The healthcare industry is a complex system of multidisciplinary professionals constrained to work together in other to achieve the collective goal of good patient health, safety and wellbeing. Delivering healthcare requires different professional groups working as teams, sharing information, and reaching agreement [1]. Whenever health professionals work together as a team, conflict is inevitable and conflict can have negative effects on patient care, job satisfaction, personal wellness, and professional productivity [2, 3]. The WHO long recognized the need for interprofessional education as a strategy for achieving world health goals [4]. Teams in health care delivery may be composed of medical doctors, nurses, laboratory scientist, radiologic diagnosticians, physiotherapists, pharmacists, medical records personnel, dieticians, health economists among many other categories. A crucial assumption therefore is that functional teams are required to better provide proper patient care.
The healthcare teams may also take many forms such as: disaster response teams; teams that perform emergency operations; hospital teams caring for acutely ill patients; teams that care for people at home; and teams that include the patient and loved ones, as well as several supporting health professionals [5]. Due to these different forms healthcare teams could take, they can therefore be large or small, centralized or dispersed, virtual or face-to-face, while their respective tasks can be focused and brief or broad and lengthy [5]. Psychologists have proposed 4 categories: (a) advice and involvement teams, (b) production and service teams, (c) project and development teams, and (d) action and negotiation teams. An example of an advice and involvement team in health care is a quality improvement team, which serves to recommend process changes in a healthcare practice or hospital and to engage people in making the changes successfully [6].
Collaboration between these heterogeneous healthcare teams is a crucial determinant of the quality-of-care process. Quality of teamwork among healthcare professionals have been associated with patient mortality, morbidity, patient satisfaction and healthcare provider job satisfaction [1, 7]. Interprofessional collaboration in healthcare delivery is therefore essential for improved patient outcome. One clear barrier to inter-professional collaboration is conflict [2]. There are many reported sources of conflict in the health care delivery settings, but these are rarely documented or even discussed [8]. Intra-professional conflicts were linked with less patient-centred care, whereas inter-professional conflicts were linked with less timely care. In any case there is a constraint to patient care [9].
Conflict, in general, refers to forms of friction, disagreement, or discord occurring within a group when the beliefs or actions of one or more members of the group are either resisted by or unacceptable to one or more members of another group. Conflict is a complex phenomenon. It can exist at different levels: intrapersonal, interpersonal, intra-group, inter-group [10]. Interpersonal conflict occurs within the person and takes place when a person must choose between alternatives while interpersonal conflict occurs between people [10]. Conflicts can also arise between members of the same profession, known as intra-professional conflict, or it can occur between members of two or more profession, known as inter-professional conflict [11]. Inter-professional conflict may involve violence, interpersonal discord, and psychological tension. Conflicts of interests, values, and ethics could arise in healthcare settings where each health care professional have a different educational background, code of ethics, value system, and perspective on patient care as well as rivalry [12].
The typical Nigeria healthcare delivery system is made up of teams, it is a classical system where conflict is inevitable. And the conflict situation could be confounded by certain cultural traditions. The scope and nature of the conflicts in healthcare teams in Nigeria has not enjoyed deserved inquiry and documentation congruent to its size and diversity especially in resource constrained settings in which many healthcare teams operate in the country. Workplace conflict among professionals is reportedly frequent in many countries [9]. Conflicts within teams can involve harsh language (yelling, threats, profanity), blaming, breakdown in communication, or disruptive conduct which may result to poor teamwork associated with high level of medical errors and adverse events for patients [1, 9]. Some investigators have reported that not all conflicts in workplaces are problematic; noting that when properly handled, such conflicts may yield positive outcomes and strengthen group dynamics. These situations are only problematic when poorly managed resulting in poor patient care, low job satisfaction and declined professional productivity [2]. Without a proper understanding of conflict between health care professionals, designing effective conflict management training programs for trainees that reflect the complexity of the clinical working environment is difficult.
In this paper, the authors studied conflicts situations of health teams and attempted to identify and describe the forms and sources of inter-professional conflicts based on real-life experiences of practitioners. We hypothesized that workplace conflicts in health professions deleteriously constrains patient care and professional development. The purpose of this study is to begin to define and document the potential consequences of conflicts in our system and to seek sustainable solutions for the overall betterment of patient care. We expect that the paper will help identify and categorize types of conflicts in Nigerian health teams.