizontal - between opponents of equal status.

Intrapersonal conflict arises when a person is faced with the problem of a choice that he cannot make. This is a struggle between needs and social conditions, desires and restrictions, necessity and possibilities, this is a dispute between “I want” and “I can’t”, between “I must” and “I don’t want.” In case of loss of ability to work due to injury or serious illness, intrapersonal conflict can be expressed in a growing discrepancy between needs and decreased capabilities. If a nurse is given conflicting instructions by the head nurse, the physician, and the department manager at the same time, this can cause emotional stress. The inability to resolve intrapersonal conflicts leads to an increase in emotional tension and aggression. With the development of auto-aggression, a person “goes” into illness, or, directing aggressiveness outward, discharges himself on others (then the intrapersonal conflict develops into an interpersonal one).

If an interpersonal conflict is not resolved in one way or another, its participants seek support, recruit supporters, and the conflict develops into an intergroup conflict or a conflict between an individual and a group.

A conflict between an individual and a group as a consequence of interpersonal conflict arises when one of the participants found support for his position: this could be a conflict between a patient and medical staff or a doctor and the patient’s relatives, etc. This type of conflict can also arise when a person does not accept group values, does not adhere to the norms of behavior accepted in a group or institution, does not satisfy the social expectations of the group, that is, he comes “with his own charter to someone else’s monastery.” Examples include a young doctor making one of the typical mistakes when applying for a new job, when a new employee transfers his previous stereotypes to new conditions: “But that’s how we were taught!”, “Your methods are outdated!”, or a patient who insists on change procedures established in a hospital or clinic. At the same time, unfortunately, conflict arises regardless of whether the “reformer” is right or wrong.

The cause of the conflict between an individual and a group can also be a conflict between a manager and subordinates, when the former takes an authoritarian position, regardless of the opinions, desires, and needs of employees. Usually, at first such a conflict occurs in a hidden form, breaking out in separate, local outbreaks. If management does not notice and does not take measures to clarify and resolve this situation, the conflict can lead to catastrophic consequences.

Intergroup conflicts also occur in medical institutions. These are religious and national conflicts, as well as conflicts between scientific schools or employees of various departments in the hospital. Intergroup conflict arises between groups and between microgroups within one team, for example, between different formal groups, between formal and informal, between informal groups. Thus, the day shift of medical personnel may accuse the night shift of poorly caring for patients, or small groups within the same team make similar complaints against each other.

Special cases of intergroup conflict include conflicts between two participants in which claims are made not to a specific patient or doctor, but in his person to an entire social or professional group (“You doctors only want money, but you don’t know how to treat”, “In your hospital there is never any order”, “You, patients, don’t take care of your health yourself, and then demand miracles from doctors.”) The difficulty of resolving such a conflict lies in the fact that one person is not able to answer for the entire team, and in order to isolate from generalized claims a specific problem, it takes time, good communication skills and stress tolerance.

The causes of conflict situations in medical practice can be very diverse. In a conflict of values, disagreements concern the value-semantic aspects of interaction. Its participants may have different understandings of the meaning and goals of joint activities. For example, for a doctor, the patient’s health is valuable and significant, but the patient is currently more concerned about his ability to work, that is, the need to be at work, perform professional functions to the detriment of his own health, and he is looking for symptomatic treatment. Or for one hospital employee, the profession of a doctor is a real calling, so he works passionately, constantly improves his skills, strives to treat patients as professionally as possible, while another doctor is not interested in self-realization, therefore he is uninitiative, although he does the required amount of work. The contradictions here affect not the norms of behavior, but the value-semantic aspects of existence. This does not mean that different value systems inevitably lead to conflicts. People can interact successfully and have good relationships despite their different values. A conflict arises when someone begins to invade the sphere of values of another person, without recognizing the freedom of personal choice. Typically, value conflicts between physician and patient are resolved by adherence to bioethical principles.

