Healthcare conflict management in resource-constrained settings: evidence from two hospitals in Ghana

Conflict is a recurring feature of healthcare delivery, especially in hospitals that operate with limited staff, inadequate supplies, and heavy workloads. Although conflict among healthcare workers in Ghana has been documented, little research has explored how it emerges within the everyday routines of resource-constrained hospitals or how staff interpret and respond to it. This study examined the causes, effects, and management of institutional conflict in two public hospitals in the Effutu Municipality, using Organizational Information Theory and the Institutional Logics Perspective to guide interpretation.

A qualitative phenomenological approach was used to explore staff experiences of workplace conflict. Thirty healthcare workers from clinical, administrative, and support units were purposively selected based on their direct exposure to work-related conflict. Data were gathered through semi-structured interviews and four focus group discussions, audio-recorded with consent, transcribed verbatim, and analyzed thematically following Braun and Clarke's framework. Trustworthiness was ensured through triangulation, member checking, reflexive journaling, and a clear audit trail.

Conflict stemmed from three overlapping sources, namely communication breakdowns, competing professional priorities, and interpersonal or behavioral tensions. Staff described rushed or incomplete handovers, unclear directives, and documentation gaps as frequent triggers. Disagreements between clinicians and administrators over resource use and decision-making authority intensified these tensions, particularly in moments of scarcity. Personal attitudes, tone of communication, and strained relationships further complicated teamwork. The effects were substantial, including threats to patient safety, reduced productivity, emotional exhaustion, and concerns about the hospitals' public reputation. Conflict was managed through management-led mediation, appeals to professional codes of conduct, and informal grouping of staff with shared backgrounds, though these strategies often addressed surface issues rather than underlying structural pressures.

Addressing healthcare conflicts requires more than interpersonal mediation. Strengthening communication processes, supporting collaborative decision-making, investing in staff capacity, and improving organizational systems are essential for reducing conflict and improving patient care.