Conflict Resolution and Prevention

When it comes to the herb cilantro, people either love it or they hate it because it tastes like soap. Conflict is much the same way: either you see it as constructive or destructive. In my case, I used to think cilantro tasted like soap and it would ruin any food it came near. When I became a teenager, my taste buds changed. Now I will eat an entire bunch of cilantro on top of a taco or khao tom. Similarly, I used to feel conflict was a destructive force, and now I sometimes even look forward to a conflict (assuming it’s handled effectively) because it is an essential stage of team development.

The Thomas-Kilmann Conflict Mode Instrument (TKI) gives you insights into how you prefer to manage conflict, whether that is through:

  • Competing
  • Collaborating
  • Compromising
  • Avoiding
  • Accommodating

Knowing what your go to method is for handling conflict allows you to actively increase your skills in the other conflict modes and applying each mode when the situation requires it. Having more than one or two management skills will allow you to respond to different types of conflict effectively and nip unnecessary conflict in the bud.

 

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-Lotte Mulder earned her Master’s of Education from the Harvard Graduate School of Education in 2013, where she focused on Leadership and Group Development. She’s currently working toward a PhD in Organizational Leadership. At ASCP, Lotte designs and facilitates the ASCP Leadership Institute, an online leadership certificate program. She has also built ASCP’s first patient ambassador program, called Patient Champions, which leverages patient stories as they relate to the value of the lab.

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Do you know that we have a comfort zone when we are handling conflicts? The Conflict Management course conducted by ASCP’s Leadership Academy offers an assessment of your conflict management style using the Thomas-Kilmann Conflict Mode Instrument (TKI). This assessment is eye-opening and helped me gain a better appreciation of my management style.

I scored high on “accommodating skills” on the TKI, meaning that when in conflict, I tend to be reasonable and accommodating with others, creating goodwill in the process. This method is particularly helpful for managers who inherit a new department through restructuring and aim to preserve harmony and avoid disruption to the work process. It is also helpful for building social credits to be use in the future for more important tasks that need larger buy-ins. As companies in the healthcare and diagnostic testing sectors evolve and adapt to the new regulatory and fiscal environment, departments within companies will continue to be restructured to ensure efficiency and relevancy. In my current position as a manager, I find these skills to be immensely useful, particularly as I’m recently given oversight responsibilities of new departments. The skills are helpful to ensure seamless transition while continuing to provide patients with unsurpassed diagnostic insights and innovation.

The course also asks us to look at our blind spots. I find that I tend to spend too little time discussing issues in depth and hashing out personal differences. “Collaborating mode” encourages us to work through issues, think outside the box, and to create a win-win solution. I’m learning to set aside time to proactively reach out to others with varying views and to understand their thoughts and evaluate their viabilities and applications. This gives me an opportunity for integrative solutions to merge insights from people with different perspectives on a problem and gain commitment from various stakeholders.

The ASCP Leadership program and the TKI gave me important revelations into my conflict management comfort styles and provided insights into my blind spots. While my favorite conflict behaviors are results of both my personal predispositions and the requirements of my work situations, I try to utilize other management styles based on the specifics of the situation. I have no doubt that the leadership program has augmented my management tool box. Now I have different tools at my disposal, whether it be “kill your enemies with kindness” (accommodating), “two heads are better than one” (collaborating), “Leave well enough alone” (avoiding), “might makes right” (competing), or “split the difference” (compromising), to approach future conflicts.

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-Paul Chiou, MPH, SCT (ASCP) CM is a supervisor of Cytology and FISH at Miraca Life Sciences. Paul is a CAP inspector and an active member of the laboratory community having served on various professional committees over the years.

Metrics, Goals, and Lab Leadership

In an April 2015 publication in Lab Manager, then ASCP President Dr. William Finn discussed the Lab Management University (LMU) program “designed to help pathologists and lab professionals take their laboratory management skills to the next level.” He also cited “gaps” in professional training and experience that revealed a lack of management skills in “pathologists, laboratory professionals, and pathology residents.” Utilizing advanced coursework available to them from LMU, laboratorians of various specialties would stand to benefit from this knowledge and effectively influence more positive outcomes for patients.