In case of a conflict of interest, two options are possible. If the interests coincide, and the participants lay claim to some limited material factors (place, time, premises, monetary reward), then such a conflict can be called a resource conflict. Each party is interested in obtaining the resource it needs (financing, new equipment) or a more profitable (in terms of quantity or quality) part of the resource. They strive for the same thing, they have the same goals, but due to limited resources, their interests contradict each other. This type of conflict includes all situations involving problems of distribution or arising from competition for the possession of something.

Another option arises when colleagues have interests that contradict each other. Due to the interaction of people in a given situation, they, willingly or unwillingly, become an obstacle to each other in realizing their interests. (For example, part of the clinic team agrees to improve their qualifications during non-working hours, and some doctors do not want to sacrifice family and personal interests.) The discrepancy between the interests of the doctor and the patient seems impossible, since both should be interested in the patient’s recovery or alleviation of his suffering , but this, unfortunately, is the ideal option.

Participants in interaction may share common values and common goals (interests), but have different ideas about how to achieve them. A conflict of means to achieve a goal occurs when a patient, for example, agrees with the diagnosis and is ready to be treated, but does not agree with the treatment plan developed by the doctor. If you focus on what there is agreement on, it is much easier to resolve the conflict of means to achieve the goal. Sometimes people coexist peacefully, even having different value systems, but if the methods of achieving goals chosen by one of them harm the overall interaction or one of its participants, problems arise. You can be calm about the fact that someone next to you performs his duties differently than you do, but when he tries to shift part of his work onto you, a conflict situation arises.

Conflicts of inconsistency associated with the potentials of interaction participants and their compliance with the requirements placed on them can take various forms. This is possible when someone, due to incompetence or, for example, physical inability, cannot make the necessary contribution to the common cause. Situations of this type are well known: one or more employees, unable to cope with their responsibilities, make mistakes, thereby complicating the work of the entire team. Another type of these conflict situations is associated with a significant gap in the intellectual, physical or other potentials of different participants in the interaction. Situations of this type arise due to the fact that the overall result of activity is the sum of individual efforts, and the “weak link” either worsens the overall result, the image of the clinic, or even becomes an obstacle in some actions.

There may be conflicts in the rules of interaction associated with any violation of accepted norms or established rules by any of the participants, if this violation damages the normal interaction or relationships of people. This includes situations of disagreement due to people’s failure to fulfill obligations to others, violation of generally accepted etiquette or norms accepted in a given group, or someone exceeding their rights. Such conflicts can also arise from the desire of one of the participants in the interaction to revise rules and norms or redistribute power or responsibilities: increasing the rights of some and decreasing the rights of others, changing the rules in the current system, etc.

Types of conflicting personalities.

Psychologists identify 5 types of conflicting personalities.

1. Conflict personality of demonstrative type

The subject wants to be the center of attention and likes to look good in the eyes of others. His attitude towards people is determined by how they treat him. He finds it easy to deal with superficial conflicts and admires his suffering and resilience. Rational behavior is poorly expressed. There is emotional behavior. Plans its activities situationally and poorly implements it. Does not shy away from conflicts, feels good in situations of conflict interaction. Often turns out to be a source of conflict, but does not consider himself to be such. Give such a person maximum attention, and if a conflict is brewing, try not to avoid it, but to manage it.

2. Conflict personality of a rigid type.

This man is suspicious. Has high self-esteem. Confirmation of your own importance is constantly required. Often does not take into account changing situations and circumstances. Straightforward and inflexible. He has great difficulty accepting the doctor’s point of view and does not really take his opinion into account. Expressions of respect from others are taken for granted. An expression of hostility on the part of others is perceived by him as an insult. Uncritical of his actions. Painfully touchy, hypersensitive to imaginary or real injustices. It is necessary to show maximum patience and attention to his opinion, speak and act “authoritatively”.

3. Conflict personality of an uncontrollable type

Impulsive, lacks self-control. The behavior of such a person is difficult to predict. Behaves defiantly and aggressively. Often in the heat of the moment does not pay attention to generally accepted norms. Characterized by a high level of aspirations. Not self-critical. He tends to blame others for many failures and troubles. Cannot properly plan his activities or consistently implement plans. From past experiences (even bitter ones) little benefit is derived for the future. Try to avoid any discussions and arguments with him, do not convince him of the correctness of your point of view. Act confidently, but be prepared for trouble.

