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Health Care Dispute Resolution


SPECIFIC CLASS
NOTES:  Index (this is a hyperlink)

Renegotiating Healthcare   

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COURSE
OUTLINE:

Class 1

Introduction

  1. Purpose of the Class
    • To teach you about Heath Care Dispute Resolution (HCDR).
    • To teach you how to teach others and to train others in HCDR
  2. Intended Audience of the Class
    • Health Care Professionals with Dispute Resolution duties or interests.
    • Consultants with Heath Care clients.
  3. Method of teaching this class
    • A concept will be taught.
    • How and why the concept was taught may be discussed.
    • Drills or case studies will be engaged in in order to focus the point or concept taught.

Session One

  1. Introductions
    • Who you are (each student will provide their name, their preferred name, their credentials, and background).
    • What your goals are -- what is your reason for taking this class and what is your reason for being involved in dispute resolution.
    • If you could ask one question right now, what would it be?
  2. Analyze the Introduction
    • Why should you have a group identify their needs and backgrounds.
    • What other methods can be or should be used to meet those needs.
    • Do introductions need to be used to start a session -- and what are the advantages to delaying introductions?

  1. Approaches to Dispute Resolution in a Health Care Environment
    • Just start a program and ad hoc it.  Numerous programs have been implemented that way.  (Handout).
    • Analyze actual needs and institutional goals (note how needs and goals can differ) (Handouts)
  2. This class covers how to implement after you have analyzed.
  3. What you might want to contrast ad hoc with planned programs.
    • Your audience needs to realize that all programs can survive and flourish, even with substantial adjustments (because no matter how good the plan, there will be adjustments)
    • Your audience needs to be reassured that Dispute Resolution is engineering and not theology (that is you take it on facts, not on faith) and that you are bringing real knowledge and value to the program.
    • Other reasons for the contrast (directed class input).
    • Note that if ad hoc was all there was to it, there wouldn't be this class.  Proper skills, structured approaches, and analysis will save time, money and serious mistakes.

Between Classes

  1. Handouts
    • Federal ad hoc case study.
    • SPIDR article, TADR article
    • Scripts for opening training/consulting session
      • ad hoc vs. scientific analysis
      • introductions
  2. Reading Assignments for next class
    • To Page 43 of Renegotiating
    • To Page 2 of Managing
  3. Notes on Reading Assignments.
    • Skimming vs. Reading.  (Before class *Read* Managing, skim [and go back read as you have the time] Renegotiating, after class skim [to refresh] Managing and finish reading Renegotiating).
    • Preparation will make class easier, but the accelerated schedule will make the reading assignments more difficult.

Class 2

Session Two

  1. Overview of CPR and Jossey-Bass textbooks
    • Managing Conflict in Health Care Organizations (Managing)
      • The Costs of Conventional Dispute Management (the alternatives to the program you will teach, train or provide).
      • Conflict Resolution Mechanisms -- A Better Way.
      • The Importance of Planning and Proper Design.
      • Specific Types of Disputes
      • Special Topics (The Appendixes)
    • Renegotiating Health Care (Renegotiating)
      • Conflict
      • Negotiation
      • Health Care Practice and Perspectives
      • Creating and Resolving Conflicts
      • Whole Image Negotiating.
  2. Why should you provide an overview of handouts or other materials?
    • To explain the value and utility of handouts.
    • To provide guidance of when/how handouts are to be used; reinforce order.
  3. Why you may not want to provide (complete) overviews.
    • To help your class come to concepts fresh, without preconceptions, or with created preconceptions.
    • To avoid being blocked in if training combines with problem solving (protect yourself from being prisoner to an agenda).
  4. Checklisting materials for an overview
    • Why I restate the materials (or why I just didn't quote the table of contents entries)
    • Why to restate, why to not restate what the materials are (and should you just relabel the names of the materials instead).

Session Three

  1. Metaphors for the Health Care Environment (and society as a whole).
    • Catering Resturaunt
    • Assembly Line
    • Captain of the Ship
    • Wagon Train
    • Professional Sports (we are a team)
    • Professional Sports (I am a star)
    • Class Room
    • Tourists/Resort
    • Evil Empire
    • Others
  2. Why discuss metaphors?
    • To determine which metaphor or which metaphors a group is using -- and how appropriate the metaphor is, whether multiple metaphors are clashing (e.g. sports and class room metaphor clashes).
    • To open up the audience to considering better metaphors.
    • To find hidden or unconceptualized conflicts and issues.
    • To continue group participation, input and thought.
    • Note that metaphor changes and shifting are essential to advanced dispute resolution approaches and can be a powerful tool for identifying conflicts and for creating solutions.
  3. When discuss metaphors?
  4. Metaphors, Conflict and Framing.