Within the last year, I’ve been writing about utilizing data from epidemiology, laboratory studies, and community partnerships in an integrated public health initiative combating mosquito-borne illness on the island of Sint Maarten. It is an ongoing multidisciplinary project I started which reaches various fields of study from immunological seroprevalence, to community health work, to social determinants of health, and team leadership and coordination. What started as a group of six students in the fall of 2016, has flourished into a team of now more than fifteen with partners in local government, local NGOs including the Red Cross, social and broadcast media, and our individualized message of local self-motivated disease prevention has reached well into the thousands.

Citing this experience as a process of a simple medical literacy proposal to an expansive public health initiative, I believe there are some significant advantages that being a laboratory professional can give you. Experiences during my time in clinical laboratories gave me many parallels to study as I became a leader of a dynamic and diverse program. Here is what I consider is a highly-oversimplified model for successful problem-solving, leadership, and ultimately measured success. As a common laboratory metric of efficiency/success—and something I have had experience with before—consider turn-around-time (TAT) as a problem many labs face. Compared to the problem of addressing risk reduction and source control for mosquito-borne illnesses like Zika, I found myself in the same model I had recognized many times before.

Example 1: Outside the Lab

Addressing Zika as a Public Health Concern

Example2: Inside the Lab

Addressing TAT as an Efficiency Metric

 

START: Clearly and Specifically Define the Problem or Need to be Addressed
With the advent of a local outbreak and information from local government regarding the increase of epidemiologic cases, behavioral change for risk reduction was highlighted as a major obstacle in improving public health outcomes. Creating self-sufficiency in the community would not only improve health but create sustainability. As a laboratory potentially signs on new clinics or accounts because of local changes in hospital structures, efficiency is being examined as workflow is slated to increase. Staffing, instrumentation, LIS/LAS, and other tools are being considered to reduce TAT and improve overall patient outcomes and strengthen quality control and quality assurance metrics.
Locate Potential Helpful Partners, Staff, or Tools that Can Assist Your Cause
To gain access to resources otherwise unavailable, it is imperative to collaborate with partners in the Ministry of Health as well as NGOs like the Red Cross. To reach communities most affected by the problem at hand, it is necessary to implement cultural liaisons to act as intercessors preserving the autonomy of individuals while creating a safe environment to communicate an effective public health message. As part of initial assessments to discover a clear problem, vendors may offer instrumentation or technology that would improve the conditions affecting the TAT. It would be highly prudent to reach out to the new accounts or clinical sites to determine if TAT is affected by workflow, personnel, communication, or procedural faults. Assessing the staffs’ skills and competency are also crucial for implementing corrective action.
Implement Initial Intervention, Paying Attention to Results Before/After
In the case of Zika virus education and prevention, initial interventions include utilizing community partners as liaisons to introduce us to targeted audiences/communities. Results should focus on the pre-and-post-survey data collected, referenced in earlier articles regarding engagement, knowledge, and behavior. In the case of TAT efficiency/improvement, initial interventions should include collecting data points regarding how specimen-to-result turnover is affected at every checkpoint while implementing changes as necessary. Data should indicate success in particular measures which improve TAT incrementally.
Take Measures to Make Further Interventions More Successful Along the Way
Educating communities about the risks associated with standing water and the spread of arboviral infections with clear demonstrations/examples of how to enact improvements. Distribution of educational or advertising materials throughout targeted areas will bolster an effective message. When staff or other changes effectively improve the streamlining process, they should be recognized and praised. Moreover, clients should be consulted in both inpatient and outpatient settings to inform procedural change and deter further external compromise of TAT.
Implement Follow-Up Intervention, Paying Attention to Results Before/After
Like before, interventions with Zika virus education include community partner meetings to hold engaging discussions about health promoting behavior. Similar surveys collect data before and after the presentation and are correlated with the previous meeting, however, with the addition of data regarding the effectiveness of secondary measures (i.e. advertising and educational materials). With the implantation of various measures to improve turnaround, assessments of protocol, instrument utility, effective transport, and other previously mentioned aspects would indicate successful outcomes. Combined with the supplemental consultation to steps both inside and outside of the laboratory, an comprehensive conclusion can be established to indicate a permanent solution via these metrics.
Conduct More Comprehensive/Translational Analysis of Intervention Effectiveness
Correlating the primary intervention with follow-up measures can indicate possible opportunities for further improvement. It can also highlight areas of significant success where interventions had the greatest impact. If significant enough, these results should promote the process and further the original cause set forth early on. Continuous metrics which analyze the TAT as a marker for productivity and efficiency before, during, and after interventions can offer insight into effective changes. Extrapolating this data can improve processes across departments and models made from this process can improve TAT and other metrics in a laboratory.
Share Significant Successes and Challenges with Partners/Staff and Share the Success
Based on standards in current literature, community partners benefit significantly from both repeat-visits as well as becoming involved and informed participants for positive change. As laboratories face staff shortages and personnel challenges, sharing the success and making sure the rewards are collectively appreciated can improve workplace dynamics.
Create a New Protocol, SOP, or Publication to Influence a New Standard
As with any successful public health interventions, shared information can lead to future improvements elsewhere. Publications often cite the process of creating a platform and approach to tackling social health concerns and highlights emphasize these positive outcomes. Many productivity projects in clinical settings are difficult, successes should be shared between departments and outside the laboratory. Ultimately, publication might present an ample opportunity for improving standings for overall hospital metrics and larger outcomes.
FINAL: Implement the Same Model Outlined Here for Potential Future Challenges