4. Conflict personality of the super-punctual type.

He is meticulous about everything. He makes increased demands on himself and others, and does it in such a way that people think that he is finding fault. Has increased anxiety. Overly sensitive to details. Tends to attach undue importance to the comments of others. Sometimes he suddenly breaks off a relationship because he thinks he was offended. He suffers from himself, experiences his own miscalculations, failures, and sometimes even pays for them with illnesses (insomnia, headaches, etc.). Doesn't have enough willpower. He does not think deeply about the long-term consequences of his actions and the reasons for the actions of others. Be extremely attentive and polite with him.

5. Conflict-free personality.

The subject is unstable in his assessments and opinions. Has easy suggestibility. Internally contradictory. There is some inconsistency in behavior. Focuses on immediate success in situations. Doesn't see the future well enough. Depends on the opinions of others, especially leaders. Excessively strives for compromise. Doesn't have enough willpower. Does not think deeply about the consequences of his actions and the reasons for the actions of others. He is easily persuaded by the doctor, but when he leaves the office, he will listen to others and may feel that he has been deceived. Patiently prove to him that his choice, made together with you, is the most correct one.

2. Tools and conditions for achieving the set goals and objectives

To ensure the stable operation of medical institutions and prevent and eliminate conflict situations, it is necessary to adhere to the following principles and strategies for conflict management.

Principles and strategies of conflict management.

Managing interpersonal conflicts in the field of medicine is rightfully considered as the ability of the head of a medical organization to master the “conflict algorithm”: to notice a conflict situation in time, understand its true causes, competently resolve the conflict and prevent the occurrence of similar conflicts in the future.

Leading domestic researchers in the field of conflict management A. Antsupov and S. Baklanovsky name the following basic principles of conflict management:

Competence - intervention in the development of a conflict situation must be carried out by people with the required theoretical training and relevant experience (psychologist, lawyer, mediator);

Radicality - the degree of intervention of a specialist in a conflict should not exceed the depth of knowledge of the issue (some analogue of the professional medical commandment “do no harm”);

Cooperation and compromise - it is preferable to ensure that the methods of resolving the dispute are the least conflicting, not allowing for active confrontation.

In our opinion, the latter provision is of particular importance for medicine, since the actions of the doctor and the patient, by their nature, are initially united by a common motivation - restoration of health.

From this follow four main strategies for the behavior of the parties to the conflict:

A normative strategy is a line of behavior based on reliance on a normative position combined with respect for the opponent’s personality (set out in various documents - instructions, orders, codes);

Confrontational strategy - active use of threats, psychological pressure, blocking actions;

At the same time, conflict actions themselves can turn from a means of achieving set goals into the ultimate goal - causing maximum damage to the opponent;

Manipulative strategy - achieving set goals through indirect psychological influence on an opponent, aimed at changing the direction of his activity;

Negotiation strategy is the implementation of the desire to find a compromise, to discuss a problem, to resolve a contradiction through concessions (unilateral or mutual), as well as to find a solution that suits both parties.

In order to optimally resolve conflicts that arise during the provision of medical care, from our point of view, normative and negotiation strategies are in demand.

Thus, conflict management is not just an activity with a clearly understood goal of resolving it, but an activity specially organized by a third party or parties to the conflict at the stages of emergence, development of the conflict and its completion, requiring special knowledge and skills.

Also, there are certain mechanisms of behavior in conflict situations that every leader should know about.

Mechanisms of behavior in conflict.

Human behavior in a conflict is characterized by a high degree of tension, both physical and psychological, because a clash, even a hidden one, requires the concentration of forces and the focus of large spiritual and psychological resources to get out of the current situation. The more complex and significant a conflict situation is for a person, the greater the effort required to resolve it. If it is not possible to withstand tension, emotional breakdowns occur and accepted boundaries of communication and behavior are violated. Then comes regret, a feeling of guilt for losing control over oneself, living the situation in one’s thoughts, talking it out. Negative emotions arising as a result of a conflict can quickly be transferred from the problem to the personality of the opponent, which will complement the conflict situation with personal opposition. There are various ways to reduce emotional stress when dealing with conflict. There is no panacea, but there is a set of methods from which you can choose the one that is appropriate for a particular person and situation.

