Training paediatric healthcare staff in recognising, understanding and managing conflict with patients and families: findings from a survey on immediate and 6-month impact.
BACKGROUND
Conflict is a recognised component of healthcare. Disagreements about treatment protocols, treatment aims and poor communication are recognised warning signs. Conflict management strategies can be used to prevent escalation, but are not a routine component of clinical training.


OBJECTIVE
To report the findings from a novel training intervention, aimed at enabling paediatric staff to identify and understand the warning signs of conflict, and to implement conflict resolution strategies.


METHODS
Self-report measures were taken at baseline, immediately after the training and at 6 months. Questionnaires recorded quantitative and qualitative feedback on the experience of training, and the ability to recognise and de-escalate conflict. The training was provided in a tertiary teaching paediatric hospital in England over 18 months, commencing in June 2013.


METHODS
A 4-h training course on identifying, understanding and managing conflict was provided to staff.


RESULTS
Baseline data were collected from all 711 staff trained, and 6-month follow-up data were collected for 313 of those staff (44%). The training was successful in equipping staff to recognise and de-escalate conflict. Six months after the training, 57% of respondents had experienced conflict, of whom 91% reported that the training had enabled them to de-escalate the conflict. Learning was retained at 6 months with staff more able than at baseline recognising conflict triggers (Fischer's exact test, p=0.001) and managing conflict situations (Pearson's χ2test, p=0.001).


CONCLUSIONS
This training has the potential to reduce substantially the human and economic costs of conflicts for healthcare providers, healthcare staff, patients and relatives.
Australian Catholic University and Calvary Health Care, Canberra, Australian Capital Territory, Australia.
Liz
L
Forbat
Lullaby Trust, London, UK.
Jean
J
Simons
Evelina London Children's Hospital, St Thomas' Hospital, London, UK.
Charlotte
C
Sayer
Evelina London Children's Hospital, St Thomas' Hospital, London, UK.
Megan
M
Davies
Medical Mediation Foundation, London, UK.
Sarah
S
Barclay
D002648:Child; D002983:Clinical Competence; D003220:Conflict, Psychological; D034462:Dissent and Disputes; D004739:England; D005500:Follow-Up Studies; D006282:Health Personnel / Q000193:education*; D006776:Hospitals, Pediatric; D006784:Hospitals, Teaching; D006801:Humans; D007318:Inservice Training / Q000379:methods; D017008:Negotiating; D010372:Pediatrics / Q000193:education*; D011368:Professional-Family Relations; D057566:Self Report
Health services research; conflict; paediatrics; training