Obviously, this is a crude and generalized model for how to approach leadership both inside and outside the laboratory, but some of the key aspects of clear goals, interdisciplinary teamwork, resource management, and creativity are paramount. Having my laboratory experience was critical for finding success with my team here with our public health work. Laboratory professionals have strong skills and unique insights for a variety of important fields. Having that experience has truly enabled me to contribute in a meaningful way as I pursue my medical career. As you can clearly see, there are so many useful tools that apply across disciplines. Furthermore, the most important part of managing a project aimed at a positive outcome is answering the simple question: how do I utilize and interpret the data I collect along the way?

And here’s another question: who does data analysis better than us laboratory folks?

Thanks for reading, until next time…

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Constantine E. Kanakis MSc, MLS (ASCP)CM graduated from Loyola University Chicago with a BS in Molecular Biology and Bioethics and then Rush University with an MS in Medical Laboratory Science. He is currently a medical student at the American University of the Caribbean and actively involved with local public health.

Everything DiSC Workplace

As part of my work as a leadership coach and consultant, I’ve had the good fortunate to participate in several life- and work-transforming certification programs and courses. Everything DiSC Workplace stands out from the others because of its simple yet transformative power. For me personally it has given me direct insights into how I can adapt my behavior to become more effective with people who behave similar to me and with those who behave differently. Understanding the four different personality types of the Everything DiSC Workplace model allows me to get better results, be more productive as an employee, and it gives insights into my own workplace preferences. As a result of this course, I’ve learned how to tailor my approach to the situation and the people involved. Should I be more direct or soften my language? Should I focus on building rapport or present a lot of data to get my point across? Here at ASCP, Everything DiSC Workplace is one of our fundamental courses that every employee takes.

Everything DiSC Workplace focuses on people’s behavioral patterns and preferences while at work. The model distinguishes between four main styles:

  • D for Dominance
  • i for Influence
  • S for Steadiness
  • C for Conscientiousness

All styles are equally valuable and useful. In fact, all people use all four styles, but everyone has a preference of one or two styles.  Typically speaking, those with a preference for the D style would describe themselves as active and questioning. Those with the i-Style are more active and accepting. The S style relates to people who are accepting but thoughtful, and those with the C Style are thoughtful and questioning.

