Links to literature on conflict in paediatrics and the use of mediation
Fassier T, Azoulay E: Conflicts and Communication Gaps in the intensive care unit. Current Opinion in Critical Care (2010) 16: 654-665
“Recent staff surveys also found that job strain was significantly associated with conflict severity. In qualitative studies, ICU workers reported feeling that conflicts were “stressful, distressing, frustrating, time-consuming and exhausting”
Brinkert R: A literature review of conflict communication causes, costs, benefits and interventions in nursing. Journal of Nursing Management 2010; 18: 145-156
“Direct costs of conflict included litigation costs, lost management productivity, employee turnover costs…increased care expenditures to handle adverse patient outcomes….Indirect costs of conflict included damaged team morale, lost opportunities to manage future oriented projects, costs to patients, cost to reputation….and emotional costs.”
Studdert DM et al: Nature of conflict in the care of pediatric intensive care patients with prolonged stay. Pediatrics 2003; 112 (3) 553-558.
“Few areas of medicine are as emotionally charged for the individuals involved as the care of critically ill children….this volatile environment is conducive to conflict.”
“We consider that there are potential advantages to using mediation in disputes about critical care decisions in neonatal medicine. Mediation will not … provide an answer to every dilemma. It may, however, facilitate better communication, reduce acrimony and narrow down the issues requiring formal adjudication in the courts.”
“If disagreements arise about what course of action would be in a child or young person’s best interests, it is usually possible to resolve them by involving an independent advocate … holding a case conference or ethics consultation or by using local mediation services.”
Mulcahy L: Mediating Medical Negligence Claims: University of London 2000 ISBN 0 11 322268 8
“Mediation promises self-determination by allowing the parties to speak for themselves and define the issues at stake.”
This study also reported that the benefits of mediation included a) addressing the real causes of the dispute b) reducing the alienation of the parties and restoring relationships and c) facilitating lasting settlements
Meller S and Barclay S: Mediation: an approach to intractable disputes between parents and paediatricians (commissioned editorial). Arch Dis Child 2011;96:619-621
“The germ of the idea for the Big Study began at least five years ago at an ACT Board meeting where we were discussing how far children’s palliative care had come since its early days and yet how little we really knew about whether children’s palliative care services were meeting the needs of children and families.”
Teuten BJ, Forbat E, Barclay SF: The Conflict Pathway: a model to address conflict in paediatric practise. Plenary Presentation delivered at the RCPCH Annual Conference in Glasglow on 24.05.12.
“Some of you may have had personal experience of conflict with a parent or family over the treatment of their child – conflict which involves a breakdown in communication, a loss of trust, a fundamental disagreement about what is in that child’s best interests, or perhaps all three”