Conflict management is an essential skill for anyone who works in patient access, in light of angry patients, frustrated clinicians, and sometimes even trouble-making colleagues.

“Many times, it is a misunderstanding, or can be resolved by meeting with whomever the conflict involves,” says Marion Knott, clinic access manager at Tampa, FL-based Moffitt Cancer Center.

Here are some recent examples from the patient access department:

Patients sometimes arrive early or late for appointments, and want to be seen. “These are handled on a case-by-case, clinic-by-clinic basis,” Knott says. Patient access staff work with the patient’s provider to determine how to handle these situations.

Patients complain about long wait times. “Patients are anxious already,” Knott says. “When the provider’s clinic day is not running on time, we are many times left with upset patients.” Keeping patients updated is the main approach patient access staff use to defuse tension.

Requests for same-day add-ons for diagnostic tests can’t always be accommodated. “Many times, we are the middle man between the clinical team’s request and the imaging center who cannot accommodate,” Knott explains. Patient access is in the position of explaining the process to both sides.

Staff spread misinformation about colleagues. Recently, changes were made to the areas covered by supervisors, because one supervisor transferred to a new area. Another supervisor was hired to cover that area. “Regardless of how transparent you make the change, rumors start — in this case, about things that one supervisor supposedly said about the other,” Knott says. To defuse the conflict before it began, the two supervisors met face to face. “They know they are both on the same page,” Knott says. “Going forward, they have established a unified front to any rumors or allegations.”

Patient access staff are wrongly blamed by colleagues. An issue arose involving staffing during the last two hours of the day at one clinic. “In this particular area, we normally have three people 5:00 p.m. until 7:00 p.m. for late clinic support,” Knott explains. However, on a particular day, there were two callouts, so there was only one employee available.

“When this sort of thing happens, we have a process in place to put up the appropriate signage at the checkout area,” Knott notes. This directs the patients to the part of the clinic where that person works for follow-up scheduling.

On Monday morning, Knott received an email from one of the clinic managers, stating that patients were left without direction. The clinic supervisor wasn’t included on the email, so Knott contacted him to obtain the facts. The supervisor assured her that the correct process actually had been followed, and the employee who was present at the time confirmed this. Knott added the supervisor to the email loop and advised the manager that the supervisor would be responding with the details. “When he did, the only response back from the clinic management was that we may need better signage,” Knott recalls.

When interviewing potential new hires, Sandra Rivera, RN, BSN, CHAM, always asks them to give an example of a conflict they’ve had with a patient, a coworker, or a supervisor at their current job. “This lets us know how the candidate views the work environment, and how they problem-solve,” says Rivera, director of patient access. If the applicant gives the example of a patient getting angry because someone asked him or her for payment, Rivera probes further. “We are looking at how they describe the issue. Did they listen to the patient? And how did they resolve this issue? Did they go to a manager?”

To improve conflict resolution skills in patient access employees, Knott routinely questions staff about why they believe someone acted a certain way.

“I truly don’t think that many times people are intentionally trying to cause conflict,” she says. “Everyone is different, and we all need to be mindful of that.”