There are behaviors, motivators, stressors, and priorities associated with each style. Understanding your own preferences and your strengths and growth opportunities is a great foundation for your leadership development.

 

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-Lotte Mulder earned her Master’s of Education from the Harvard Graduate School of Education in 2013, where she focused on Leadership and Group Development. She’s currently working toward a PhD in Organizational Leadership. At ASCP, Lotte designs and facilitates the ASCP Leadership Institute, an online leadership certificate program. She has also built ASCP’s first patient ambassador program, called Patient Champions, which leverages patient stories as they relate to the value of the lab.

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I thoroughly enjoyed the Everything DiSC Workplace. It was an assessment that I hadn’t done before and I found it to be very accurate in describing my behaviors and attitudes. I have gained quite a few insights about myself, the people I work with, and even the leaders that I report to.

I am a C DiSC style, the conscientious style, the one who likes to take the time to consider all the facts and make an objective decision. Great, right? Well, I don’t always remember to be personable. So, when I look over a project, I can be rather blunt. My input can come across as corrections or criticisms. This is something I need to watch out for as a C. In the past I have tried to explain that there were no bad feelings on my part; no dislike or intention to belittle. Those who were upset by my manner often continued to react in the same way. Now I have learned to never lead with a correction or change, but to stop and consider what someone has done first. If what they have done will work, even if it is not what I would have done, I thank them for taking care of it and doing such a great job. If it won’t work I still thank them first, but I may ask a few leading questions as well. Perhaps we can come up with some improvements together. I seem to have a much better rapport with my coworkers now and they seem to be more willing to add their own suggestions.

As I look around my workplace, I can see the styles that many of my coworkers prefer.

A D-style that I know gets argumentative when I dismiss her ideas without explanation, yet doesn’t allow me time for the full explanation. There have been many disagreements between us. I have learned that if I acknowledge her ideas first and then add a few bullet points, it turns out that we are often actually working towards the same goals.

If I need to sell an idea to everyone, I know an “i” that I can go to. Once she gets excited about it and starts bouncing ideas off everyone, things take off from there. It is an awesome talent. It is also one that doesn’t usually work on me. This is another situation where I have learned to appreciate her ideas first and then, considerately, discuss them in more detail. I want to encourage her spirit but not dampen it if I happen to disagree.

I see the S-styles as the backbone of my lab. As I get all wound up about sudden changes, they take it all in stride. That is my C-style again, wanting to think it through before making the change. The S’s have been through a lot of changes though, and calmly accept most of them. A little appreciation goes a long way with these guys. If they feel compelled to complain about a change, it’s time to listen.

Interestingly, I have also started paying close attention to how my leaders talk to me. I have one who talks to me about big changes, explains the situation, listens to my thoughts, and gives me time to think about it. I don’t necessarily get my way, but when I go into her office ready to fight to prevent a change, I generally come back out supporting it and eager to help. It’s a C thing. Make me feel like I’m a part of what’s happening and I’m fine.

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-Stacey Robinson, MS, MLS(ASCP)CMSHCM,QCYMCM is a graduate of the Clinical Laboratory Science program at the University of Texas Health Science Center in San Antonio and holds a Masters in Science in Biotechnology from Johns Hopkins University. She currently serves as the Vice Chair of the Hematology Exam Committee for ASCP.

 

Myers-Briggs Type Indicator

Let me be honest and straightforward: this was not my favorite model when I first learned about it. Until, that is, I went through the certification to become a trainer and I fell head over heels in love, despite it being more complicated and intricate than the other models used and discussed in the Leadership Institute. The MBTI provides a deep understanding of your personality traits, natural skills, and tendencies while highlighting skills you have learned along the way. As an added bonus, this understanding isn’t tied to any life role (work, parent, child, friend, etc.). I, for instance, have a slight preference for extraversion with a lot of introversion tendencies. However, I usually come across as highly extraverted, as I learned to act more extraverted because my sister was very shy growing up and I wanted to balance it out.

