Patricia Moore and Lawrence SusskindFive-party, four-issue negotiation among representatives for a financially struggling hospital's administrators, doctors, and nurses over budget priorities and expanded application of the managed medical model
A hospital in a large urban center is struggling to improve patient care, meet financial obligations, and resolve inter-professional differences. A new Medical Management Model, under which physicians assume responsibility and accountability for the operation of all medical services, has been developed by the Chief of Medicine. The CEO and Chief Financial Officer have both supported the model, as well as the new Management Information System on which it rests. Other members of the hospital community–most notably the Vice President for Nursing and the most senior Attending Physician–are either opposed to its adoption or determined to obtain some compensating benefits if they go along with it. The CEO has called a meeting of these five major players to see if they can reach agreement on four issues facing the Executive and the Board of Directors. If the CEO cannot obtain agreement on a package, the Board will make decisions on these issues; none of the managers would be happy with that outcome.
This five-party exercise requires approximately 3 1/2 hours to play and debrief; additional preparation time is useful. Negotiations require a minimum of 90 minutes. General instructions are distributed at some point prior to the start of the exercise. At least 20 minutes should be given for reading the general instructions, 20 minutes for the confidential instructions and 20 minutes for same-role group discussion — giving players time for preparation and strategy. Allow 90-105 minutes for negotiating and 45-60 minutes for debriefing.
Room with seating and writing materials for 5. At least one private breakout room is highly recommended.
- Interests vs. positions – Many difficult negotiations start with parties offering their positions. It is important to identify the underlying interest behind these positions. Focusing on interests encourages the parties to listen carefully to each other so as to discover what each considers important. This encourages joint problem-solving rather than adversarial posturing.
- Different values and priorities facilitate agreement building: When parties value issues differently, the possibility of reaching an agreement is high if the parties are able to identify these differences during the negotiation. Awareness of different preferences and values can enable negotiators to work together and structure agreements which create maximum value for all parties.
- Trading across options to create a package: Packaging involves putting together a proposal that provides solutions to a set of problems. In many negotiations, no agreement can be made by dealing with each issue separately. However, agreement can be reached by parties trading across all the issues.
- Coalitions: The building of coalitions is an important consideration in multi-party negotiation. It is important for parties to ask themselves, “who might share my interest? If we unite as a coalition, might be able to block agreements that do not meet our interests? How stable is our coalition and who are my preferred coalition partners?” Coalitions are likely to be fragile and unstable. Members of coalitions should for ways to strengthen the coalition. This will frequently involve paying close attention to coalition members’ interests and priorities.
- The Mediator or Manager: Managers frequently function as mediators. The skillful use of mediation techniques can benefit not only the manager personally, but also the participants as a whole, in terms of maximizing value.
For all parties:
- General Instructions
- Fact Sheet from Executive Summary prepared by hospital consultants
Confidential Instructions for
- Dr. M. Mason, M.D., Chief of Medicine
- C. Marshall, Chief Financial Officer
- N. MacNamara, Senior Vice President of Nursing
- G. Bennett, CEO
- Dr. A. Parker, M.D., Senior Attending Physician
Teacher’s Package (58 pages):
- All of the above
- Teaching Note
Health care negotiations; multi-party negotiations; managed conflict inside the organization
Williams Medical Center
St. Francis Hospital and the Managed Medical Model Attributes
- Time required:
- 3-5 hours
- Number of participants:
- Teams involved:
- Agent present:
- Neutral third party present:
- Teaching notes available:
PON Teaching Negotiation Resource Center
Soft copy vs. hard copy
You may order this role simulation in either soft copy (electronic) or hard copy (paper) format. If you select the soft copy option, you will receive an e-mail with a URL (website address) from which you may download an electronic file in Adobe Acrobat PDF format. You will have one week to download your materials from when you receive the email. You are then only authorized to use, print, or share the materials as many times as the number of copies you purchase. The TNRC charges for use of this simulation on a per-participant basis. Therefore, you must purchase a separate copy of this simulation for each person who will be participating, regardless of the number of roles in the simulation. You will only receive a link to one electronic file, which includes all general instructions, confidential instructions, and any teaching notes for the simulation. You should separate out the instructions before distributing to participants.
If you select the hard copy option, you will receive paper copies of this role simulation via the shipping method you select.
For additional information about the soft copy option, please visit our FAQ section, or contact the PON Teaching Negotiation Resource Center at firstname.lastname@example.org or 800-258-4406 (within the U.S.) or 301-528-2676 (outside the U.S.).
Please note: At the present time, Teaching Negotiation Resource Center soft copies are compatible with the following versions of the Adobe Acrobat Reader: English, German, French, Spanish, Swedish, Portuguese, Japanese, and Korean. If you have a different version of the Acrobat Reader, you may wish to download one of these at http://www.adobe.com/products/acrobat/readstep2.html, or contact the PON Teaching Negotiation Resource Center at email@example.com, 800-258-4406 (within the U.S.), or 301-528-2676 (outside the U.S.) for further assistance. This restriction does not apply to the freely available Teacher’s Package Review Copies.
Ordering a single copy for review
If you wish to review the materials for a particular role simulation to decide whether you’d like to use it, a PDF, or soft copy, version of the Teacher’s Package for the simulation is available as a free download from the description page of most role simulations and case studies. All Teacher’s Packages include copies of all participant materials. In addition, some Teacher’s Packages (but not all) include additional teaching materials such as teaching notes or overhead masters.
Ordering copies for multiple participants
To order multiple copies of a role simulation for use in a course or workshop, simply enter the total number of participants in the box next to “Quantity.” There is no need to calculate how many of each role is required.
If you are ordering hard copies, the Teaching Negotiation Resource Center will calculate the appropriate numbers of each role to provide, based on the total number of participants. For example, if you wish to order a 2-party role simulation for use with a class of 30 students, you would enter “30” in the box next to “Quantity.” You then would receive 15 copies of one role and 15 copies of the other role, for use with your 30 participants. As another example, if you ordered 30 participant copies of a 6-party role simulation, you would receive 5 copies of each role.
In the event that the number of participant copies you order is not evenly divisible by the number of roles in the simulation, you will receive extra copies of one or more roles. Participants receiving the extra roles may partner with other participants playing the same role, thus negotiating as a team. So, for instance, if you ordered 31 copies of a 2-party role simulation, you would receive 15 copies of the first role and 16 copies of the second role. One of the participants playing the second role would partner with another participant playing that same role, and the two would negotiate as a team.