Managing difficult conversations

Dorela Priftanji, John D Hill, Daniel M Ashby, Managing difficult conversations, American Journal of Health-System Pharmacy, Volume 77, Issue 21, 1 November 2020, Pages 1723–1726, https://doi.org/10.1093/ajhp/zxaa149

Extract

Whether you are a pharmacist, resident, preceptor, or manager, situations where you find yourself faced with difficult conversations will arise in the workplace. Difficulty may occur anytime you find it hard to talk about something or when opinions differ, emotions are strong, or stakes are high. 1, 2 Examples of such situations include providing feedback to your preceptor or a supervisor, critiquing a colleague’s work, or speaking with a colleague or employee about poor performance. Not surprisingly, the more crucial a conversation is, the less likely individuals are to have one. Delivering bad news is challenging, and the tendency to avoid confrontation hinders our ability to resolve issues rationally.

While difficult to initiate, crucial conversations are essential to address problems and maintain relationships. When faced with any difficult conversation, there are three possible outcomes. You hold a crucial conversation that goes well, you have a conversation that goes poorly, or you avoid the conversation entirely. 1 Avoidance can worsen the situation, negatively affect relationships, and lead to declining productivity. In a healthcare setting, unaddressed issues can lead to patient safety concerns. Categories of crucial conversations within healthcare teams include broken rules, mistakes, incompetence, poor teamwork, disrespect, or micromanagement. 3 Published evidence suggests that only 10% of healthcare workers raise crucial concerns and have difficult conversations regarding these topics. However, those who do raise conversations have witnessed better patient outcomes, are more productive, feel more satisfied, and are more committed to staying in the institution. Based on a study of over 1,600 workers and managers across over 30 companies, those organizations with employees skilled at having crucial conversations were two-thirds more likely to avoid death from unsafe workplace conditions and behaviors resulting from colleague incompetence, safety precaution violations, or unsafe practices due to strict deadlines. 4 If more healthcare workers learn the skills needed to manage these types of conversations, there may be fewer errors, lower staff turnover, and increased productivity. 3