COHESION: VALUE AND SAFETY
THROUGH NEGOTIATION
Resilient Health Care Network
Dr Paul J Lane and Dr Andrew J Johnson
13 August 2015
The 10C’s
•
•
•
•
•
Cohesion
Clear Ownership
Communication
Cognition
Challenge
•
•
•
•
•
Compliance
Competence
Culture
Constraints
Capture
What is Cohesion
•
•
•
•
•
•
cohesion
kə(ʊ)ˈhiːʒ(ə)n/
noun: cohesion
the action or fact of forming a united whole.
"the work at present lacks cohesion"
synonyms: unity, togetherness, solidarity, bond, sticking together,
continuity, coherence, connection, linkage, interrelatedness
"rewarding individuals breaks the cohesion in the group"
• Physics
• the sticking together of particles of the same substance.
Cohesion – The Force Multiplier
• We demonstrate
mutual respect in
practice
• You can show that you
respect someone by
investing in them with your
trust.
• Being brilliant is no great feat if
you respect nothing.
– Johann Wolfgang von
Goethe
• One of the most sincere forms
of respect is actually listening
to what another has to say.
– Bryant H. McGill
Let every man be respected as an
individual and no man idolised
Albert Einstein
Cohesion – Sounds Great
How do I get more of that?
Healthcare really looks like this …
8
Healthcare Delivery Continuum
Information Delay and Decay
…Learning to Juggle
Adapted from Hollnagel
Creating Value with Negotiation
• To be able to effect
change we need to
negotiate.
• There are rules to this
sport and with training
you can master them.
• Integrative vs Distributive
• Move from positions to
interests
Two sisters, one orange
Relationship
Negotiation Styles
Accommodate
GWA
Collaborate
Compromise
Give / Take
Engage / Withdraw
Accept / Redefine
GER
TWA
Avoid
GWR
Compete
TEA
Outcome
Con
TER
RobTWR
•
Golden Rules
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
If you get the process right then the result will look after itself.
Concessions are essential to negotiation
Go Slow to Go Fast
Be completely trustworthy yourself but NOT completely
trusting
Do not engage in misleading or deceptive conduct
The Primary mechanism that brings most negotiations to a
close are enforceable deadlines
Help your opponent to back away WITHOUT backing down
When in doubt compromise
The other side always has the right of veto
High emotion gets in the way of rational negotiation
Interfere with the ritual of negotiation at your peril
Your (credible) starting point has more to do with the outcome
of a negotiation than any other single factor
Never do a deal that's worse than your No Deal Option
Don’t move too soon, don’t move too late
Try to negotiate in a room with an external window
Dress appropriately for the occasion
Talk to people in their language
Purpose of a negotiation is to control your own outcome
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
If you must negotiate by phone always make, never take the
important call
Say what you mean and mean what you say
By all means disagree but don't be disagreeable
You can almost never over-consult
Keep your eyes on the prize
Don't get mad, don't get even, get what you want
Escalation is largely your choice
Never interrupt an offer or a prelude to an offer; listen
respectfully
Thinking trumps instinct
Your counter-party is almost never behaving irrationally
The engine room of negotiation are the interests of the parties
Nothing is agreed until everything is agreed
Two things will stop you cutting a deal: impasse & uncontrolled
escalation
If they are still in the room they are still negotiating
The goal is to establish slow forward controlled momentum
The negotiator least affected by deadlines has the greater
power of negotiation
Most deadlines are negotiable
Good negotiations take time to mature
Open ended negotiations rarely work effectively
Good negotiations use up all the allocated time for negotiation
Get them into a habit of agreeing
Committed negotiations always succeed
Flip your
approach
• Investigate to
understand WAD
• Integrate Interests
• Negotiate in good
faith
• Create Value
• Do not
Procrastinate
They liked it.
In Summary
• Its all about relationships
• You can’t improve a service unless you know
how it actually works
• Look for the interests, avoid taking positions
• If it goes to power, you have failed to
negotiate and lost the opportunity to create
value
COHESION AND VALUE
• Understanding the interests facilitates
RESPECT leading to COHESION
• Aligning the interests CREATES VALUE
The Ten C’s
Safety II: “Safety”? or
“Creating Value”
Value
Safety
•
•
•
•
•
•
•
•
value
ˈvaljuː/
noun: value; plural noun: values
the regard that something is held to
deserve; the importance, worth, or
usefulness of something.
synonyms:merit, worth, usefulness,
use, utility, practicality, advantage,
desirability, benefit, gain, profit, good,
service, help, helpfulness, assistance,
effectiveness, efficacy, avail,
importance, significance, point, sense;
informal mileage
•
•
•
•
safety
[seyf-tee
noun, 1. the state of being safe;
freedom from the occurrence or risk of
injury, danger, or loss.
2. the quality of averting or not causing
injury, danger, or loss.
3. a contrivance or device to prevent
injury or avert danger. …
6. Football. A play in which a player on
the offensive team is tackled…
8. Slang. a condom.
PAUSE FOR APPLAUSE
Elastic Boundaries in an
Imperfect System
What we like to think
What we really
know in our
heart of hearts
then stretch