Between Classes

  1. Handouts (to review)
  2. Reading Assignments
    • Page 3-10, 11-13 of Managing
    • Pages 45 to 118 of Renegotiating
  3. Other Assignments
    • Consider metaphors (list three that you encounter at work, home or other places).

Class 3

Reports

  1. Each class member is to report on two metaphors they have encountered, use, or interact with.
  2. What and which metaphors are most common in the health care environments they have dealt with?  What metaphor would they prefer?
  3. Reports help to emphasize the point, cross-fertilize class members with other perspectives and are a good initial lesson in reframing.

Session Four

  1. Explaining the value of a dispute resolution program to administrators.
    • The Costs of Conventional Dispute Management (the alternatives to the program you will teach, train or provide).
    • Conflict Resolution Mechanisms -- A Better Way.
  2. What you should be doing
    • The Importance of Planning and Proper Design.
    • Teaching your audience the importance of Planning and Proper Design.
  3. Role-Play and Practice initial meetings/consultations on DR applications.

Session Five

  1. Teaching Negotiation
    • The importance of teaching negotiation skills.
    • The importance of using simple models for negotiation skills.
    • How to teach Negotiation (combining lecture with practice).
    • Why combine lecture with practice.
  2. Teaching Framing and Reframing Techniques
    • What is framing.
    • What is reframing.
    • How to teach.
    • Reconceptualize.
  3. Practice and role-play.

Between Classes

  1. Handouts (to review)
  2. Reading Assignments
    • Pages 119 to 147, 151-177 of Renegotiating
  3. Framing Assignment


Class 4

Session Six

  1. Cultural issues, Policy Issues in Health Care (pages 151-177)
  2. Reframing (continuing the framing discussion and analysis)

Between Classes

  1. Handouts (to review)
  2. Reading Assignments
    • Pages 179 to 206, 237 to 267 of Renegotiating
  3. Assignments


Class 5

Session Seven

  1. Further Policy Issues and Perspectives
  2. Analyzing Roles and Changing Roles.
    • It is useful to discuss with any group how their role has changed.  Nurses, administrators, staff and doctors have all changed their roles over the last twenty years.  Changes in roles create conflict, worry (including FUD) and confusion.
    • Discussing changes in roles help people redefine themselves and their roles and help them to revisualize conflicts.  This works with every group.

Between Classes

  1. Handouts (to review)
    • Advanced Negotiation Concepts
    • Personality Driven Disputes (checklist and guide sheet).
  2. Reading Assignments
    • Pages 271 to 315 of Renegotiating (Positional Bargaining)
  3. Other Assignments
    • Consider metaphors your negotiation style.
    • Consider why discussing and analyzing negotiation styles is important.


Class 6

Session Eight and Nine

  1. (Eight) Bargaining and Negotiation Training (Revisiting and expanding on concepts).
    • Paradigm conflicts
    • Institutional Pathologies
    • Five patterns of conflict and resolution vis a vis negotiation.
    • Postitional bargaining in this context.
  2. (Nine) Teaching mediation concepts and mediation skills and facilitation skills (24 hours of initial training)
    • Faciliative mediation (enhanced negotiation)
    • Transformative mediation (enhanced personal recognition)
    • Co-opting mediation (enhanced relationships)
    • Systemic mediation (everyone as a mediator -- risks and issues)
    • True facilitation (when a situation calls for more than just mediation).
  3. Texts and handbooks for training purposes.
    • This is not attorney-mediator court annexed mediation.
    • Closest analogy is community dispute mediation followed by religious conflict mediation.

Between Classes

  1. Handouts (to review)
  2. Reading Assignments
    • Pages 317 to 398 of Renegotiating
    • Pages 60 to 62 of Managing
  3. Other Assignments


Class 7

Session Ten

  1. What are your goals (revisit class member goals)
  2. Why to revisit goals during training.
  3. Class Project Discussions, Discuss Final.

Between Classes

  1. Handouts (to review)
  2. Reading Assignments
    • Pages of  399 to 411 of Renegotiating
    • Pages 14 to 34 of Managing
  3. Other Assignments


Class 8

Session Eleven

  1. Specific Types of Disputes
    • Coverage
    • Bioethical
    • Disaffiliation
    • General Business
  2. Case Studies
    • The value of case studies, learning by analogy
    • The value of case studies, creating memories
    • The value of case studies, improvement of authority.

