In Pursuit of Effective Communication in Health Service Organizations - Term Paper Example

?In Pursuit of Effective Communication in Health Service Organizations Health is wealth, as is accepted by most people. That is why more and more individuals are doing a myriad of means to achieve good health such as going on healthy and nutritious diets, exercising, getting effective medication for illnesses, therapeutic interventions and researching about life-threatening diseases that they want to prevent. Such increased health consciousness has brought many people to hospitals for regular medical check-ups in order to maintain their physical fitness as well as for continuous treatments for recurring illnesses. In view of this, healthcare professionals should be on their toes in providing high quality service to their growing clientele. To achieve this, teamwork should be established between doctors, nurses and other health professionals concerned with the provision of health services. Such team work entails effective communication. However, due to organizational and personality factors that bring about more issues such as the hierarchal positioning of hospital personnel, scheduling, and the management of multiple tasks, among others, communication within the organization usually suffers. This is emphasized further in multidisciplinary cases wherein health professionals from various fields work on a case. Transfer of knowledge from one professional to another may be impaired due to a host of factors. Personal Communication Human beings communicate their thoughts and feelings to one another in verbal and non-verbal ways. Verbal communication, or speaking out to another person is often accompanied by non-verbal language which includes facial expressions, gestures, posture, body language and tone of voice. Sometimes, such non-verbal expressions say more than the verbalizations of a person. The way one communicates and receives information matters much in the quality of relationships he or she has with others. Effective communication takes practice and hard work especially for those who are not skilled in interpersonal relations. Several factors need to be considered when communicating: age, gender, relationship to the person, nature of the communication exchange, temperament and personality and even culture. The adage “Actions speak louder than words” rings true in a variety of situations. In the workplace, people manifest explicit verbal communication and implicit, non-verbal communication (Lee, 2008). Explicit verbal communication takes the form of direct reprimands or written memos to delinquent workers. Implicit, non-verbal communication is more action-oriented. An example is a boss deliberately showing a delinquent worker that he is taking over the tasks formerly assigned to the worker. The boss may not say anything, but the message comes across very clear to the worker that his inefficiency is noted by the boss. In times of conflict, the impact of implicit, nonverbal communication and explicit, verbal communication (that is, the written norm) is never equal. The more visible and stark the image, the more effective the message is delivered and received. Lee (2008) gives the example of a Fortune 500 chief executive choosing to lunch spontaneously in the cafeteria with employees he has never met. He approaches them and asks for their perspective on street-level obstacles to strategic execution. A little while later, he begins to take notes on the back of an old envelope. His action of lunching with ground-level employees communicates the message that he values ideas of his people no matter what position they have in the company. His non-verbal language goes way beyond body language, facial expression and vocal intonation. To sum up, verbal and nonverbal interactions play a part in the effective exchange of ideas. LeFebvre (2008) advises that when speaking, one must also be aware of body language and tone and inflection of voice. She notes that different ideas may be conveyed by simply emphasizing different parts of the statement. Being an active listener helps one understand the message being relayed to him. As the listener, one should hold his response until the speaker is done, and keenly observe nonverbal cues expressed. It must always be remembered that communication is a give and take process. One must learn to wait his turn to be the speaker and the listener. Organizational Communication In the workplace, good communication is key in accomplishing tasks in pursuit of organizational goals. Dialogue is defined as “a sustained collective inquiry into the processes, assumptions and certainties that compose everyday experience.” (Isaacs, n.d.). In the organizational setting, dialogues are used to have a “meeting of minds”, extracting what each member believes and coming up with an agreed decision that takes into account those beliefs, Members think together, analyzing causes and effects, and end up understanding a shared meaning. Usually, they reach greater heights in idea-storming that as individuals, they could not have thought of. This is contrasted with the construct of consensus building wherein people “seek some rational means to limit options and focus on the ones that are logically acceptable to most people.” (Isaacs, n.d.). Usually, the final consensus is reached if only to end the discussion, and that is what the group can “live with for now”. There is no guarantee that whatever factor initially leading some members to disagree will just vanish after the consensus has been made. It is likely that some members walk away in resignation but not in total satisfaction. Richmond & McCroskey (2005) defines organizational communication as “the process by which individuals stimulate meaning in the minds of other individuals by means of verbal or nonverbal messages in the context of a formal organization” (p. 20). There are six functions that seem to dominate communication in the organizational context. The functions are to inform, regulate, integrate, manage, persuade, and socialize. These functions shall be briefly discussed in relation to the healthcare profession. Informative communication usually entails a message in written format disseminated to all the employees by way of memos, circulars, email, etc. This way, information is disseminated quickly. Another way to spread information in the organization is through regular meetings. When meetings are scheduled, employees must be prepared to raise questions regarding their concerns which need more information for them. This