The MBTI focuses on your innate personality preference, organized into four dichotomies:

  • Extraversion vs. Introversion (E –I)
  • Sensing vs. Intuition (S – N)
  • Thinking vs. Feeling (T – F)
  • Judging vs. Perceiving (J – P)

Your preferences in each category, when combined, are your type. For example, if I had a preference for Introversion (I), Sensing (S), Feeling (F), and Perceiving (P), my type would be ISFP. This type gives me insights into how I interact with others, process information, come to conclusions, and approach the outside world. Understanding this will allow me to know my strengths and weaknesses as well as those of others. As a leader, applying that knowledge effectively in different situations and with different people is essential.

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-Lotte Mulder earned her Master’s of Education from the Harvard Graduate School of Education in 2013, where she focused on Leadership and Group Development. She’s currently working toward a PhD in Organizational Leadership. At ASCP, Lotte designs and facilitates the ASCP Leadership Institute, an online leadership certificate program. She has also built ASCP’s first patient ambassador program, called Patient Champions, which leverages patient stories as they relate to the value of the lab.

Yin and Yang

Who would have thought that our personality is made of contradicting elements?

I truly enjoyed the MBTI course, it was an eye opener of who I am and a trip inwards. Knowing who we really are, our talents, comfort zones and blind spots will help us become better leaders.

So now I know and after all these years (on a personal or professional level) that I am an “ENFP,” these four letters mean that I tend to be extraverted, intuitive, feeling and perceiving. I do agree with the assessment as it reflects who I am and decided after taking the course to put my Middle Eastern Ego aside and not challenge the blind spots.

ENFPs see new possibilities in people, situations, tasks and projects at hand. We tend to have high energy and flexibility. In my line of work, being the Chief Quality Officer at MedLabs Consultancy Group in Amman-Jordan, I find these personal traits very critical to our success as a company to ensure the highest compliance in implementing quality standards throughout our network of laboratories spanning four countries and exceeding 50 in total. Being a people’s person is a great asset in order to touch the hearts, minds and souls of our staff to sustain these quality standards, being 150% convinced rather than simply following the rules. We are trying to “personalize” Quality and Safety, this can only be accomplished through connecting with each staff member and it requires inspiration, a trait that is “built in” ENFPs.

Looking at the blind spots, I find that we tend to get overexcited about projects, juggling many at the same time and loosing track of priorities in the hope of making a difference. Guilty as charged.

I am learning to take one project at a time, see it through completion and start the next one in the pipeline, this gave me and my colleagues a breather and time to reflect if the road that we are taking is indeed the correct one.

So now I am asking myself, what if I did not have the great opportunity to be part of the ASCP Leadership Program and I have missed out on MBTI? What if I did not realize that I am an ENFP? What if I could not appreciate the blind spots?

The simple answer is: I will be a classical leader in it for the title, with little contributions and not much of a positive effect on those who are around me. My job will be stale, with no spirit and dull, so I guess Yin and Yang actually works.

Soudi

-Nael M. Soudi holds a bachelor degree in Microbiology from State University of New York at Plattsburgh (USA). He completed both his Master Degree in Molecular Biology and a postgraduate program in Cytotechnology at Johns Hopkins University (USA). Mr. Soudi is a certified Practitioner in Health Care Quality (CPHQ) and a certified consultant and inspector with the Healthcare Accreditation Council. He is also certified by the International Academy of Cytology (IAC) and the American Society of Clinical Pathologists (ASCP) – Cytology. Mr. Soudi is fully licensed by the American Society of Clinical Pathologists and the College of American Pathologist (CAP) as a Certified Inspector. He is a frequent presenter at regional and international conferences discussing topics in Cytology, leadership, accreditation and healthcare quality. 

