title: [Conflict matrix : Risk management tool in the operating room].
abstract: BACKGROUND
  In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patient's environment rather than acting as art of a multiprofessional team. This inevitably leads to the emergence and escalation of conflicts.
  
  
  OBJECTIVE
  We developed a conflict matrix to provide an inexpensive and objective way for evaluating the level of escalation of conflicts in a multiprofessional working environment, such as an OR.
  
  
  METHODS
  The senior members of all involved disciplines were asked to estimate the level of conflict escalation between the individual professional groups on a scale of 0-9. By aggregating the response data, an overview of the conflict matrix within this OR section was created.
  
  
  RESULTS
  No feedback was received from 1 of the 11 contacted occupational groups. By color coding the median, minimum and maximum values of the retrieved data, an intuitive overview of the escalation levels of conflict could be provided. The value range of all feedbacks was between 0 and 6. Estimation of the escalation levels differed widely within one category, showing a range of up to 6 (out of 6) levels.
  
  
  CONCLUSIONS
  The presented assessment using a conflict matrix is a simple and cost-effective method to assess the conflict landscape, especially in multidisciplinary environments, such as OR management. The chance of conflict prevention or the early recognition of existing conflicts represents an enormous potential for cost and risk saving and might have positive long-term effects by building a culture of conflict prevention at the workplace and a positive influence on interdisciplinary cooperation in this working environment.
authors.affiliation: Universitätsklinik für Anästhesie, Allgemeine Intensivmedizin und Schmerztherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: D
authors.initials: D
authors.lastname: Andel
authors.affiliation: Universitätsklinik für Anästhesie, Allgemeine Intensivmedizin und Schmerztherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
authors.forename: K
authors.initials: K
authors.lastname: Markstaller
authors.affiliation: Universitätsklinik für Anästhesie, Allgemeine Intensivmedizin und Schmerztherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich. harald.andel@meduniwien.ac.at.
authors.forename: H
authors.initials: H
authors.lastname: Andel
mesh_terms: D000465:Algorithms; D000066491:Clinical Decision-Making; D003142:Communication; D003220:Conflict, Psychological; D006801:Humans; D007400:Interprofessional Relations; D017008:Negotiating; D009873:Operating Rooms / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D012308:Risk Management / Q000458:organization & administration*
keywords: Conflict management; Mediation; OR management; Patient safety; Risk management