Too often health care managers spend their time dealing with conflict in the workplace. Many leaders I work with tell the same story: Their teams are affected, to one degree or another, by infighting, negative attitudes, cliques, back-biting, gossip, and angst. In the highly charged environment that is health care, stress comes with the territory, but when team conflict is pervasive, the root causes need to be identified and addressed.

Here are four common causes:

1. You tolerate bad behavior. If managers fail to hold individuals accountable for inappropriate, disrespectful, or negative comments or for lazy, sloppy, or substandard performance, the team suffers. Establish expectations for how team members will communicate and act, and appropriately address those who don't meet expectations. Insist that members of your team treat each other with respect and perform the duties of their job well. Make it clear in words and actions that anything less won't be tolerated.

2. Your team is overworked. At least 75 percent of the managers I work with tell me their team is under-staffed. Perhaps there's a vacancy, or several. Perhaps the practice has grown but funding for expanding the team is limited or nonexistent. In any case, when team members are pushed to their limit on a daily basis, they “stop being polite, and start getting real,” as a TV show famously said. Stress, fatigue, and pressure remove our filters. Negative environments narrow people's emotions to survival mode (fight or flight). Be sure you're not overestimating what people can reasonably accomplish in their position. If your team legitimately needs help, do whatever it takes to get it for them.

3. There's a toxic personality. Is there one person on your team who, if they were to leave, would largely make your problems go away, too? If you answered yes to this question, you have a personnel management issue that needs to be addressed. Left unabated, it can be cancerous to a team. The first step is to engage that person in focused, specific, behavioral conversations about what he or she needs to do differently. If no change occurs, involve Human Resources and take appropriate steps to remove that person.

4. Your team members don't know or don't trust each other. In most work environments, employees spend a lot of time together. But if they are never given the chance to interact with each other beyond the duties and tasks of their jobs, they rarely get a glimpse of each other's humanity. Find ways to create non-work interaction at work. Celebrate birthdays, share photos, or plan staff retreats. When colleagues get to interact as people, it builds stronger team relationships. They become less afraid to ask for help and admit mistakes, and trust grows.

When faced with team conflict, the most successful leaders recognize that they need to take ownership of their team culture. Addressing the root causes of conflict outlined here can help your team move past problems and perform at a higher level.