Leadership is WEadership

Leadership is all about the other person; it is about adapting your own behavior and communications styles to meet the needs of the people you are leading. However, in order to be able to adapt your own behavior, you first need to learn about yourself.  Discovering your natural leadership styles, communication and delegation preferences, views about conflict, and your strengths and weaknesses will improve your leadership abilities. This learning requires a deep-dive analysis through one (or preferably all) of these methods:

  • Self-reflection
  • Feedback from others
  • Coaching
  • Self-assessments

Personally I have always been drawn to constructive feedback so I can discover areas for growth. It’s not always pleasant to hear, but we all have blind spots, and feedback is a crucial first step in personal and professional development. In the last few years I have added another layer of self-discovery: self-assessments. In my experience, self-assessments give you 1) a sense that you are not alone; that your thoughts, behaviors, the ways in which you process information are not different than everyone else but that there are people who behave, think, and process in similar ways, 2) a deeper sense of understanding where your behavior or communication preferences come from, and 3) a practical understanding of people who act differently than you and how to approach them more effectively. In other words, self-assessments are a way to acknowledge one’s own behavior and that of others. So much of leadership is about acknowledging other people through adapting your own behavior.

When I got hired to create a Leadership Institute for ASCP members, I used self-assessments as the cornerstone of our curriculum. I want our members to have access to the same level of awareness and development that I have enjoyed throughout the years. Learning about your motivators and blind sides is crucial before you can truly turn leadership into WEadership.

 

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-Lotte Mulder earned her Master’s of Education from the Harvard Graduate School of Education in 2013, where she focused on Leadership and Group Development. At ASCP, Lotte designs and facilitates the ASCP Leadership Institute, an online leadership certificate program. She has also built ASCP’s first patient ambassador program, called Patient Champions, which leverages patient stories as they relate to the value of the lab.

Steady the Ship

The relationships you have as a supervisor with the people you lead (notice I did not say “manage”) are important when it comes to day to day operations. They become especially important is when you have to guide them through change or conflict. I won’t even comment on the appropriateness of intimate relationships except to say if you engage in one then you are taking your career into your own hands and don’t plan on it lasting long. Beyond that, the lines are blurred and you may be engaging in an inappropriate relationship that won’t get you in trouble with management but will with the people you lead.

I am 31 years old and the majority of the people I lead are double my age so I have a unique (but becoming a bit more common) relationship with them. With many reaching retirement age in the near future the younger generation is taking the responsibility of leading and it creates unique issues. Do I sometimes feel awkward discussing a behavioral incident with someone who could be my grandmother? Absolutely, but my approach is what makes it a successful or unsuccessful discussion. I have learned that a “by the book” or “letter of the law” approach is not always successful. This is where emotional intelligence comes into play. As a leader you need to identify the needs of the people you lead, both as a group and individuals. It is very important to distinguish between the two because the needs of the group may be vastly different than as individuals. Once you do this it is easier to lead them because you know what they need to be successful and what you need to avoid, staving off failures. If you can successfully identify the needs of the group and individuals you can have relationships that grow and the people you lead will have confidence in you to lead them.

One issue that gets supervisor/managers into trouble is favoritism. It doesn’t even have to be true; perception in any workplace is often seen as fact. If one employee thinks that you favor another employee over them you will instantly lose their respect (not to mention a certain amount of work ethic). This can be especially difficult if you have worked with a group for an amount of time as coworkers and then you are promoted to supervisor. You will already have developed relationships and more than likely friendships with them so some of the perceptions may start with the start of your new role. If this is the case it may be a good idea to have a discussion with the group once the new role is assumed.

I have had the experience of taking over for someone that had their responsibilities taken away so I had some hard feelings to deal with when I took over. It was very difficult but I learned that if I took it day by day and worked with each individual they eventually came around and understood I was only there to help. There are all different kinds of situations that pop up as we lead our teams. We fight fires and make sure we don’t take on too much water that we cannot float. If you do not address these issues when they present themselves you may wait too long and not be able to steady the ship.

 

Herasuta

Matthew Herasuta, MBA, MLS(ASCP)CM is a medical laboratory scientist who works as a generalist and serves as the Blood Bank and General Supervisor for the regional Euclid Hospital in Cleveland, OH.