Problem Solving and Prevention in Health Care
3 units/practicum
Prof. Linda Morton
California Western School of Law
Fall 2004

Students who take this course will learn a wide variety of collaborative approaches to problem solving and prevention in the health care context. Approaches include negotiation, mediation, arbitration, judicial processes, with particular emphasis on the newer practices of facilitation and systems design in conflict management. These approaches will be taught in a mandatory weekend training early in the course. Classes will include discussions from the fields of health care and law. In lieu of a final exam, students will conduct a simulated problem resolution of a health care issue in class, and work in teams to design an actual conflict management plan for a health care facility in San Diego.

This course is for students who want hands-on experience preventing and solving problems related to health care. There are no prerequisites for the course. The syllabus and course requirements are available on Prof. Morton’s web page.

The goals of this course are to expose students to a variety of approaches to issues in health care, and to provide students with continuous opportunities, in and outside of class, to practice these approaches to problem solving and prevention. The text for the course is Collaborative Approaches to Resolving Conflict (CARC) by Myra Warren Isenhart and Michael Spangle, with an accompanying supplement (S), available in the bookstore.


Week/Topic Reading Class
1. 9-1 Conflict Theory &
Culture of Health Care
CARC Ch.1; S 1 course admin; discussion
2. 9-8 Problem Solving CARC Ch.2; S 2 discussion; team reports
**Mandatory Training: Fri 9-10 from 4-8pm & Sat 9-11 from 9-5pm at CWSL**
3. 9-15 Negotiation CARC Ch.3; S 3 discussion; team reports
4. 9-22 Mediation CARC Ch.4; S 4 discussion; team reports
5. 9-29 Facilitation CARC Ch.5; S 5 discussion; team reports
6. 10-6 Arbitration CARC Chs.6&7; S 6 discussion; team reports;
Report 1 due in class
7. 10-13 Systems Design CARC Ch.8 & S 7 discussion; team reports
8. 10-21 Creative Thinking S 8 team reports; mid trim evals
9. 10-27 Cultural Issues S 9 discussion; team reports;
Report 2 due in class
10. 11-3 Private Meetings Work on simulation No class
11. 11-10 Skills Summary Work on Rep 3 & sim Simulations 1 & 2
12. 11-17 Skills Summary Work on Rep 3 & sim Simulations 3 & 4
13. 12-1 Career Opportunities Finish CARC; S 10 discussions; team reports
14. 12-8 Team Reports Work on Report 3 team reports;
Report 3 due in class

Requirements and Grading

Your grade for the course is based on your Professionalism (100 pts.), your In Class Simulation (100 pts.), and your 3 Reports (50 pts. each), as described below.

Professionalism includes
- attending every class (you are allowed one absence)
- being on time (arriving more than 10 mins. late or leaving more than 10 mins. early counts as an absence) and submitting reports timely
- participating in class discussion (joining in the discussion, asking questions)
- being respectful of others (listening; being courteous)
- collaborating with your team (problem solving and simulation) & other classmates and members of the community

Your In-Class Simulation will be a Negotiation, Mediation, Facilitation, or Arbitration problem of your team’s own design. Your team will have ˝ hr of class time to perform it, with a brief evaluation following. The remaining members of the class can either participate or observe, depending upon the nature of your problem. Within one week of your simulation, you must turn in a one-page evaluation of your team collaboration and your performance. We will discuss the process and grading for the simulation in further detail in class.

Your Community Health Care Problem will be an actual health issue in the San Diego community. Your team’s job is to create a problem solving or prevention plan for the issue, in conjunction with other community members involved. Each team will turn in one report for Reports 1 & 2. Every individual on the team will receive the same grade for the reports. The third report will be an individual, not a team report. All reports are to be no more than 4 pages, double-spaced. The substance of the three reports is as follows:

Report 1: Statement of Situation; Problem Definition; Stakeholders; Investigation
Evaluation of the team process (separate page) (5 pp. maximum)

Report 2: General Approaches/ Possible Solutions; Evaluation of the Team Process (separate page) (5pp. maximum)

Report 3: Your recommended approach, including any possible creative solutions;
Your evaluation of the team process; Your description of what you learned. (5 pp. maximum)

Supplemental Readings

1. Culture of Healthcare
    Debra Gerardi, Why Manage Conflict in Health Care? (2003)

    How does the culture of Health Care create barriers to conflict resolution?

2. Problem Solving and Prevention
    Bryan A. Liang, Understanding and Applying Alternative Dispute Resolution Methods in Modern Medical Conflicts, 19 J. Leg. Med. 397 (1998);
    Debra Gerardi and Ginny Morrison, “Uses for Conflict Resolution in Health Care”, Training Manual, Conflict Management in Health Care – the Inside Scoop for Mediators (April, 2004)

    What factors determine choice of conflict resolution technique(s)?

3. Negotiation
    Leonard J. Marcus, A Culture of Conflict: Lessons from Renegotiating Health Care, 5 J Health Care Law and Policy 447 (2002)

    How are the techniques described as “A Walk in the Woods” specific to Health Care?

4. Mediation
    Douglas W. Taylor, Assessment and Plan for Medical Malpractice: Quality Improvement through Mediation, 6 DePaul Journal of Health Care Law 343 (2003)
    Eric Galton, Mediation of Medical Negligence Claims, 28 Cap. U. L. R. 321 (2000)

    How do mediations of health care disputes differ from the typical mediation model?

5. Facilitation
    Linda L. D’Antonio and Roopa Nagarajan, Use of a Consensus Building Approach to Plan Speech Services for Children with Cleft Palate in India, Folia Phoniatrica and Logopaedica, 2003;55:306-313 (2004).

    How does Dr. D’Antonio’s facilitation model compare with other facilitation models?

6. Arbitration
    Fillmore Buckner, A Physician’s Perspective on Mediation Arbitration Clauses in Physician-Patient Contracts, 28 Cap. U. L. R. 307 (2000)
    Edward A. Dauer, Engalla’s Legacy to Arbitration: The Importance of Independent Administration, 27-MAR Colo. Law. 37 (1998)
    Juris Publications, Inc., Kaiser Permanente Promises to Modify its Arbitration System in Light of Advisory Panel Report, 9 World Arb & Med Rep 27 (1998)

    Under what conditions might you suggest arbitration of a health care dispute?

7. Systems Design
    Karl A. Slaikeu, Designing Dispute Resolution Systems in the Health Care Industry, 5 Negotiation Journal 395 (1989)

    What principles of Systems Design are universally applicable?

8. Creative Thinking
    Jennifer Gerarda Brown, Creativity and Problem Solving, 87 Marquette L. Rev. 697 (2004)

    Consider a problem you currently have, and using one or more of the techniques described in the above article, try solving it creatively.

9. Cultural Issues
    Anne Fadiman, The Spirit Catches You and You Fall Down (1997)

    How can we use the experiences in treating the Hmong to better sensitize our healthcare system to non-Western cultures?

10. Career Opportunities
    Debra Gerardi and Ginny Morrison, “Marketing Principles”, Training Manual, Conflict Management in Health Care – the Inside Scoop for Mediators (April, 2004)

    How do you plan to incorporate what you have learned in your career?

Copyright 2004 Linda Morton. Teachers are free to copy these materials for educational use in their courses only, provided that appropriate acknowledgment of the author is made. For permission to use these materials for any other purpose, contact the author.