Active methods are based on physical activity. They are based on the fact that adrenaline, a companion of tension, is consumed during physical activity. Of the sports activities that most quickly relieve aggressiveness, those that include strikes: boxing, tennis, football, hockey, volleyball, golf, etc. It is easier to cope with resentment by doing cyclic exercises: running, swimming, aerobics, dancing or just brisk walking. Instead of sports, you can do something useful that requires physical activity. Work that involves dissecting a whole is very suitable: digging earth, preparing firewood, mowing, chopping vegetables. Sometimes it’s enough just to sort things out on your desk - this action both relieves emotional stress and frees you from unnecessary papers and things.

The logical method is acceptable for purely rational people who prefer logic to everything else. The main thing for such a person is to get to the bottom of the phenomenon. It is more expensive for him to forget about the conflict, so it is better, postponing other matters, to focus on the conflict situation until a way out of the current situation is found. This analytical work itself is calming, as it takes up a lot of energy, and, in addition, mental concentration dulls emotions.

If it is urgent to reduce the emotional intensity, since the situation requires a quick solution, you can “take a break” and count from 10 to 0 or perform several breathing exercises. The main thing is to switch your attention. Some traditional methods of relieving tension - a glass of vodka or cognac, a cigarette or something sweet - are also effective, but after a short time this method of emotional release turns into addiction and becomes the cause of new conflicts.

It is important to remember that no two people are the same, so any method can be ideal for one and completely contraindicated for another, be it members of the same family or employees of the same team. You can look at the conflict from the outside, mentally imagine the whole picture of the current situation, consider different ways to solve it - visualization techniques; You can carry out emotional relief: use auto-training, go in for sports, play any game that allows you to throw out aggression, take a break, etc. You can try to retell each position in the first person.

To increase the efficiency of conflict resolution and prevention, you can, for example, use the rules of conflict-free behavior proposed by O. Gromova.

1. Adequately evaluate your own actions and the actions of your opponent, avoiding false perceptions of your own and his actions, a double standard of assessment.

2. Look at the situation through the eyes of your opponent in order to understand (not necessarily accept) his point of view.

3. Do not make value judgments about the actions and statements of your opponent, so as not to provoke his aggressive reaction.

4. Involve even an incompetent opponent in the discussion of controversial issues in order to make it clear that his position is respected, he participates on equal terms in the search for a solution and is responsible for it.

5. Personally inform your opponent about your position and interests, so as not to force him to use distorted or false information.

6. Do not allow the manifestation of negative emotions when communicating with your opponent; if you lose control over emotions, stop the discussion until control is restored, so as not to cause symmetrical emotional reactions on the part of your opponent.

As project our group offers the following practical recommendations on managing conflicts that have already arisen and preventing them. These mechanisms can be adapted in a medical institution of any profile.

1. Creation and maintenance of organizational culture in an institution as a system of conscious ideas, values, rules, traditions shared by all members of the team. Formation of value-normative organizational consciousness adequate to the goals and objectives of the institution.

2. Correct selection of personnel, taking into account not only professional, but also individual personal qualities of a person. In order to improve the quality of medical care to the population, optimize personnel policies and stabilize the psychological climate in medical institutions, carry out preliminary testing of medical workers in order to identify potentially high-conflict individuals.

3. Improving the system of motivation and stimulation of personnel activities. Translation by management of organizationally significant motives and stereotypes of organizational behavior to employees. Achieving the goals set for the organization involves the creation, dissemination and implementation of a system of organizational behavior. Such systems exist in every organization, but in different forms. Management activities require managers to adopt a particular leadership style, use their communication skills and knowledge of interpersonal and group dynamics to achieve a high quality of work life in the organization. Solving this problem allows you to motivate employees to achieve the goals of the organization. An effective system of organizational behavior allows us to achieve a high level of employee motivation, which, in combination with the qualifications of personnel and their abilities, allows us to get closer to the goals set for the organization, as well as individual job satisfaction.