Between Classes

  1. Handouts (to review)
  2. Other Assignments
    • Analyzie Case Studies.


Class 9

Session Twelve

  1. Specific Types of Disputes
    • Workforce
    • Patient (ombudsman/mediation)
    • Patient (arbitration/court)

Session Thirteen

  1. Review Role-plays and Case Studies (Preface to Renegotiation)
  2. Creating Role-plays and case studies.
    • Breaking a situation into elements.
    • Resolving the elements one at a time, and in what order.

Between Classes

  1. Handouts (to review)
  2. Reading Assignment:  Appendixes A to F of Managing
  3. Other Assignments
    • Analyzie Case Studies.


Class 10

Session Fourteen

Final Lecture, Discussion, Role-Plays

Review Appendix Materials from Managing Conflict in Health Care Organizations

Final Exam

Class Extra

  1. Student Discretionary Session.
  2. Make-up Session.
  3. Class Projects.


COURSE
DESCRIPTION:

This is a course for those who consult in the health care area or for those who are involved in health care as a provider, administrator, human relations or risk management.  You will learn how to apply dispute resolution techniques and programs to health care settings and how to teach others to do the same.  The course is broken into sessions or units that you will be able to apply.  See the Course Objectives, below, for the three things that this course emphasizes.


COURSE
OBJECTIVES: 

You will learn:

INSTRUCTOR:       

Stephen R. Marsh, J.D.; resume at http://adrr.com/smarsh/smresume.thm; e-mail at smarsh@adrr.com.


TEXTS:       
                

  1. Managing Conflict in Health Care Organizations (Managing) published by the American Hospital Association and CPR (CPR Institute for Dispute Resolution).

  2.  Renegotiating Health Care (Renegotiating) published by Jossey-Bass Publications.

  3. A Three Ring Binder that has the informal title: My Consulting Notebook (You are the publisher for this, it should contain your scripts, case studies, role plays, notes and your copy of Managing Conflict in Health Care Organizations)

The Following Material (in teal) is generic to every class taught in the Dispute Resolution Program at Southern Methodist University:


ATTENDANCE:

Regular attendance is very important in this course and a function of grading from two separate perspectives.  First, after six (6) unexcused class hours (hours, not absences) a student is subject to a grade of “F.”  Class hours missed due to an illness or work conflict will be excused, subject to the instructors sole discretion.  Students agree to binding arbitration of any conflict with the arbitrator of the instructor’s choice and at the student’s expense should an appeal be taken from the sole discretion of the instructor.  Expect to present documented proof of the reasons for any and all absences. 

Second, students will automatically fail the course after twelve (12) hours of class have been missed for any reason.  Also, a student will be considered tardy if the student is late by thirty (30) minutes or more.  If the roll has already been taken, the tardy student bears the responsibility of calling the instructor’s attention (after class) to the student’s attendance.  Failure to do so may result in an attendance roster result of an unexcused absence for the entire class period.

This policy follows the policy manual policy and is intended to conform strictly with the guidelines set by SMU and required of instructors.
 

RELIGIOUS
HOLIDAYS:

Students desiring to observe a religious holy day, which will result in a class absence, must notify the instructor in writing no later than one week after the first day of the semester in which the absence will occur.  Students will be required to complete any assignments or take any examinations which may have been missed as the result of the absence within a reasonable time.

COURSE
WITHDRAWAL:

Students are urged to consult with an instructor before withdrawing from this course, however it is the student’s responsibility to withdraw from the course if necessary.  Failure to follow SMU’s prescribed procedures will result in the student receiving a performance grade, usually an “F.”


CLASS
DECORUM:

EVALUATION/GRADING: 

A final and a project, as well as attendance and participation are required.

The following components will comprise a student's course evaluation:

The final grade will be calculated as follows:
A, A+     Excellent Scholarship
B+,B,B- Good Scholarship
C+, C,C-   Fair Scholarship
D+,D,D- Poor Scholarship
F    Failure
I Incomplete
NC No Credit Received
WP/W Withdraw Passing/Withdraw

IMPORTANT
INFORMATION:

Every student is expected to adhere to the Honor Code when doing all assignments and in taking all tests, whether in class, the law library, or any other location.

 

ANY FORM OF CHEATING OR PLAGIARISM WILL NOT BE TOLERATED AND WILL RESULT IN EXPULSION FROM THE CLASS.

Students will be required to display name identification at every class.

The syllabus is subject to change at the instructor's discretion.
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Copyright 2000 by Stephen R. Marsh