Forums

How would you come to a consensus with two groups whose goals are very different?

Group 1: The mission of this group is to write medication criteria that suits the best interests of the patient based on the available evidence and a perfect world. The best practice, focus on effectiveness.

Group 2: The mission of this group is to take receommendations from group 1 and operationalize them in the real world. Operational Implementation, focus on efficiency.

Would you:

1. Have a discussion with both groups present?
2. Have group 1 give their recommendation to group 2 and group 1 make their changes based on group 1?
3. Have a third party be tiebreaker?

The other caveat is that multiple members are part of both groups. Scenario #2 is how it is done, but things keep going in a circle with the same material being presented at different meetings. People who are in both groups make efficiency the priority not effectiveness.

Due to the nature of the medical/pharmacy field we may have to make 4 to 6 of these decisions in a 2 hour meeting that occurs every other week.

Thank you for your input.

TomW's picture

I'm not entirely clear.... what issues do the two need to reach a consensus on? The compromises between idealism and implementation?

NorthwestPassage's picture

[quote="tomwaltz"]I'm not entirely clear.... what issues do the two need to reach a consensus on? The compromises between idealism and implementation?[/quote]

Yes, group 1 wants the best practice and to implement the "ideal" guidelines.

Group 2 because they think the guidelines will be difficult to implement wish to make drastic changes based on their experience and workload.

One is example that group 1 want to implement guidelines based on diagnoses in textbooks and are considered the standard of care in the medical literature.

Group 2 wants to modify the guidelines becuase they believe that it would be too difficult to implement the guidelines and that the responses that they request for the guidelines would be largely ignored. This is based on their experience, not on any hard data.

Hope that helps.

RichRuh's picture

The discussion should focus on the goals of [i]the business[/i] and how to achieve them- not about the goals of the groups. I suspect getting the team leaders together is the right way to achieve that.

jhack's picture

Health care is famous/notorious/infamous for the lack of alignment amongst goals. Rarely do constituents agree on basics. Doctors and nurses are focused on patient care. Would you agree to a different process or procedure if it might lead to death or disability?

Payers/insurance companies and hospitals have goals of their own. There are structural and systemic issues that prevent them from having shared goals (you can't really fire doctors). "Sure, that procedure might work at some fancy pants research hospital in X city, but here in inner city Y we've got to do things different." And if the hospital spends more on patients than they can bring in, because they want everyone to have the best care possible, eventually they'll serve no one.

I think you have to have both groups together, not just the leader. If both groups don't "own" the decision, they are not likely to follow it. A tiebreaker would work only if both groups agreed ahead of time that that person was respected enough to take on the role.

This is a very tough situation, and my advice is given most humbly.

jprlopez's picture

[quote]
Group 1: The mission of this group is to write medication criteria that suits the best interests of the patient based on the available evidence and a perfect world. The best practice, focus on effectiveness.

Group 2: The mission of this group is to take receommendations from group 1 and operationalize them in the real world. Operational Implementation, focus on efficiency.
[/quote]

I would be wary when making recommendations based on a perfect world specially to an operations group. I remember a comment I heard in the field once about how you can care so much about processes when what the people need is immediate relief.

Are these internal groups in the same organization? It would be a good idea as Rich suggested to align them based on organizational goals rather than group goals if they are internal groups.

One thing not clear as well is you role in all of this. Are you the manager for both groups or in one of the groups? The advice we can give can be more specific depending on this.

You may also want to look back if consensus decision making is what is really needed. Is this the organizational culture/norm?

WillDuke's picture

[quote]How would you come to a consensus with two groups whose goals are very different?[/quote]

I think I would start with whether or not their goals really are different. It doesn't seem to me that they are. Aren't both groups primarily interested in taking care of people?

It seems to me that group 1 just isn't being realistic in group 2's opinion. And group 2 is a bunch of heartless money-grubbers in group 1's opinion.

Open up communication. Maybe have a regular meeting where both groups are present. Get these people to work together as a team. Get them to see each other as decent people with good intentions.

Mark's picture

I have two thoughts. First, this is a classic negotiation problem. I strongly urge you to read "Getting To Yes" about negotiation, and implement some of the great suggestions therein. I teach negotiation, and it works wonderfully.

Second, this is a failure of leadership that has led to a failure of professionalism and therefore a loss of communication. The two groups believe there is no sanction for their failure...and that means the boss isn't dong enough to make things clear and to ensure timely outcomes.

Mark

thaGUma's picture

Is there a need for agreement?
Group 1 identifies a theoretical ideal. Group 2 translates this into practical procedure.
If Group 1 do their job correctly, group 2 will have all the information to construct a meaningful, pragmatic solution.
Why does Group 1 need to be involved subsequently? They will naturally raise concerns whenever one of their recommendations is 'watered down'.
At best they provide a list of fall-out from group 2 decisions. Group 2 should be able to identify these themselves before making recommendations.

Chris

NorthwestPassage's picture

I appreciate all the advice provided.

[quote="jprlopez"][quote]
Are these internal groups in the same organization? It would be a good idea as Rich suggested to align them based on organizational goals rather than group goals if they are internal groups.

One thing not clear as well is you role in all of this. Are you the manager for both groups or in one of the groups? The advice we can give can be more specific depending on this.
[/quote]

[/quote]

Both groups are internal and I am the chair of both committees. The members are made up of some of my directs (I am a manager), indirects, managers and a few directors.

So far my plan looks like:
1. Review the company’s Mission, Vision and goals so that both all we are all aligned at each meeting.
2. Review groundrules prior to each meeting.
3. Review consensus procedures and negotiation techniques
4. Communicate expectations and encourage open communication

I feel more confident now after reading everyone's comments. I'll let everyone know how the next few meetings go (if you want).

Mark's picture

Wait! You're the chair? Whack their heads together!

Okay, mostly kidding. I'm glad I made the point about leadership in my previous post. This situation is now MUCH easier, because you can make things happen.

Consider steps to encourage both sides to develop relationships outside of the meetings. Consider a cross functional team which makes recommendations to the larger group. Consider some basic work around introductions and the basics of negotiations and what consensus really is. Consider changing membership to eliminate those who don't listen or are argumentative. There is NOTHING wrong with standing firm on a point...but that often goes along with rudeness, or less than team-aligned behaviors. You don't have to stand for that. get rid of those who don't play nice. There are others who will stand up on key points....WITHOUT driving the groups apart.

It's all about people...and more communication is better.

Keep us posted.

karaikudy's picture

This is the classic situation I face when I work on projects and product introduction. As Safety, Health and environment professional in a ideal world, when we conceive projects, we can go ahead with everything as best in place on paper,as much equivalent to gold plating. That makes my day with no after issues from operational perspective once the project is alive and kicking.

We as a team optimize the requirement that need to go in, based on the process of Risk assessment, with Probability factor of something going wrong (Adverse situation) multiplied by severity factor of the consequence. After identifying,then accept protection level. Then work for the risk mitigation by allocating optimum resources and working action plan for the same. The philosophy of [b]"Minimum adequate"[/b] is used for[b] execution to convert paper situation in to reality[/b]. Of course, any statutory requirements is 0 compromise. The same methodology is used for introducing new products and service implementation. This may leave some situation as no change or improvement. But we are aware of it and we are ready to live with it.

Sounds technical, but helps and keeps every one happy at the end.

Karthik.