4. Creation of a favorable moral and psychological climate. The relevance of this problem is determined, first of all, by the increased requirements for the level of socio-psychological involvement of people in the team, in their work activities. The formation of a favorable moral and psychological climate in a team is, first of all, the task of demonstrating the psychological and moral potential of both the individual and society as a whole, creating the most complete way of life for people. Improving the moral and psychological climate in the workforce of a medical institution is one of the most important conditions in the struggle to improve the quality of medical services provided. Also, the moral and psychological climate is an indicator of the level of social development, both of the entire team and of individual workers in particular, capable of more promising production. The overall socio-political and ideological situation in society, as well as in the country as a whole, largely depends on the level of optimality of the moral and psychological climate in each individual work collective. Relationships in a team are one of the most complex and at the same time most subtle areas of social activity. This is interaction between each other in various spheres of human activity, and man is a complex and multifaceted being, each with his own views, values, moral and psychological foundations.

5. Development of a code of ethics and ethics cards that specify the institution’s ethical code for each of its employees. The ethical factor is traditionally of great importance in medicine. The medical Hippocratic Oath has been known since ancient times. The development and adoption of the Code of Ethics for Medical Workers confirms the general historical pattern, being an important stage in health care reform in our country, the main goal of which is to establish the autonomy and self-sufficiency of this profession. The Code should be drawn up taking into account new ideas that have determined the content of medical ethics over the past two to three decades, as well as on the basis of international and Russian legislation, international documents on medical ethics. As for ethics cards, this is a set of ethical rules and recommendations that specify the organization’s ethical code for each employee. They also contain the name and telephone number of the institution's ethics consultant. This method is actively used in Japanese companies.

6. Formation of corporate standards. Corporate standards are the principles and rules governing the activities of an institution, and regulatory documents establishing these rules. Why are corporate standards needed? What will change in the organization with their appearance? Corporate standards allow you to reproduce a given work technology, help identify common errors, and form the desired corporate culture. Employees receive ready-made solutions for typical tasks, and managers of medical institutions receive clearly formulated, formalized requirements for the results of employees’ activities. Regulatory documents - procedures and regulations - describe the main processes existing in the organization; they can be called operating standards. They provide answers to the questions: what to do? When? who is doing? Where? what is needed for this? We can highlight standards that determine the attitude towards the patient, colleagues, and partners of the organization, regulating the performance of professional duties, and the design of the workplace. The standard formulates the skills and competencies that a person occupying a certain position must have. In addition, the level of quality of the duties performed is recorded, and the external circumstances in which the quality of his work will be assessed are described.

7. Providing advisory assistance to employees of the institution in order to increase their individual stress resistance. Providing ethical advice from competent independent business ethicists. Stress, if not dealt with, invariably leads to diseases. Any medical institution can develop a program to increase stress resistance and self-regulation of the psychological state of workers, which may include various trainings to increase stress resistance and relaxation techniques. Similar programs have been operating for a long time in organizations of various profiles. Also, the manager can use the services of a psychologist or personally provide appropriate assistance to the employee. As for the ethics of business relations, more and more attention has recently been paid to it. Employers pay great attention to issues of ethics in business and personal relationships when selecting and hiring personnel, as well as in the process of employees directly performing their professional roles. Compliance with ethical business relations is one of the main criteria for assessing the professionalism of both an individual employee and the organization as a whole.

8. Development and introduction in the institution of various corporate events, holidays, trainings that expand the professional and business capabilities of staff and reduce professional stress. With the help of such events, the tasks of creating and maintaining a favorable moral and psychological climate in the workforce are solved. Corporate events help unite employees of different departments; maintaining a positive image of the institution among staff; creating a positive image of the institution among new employees. Every manager must know that a corporate holiday is not just an entertainment program, it is primarily an intangible way to motivate employees. In addition, it is a tool for the formation and development of corporate culture. When planning a corporate event, you need to understand what goal should be achieved. That is, it is necessary to work out the issue from an ideological point of view. If fun becomes the main goal of the event, then it hardly makes sense to talk about the effectiveness of the holiday. The ideological components of a corporate holiday may be different, but they are the ones that determine the content and format of the holiday.

