Conflict Management in Pediatric Intensive Care Units: Key Findings and Implications

Research on health and medicine has found that decision-making conflicts are common in pediatric intensive care units (PICUs) and can lead to negative outcomes for patients, families, and teams. A new study has explored the conflict management approaches used in these units, highlighting the need for standardized and evidence-based processes to address conflict and reduce disparities in outcomes.

Key Takeaways:

• The study found that conflict policies and behavior contract tracking are not universally implemented in PICUs, with only 65% of institutions having policies for conflict management and 23% tracking conflicts and their outcomes.
• Institutions that tracked conflicts and their outcomes were more likely to call ethics consults for conflict management and implement behavior contracts for more objective reasons.
• Respondents shared ideas for preventive and responsive processes that could be implemented and tested in the future, highlighting the need for standardized and evidence-based approaches.
• The study found that training staff in conflict management techniques is lacking, with few institutions providing such training.
• The research concluded that learning from existing management approaches could help develop standardized, generalizable interventions to reduce conflict and improve interventions.

Statistics:

• 57% of PICU physician and nursing directors responded to the survey, with 65 of the 120 surveys being complete enough for analysis.
• 30 of 51 respondents identified as female, with a wide distribution of reported years in current role and percentage of time spent in clinical care.
• 65% of institutions reported policies for conflict management, while 23% tracked conflicts and their outcomes.
• 25% of institutions called ethics consults for conflict management, compared to 0% of those that did not track behavior contracts.
• 73% of institutions implemented behavior contracts for more objective reasons, compared to 25% of those that did not track behavior contracts.

Sources:

• NewsRx. Studies Conducted at University of Pittsburgh on Health and Medicine Recently Reported (Pediatric Intensive Care Unit Conflict Management Perspectives Among Physician and Nurse Leaders). Health & Medicine Week. June 13, 2025; p 610.
• Pediatric Intensive Care Unit Conflict Management Perspectives Among Physician and Nurse Leaders. JAMA Network Open, 2025;8(5).