With the help of corporate software you can solve many problems, for example:

b getting employees to know each other, which is especially important for large medical institutions;

l familiarization with the development plans of the medical institution;

b increasing employee loyalty to your organization;

b speeding up the adaptation process of new employees.

9. Timely information by management of employees about upcoming organizational innovations. Every manager is interested in ensuring that the work of employees of a medical institution and the results of their work meet the requirements of the institution. In maintaining this compliance, informing the organization’s employees plays an important role. Information communicated properly and within the required time frame to a specific employee has the greatest value. Otherwise, the utility effect is reduced. Often, poor internal information becomes the cause of such problems as the decision-making by managers and specialists of medical institutions due to loss or distortion of information; ineffective use of manager’s time, errors in staff work, disruption of events. It is necessary to correctly determine the content and volume of information that must be communicated and collected from personnel; specific recipients of information; time, timing of obtaining information, frequency; adequate methods of conveying information to specific performers; forms for providing information from employees to management, because errors in their definition can lead to loss and distortion of information. The information system assumes two-way communication. On the one hand, management informs staff, and on the other, it receives information from employees. Organizational personnel must be informed of the following:

Strategy and development prospects of the organization, its mission, long-term and short-term goals;

Corporate values of a medical institution; the image that the organization seeks to create;

All significant events in the life of the organization (assessments of influential persons, anniversaries, victories in competitions);

Achievements of the organization;

Personnel movements (major appointments and dismissals), new functions;

Information about personnel (training opportunities and its results, internal competitions for filling vacant positions, criteria and results of certifications, incentive indicators and criteria, etc.), as well as information about social guarantees for personnel and the possibility of receiving them;

Internal administrative documentation;

Innovations and their preliminary discussion (the opportunity to make proposals before a final decision is made);

Regulatory documents (documented and informal rules and procedures, regulatory documents, etc.) and other information.

Now a few words about obtaining information from employees. We are talking about two types of information: the first is factual data, the second is staff opinions on various issues or feedback. So, the manager should collect the following information from employees:

About the current state of affairs;

Opinions on changing the established procedure;

Attitudes towards innovation;

Expert opinion on various issues.

Various methods of informing and obtaining information from personnel are possible. They are selected depending on the content of the transmitted information, and also depend on the size of the medical institution.

10. Formation of conflict management competence of the head and employees of the institution. Development of emotional competence of the manager and employees of the organization, and first of all its leaders. The conflict management competence of a leader is an integral part of professional competence and is included in the structure of professionalism of the individual and activity. A high level of conflict management competence allows managers in many cases to exercise conflict-free management of the system and thereby increase its efficiency. Back in 1912, German psychologist William Lewis Stern proposed measuring a person's intellectual abilities using the now widely known IQ (Intelligence Quotient). 83 years later, American psychologist Daniel Goleman (Goleman D.) created a real sensation by declaring that EQ (Emotional Quotient or Emotional Intelligence) - an emotional indicator of intelligence - plays a more important role than IQ. This is due to the fact that control over one’s own emotions and the ability to correctly perceive other people’s feelings characterize intelligence more accurately than the ability to think logically. According to Daniel Goleman's definition, "Emotional competence is the ability to be aware of and acknowledge one's own feelings, as well as the feelings of others, in order to self-motivate, to manage one's emotions within oneself and in relationships with others." Developed emotional competence is the most important quality of a good leader. If a person has a high IQ, but his EQ is very low, he is unlikely to be a successful manager. After all, 90% of a manager’s job consists of communication, the success of which directly depends on the emotional intelligence quotient.

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Conflict situations and ways to resolve them in an organization. Conflict situations (CS) and ways to resolve them Chechenin Gennady Ionovich Doctor of Medicine

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