way, both management and employees get to open communication lines. Healthcare organizations need to be constantly updated with the current developments in health research. To maintain one’s good reputation in the community, healthcare workers should be vigilant in securing fresh information and diligently share it with the professionals and staff so they are adequately informed. Regulative communication is usually directed toward regulatory policies within the organization or messages about maintenance of the organization. Integrative communication focuses on the coordination of tasks, work assignments, group coordination, or the fusing of work units toward a common goal. In other words, it is communication directed at getting people to work together and have tasks coordinated so each member of the team is aware of what is to be done (Richmond & McCroskey, 2005). Huge problems are encountered when one staff group seems only concerned with doing their assigned tasks and not so much inquire about what the other groups are doing on the same case. The management function of communication is focused on getting personnel to do what is needed, learning information about personnel to know them better, and establishing relationships with personnel. Basically, if a manager is successful in these three, then he has better chances of gaining employee respect and support. The persuasive function enables one to influence another to do something in particular, sort of cajoling a co-worker to do something like covering for him when he fumbles at work. Finally, the socialization function of communication in the organization is the one that determines one’s survival in a team even if it is under stress. It attempts to get along well with others so that each one gets integrated into the communication network (Richmond & McCroskey, 2005). Some nurse managers, due to juggling of multiple tasks may be negligent of this function of communication that nurses under their supervision may see them as cold and distant. In healthcare organizations, the aspect of human connection is emphasized and it should be manifested from the organization outwards to the patients and back. Communication can either go horizontally, or across co-workers who are considered equals in terms of position in the organization, and vertically, indicating a hierarchy in position that either goes upward towards higher management or downward, towards rank and file. Downward communication from management to the employees usually involves job instruction, rationale, ideology, information and feedback (Richmond & McCroskey, 2005). Job instruction includes directions mandated by management such as direct orders, written memos, workshops on how to do the job, and so on. An example is the kind of treatment or therapy a patient should receive at a particular shift is instructed to the nurses on duty. Rationale is the rationalization or explanation of a duty or assignment and how it is compatible with what the personnel are already doing. Ideology is the philosophy of the organization that managers expect their employees to share. If they do believe in the same views, then communication would flow much easier within the organization. Information is concerned with acquainting employees with general knowledge that they need to know, such as regulations, changes in benefits, and general policies done (Richmond & McCroskey, 2005). In the case of health services, it may be new diseases that breakout, a new therapy approach that the hospital may be trying out or specific medications for certain symptoms. Feedback is the manager's way of giving employees information about how they are doing. This is usually expressed as praise, recognition, salary increase, criticism, a frown or a termination notice. Managers should provide feedback to their employees so that they would be guided well enough in their work performance. Employees are used to being the receiving end of downward communication, but usually struggle with initiating upward communication such as speaking up about one’s situation and need for consideration, request for an increase, complaints about a co-worker, etc. Upward communication can only be successful if those at the higher levels are willing to allow the communication to be effective. Horizontal communication is the more common, everyday kind that is transmitted from peer to peer. It usually focuses on how the work day goes, feelings about the organization or problems faced. In addition, horizontal communication promotes social interaction and increases one’s knowledge, communication skills and socialization skills that are necessary for survival in the organization (Richmond & McCroskey, 2005). Workers in the healthcare profession should be conscientious enough to provide high quality service. To achieve this, good team work must be established. The unified vision of what the organization wants to achieve and where it wants to go in the future in terms of quality, professionalism, services offered and expertise is what each of the team should aspire for. Management must be consistent in communicating to each worker its philosophy of providing the best quality health care and treatment through collaborative efforts of professionals from different disciplines. Each worker should be able to feel that he is part of a great team that sets high goals and successfully attains them. According to Burgess (2005), top leadership must be required to create conditions that engender knowledge transfer among the staff and convey that the benefits of knowledge transfer outweigh the costs. In the absence of this commitment, it is unlikely that attempts to increase knowledge flow will succeed. Koch (1995) has proposed a model outlining four factors essential in motivating staff to provide high quality service to their clientele. These are: (1) An understanding of the “psychology of excellence in teams”. This entails everything related to a psychological understanding of people and how they can work together towards quality improvement; (2) Quality improvement teamwork (QIT). Koch (1995) defines it as “cross-functional/ multidisciplinary; voluntary; and able to harness individual’s energy and enthusiasm” (33-34). He also mentions the need for a trust strategy for TQM or total quality management, commitment of senior management, introductory workshops for facilitators and members and of course, the aims clearly laid out; (3) Understanding and reviewing the processes of care and service. Everyone on the staff involved with quality improvement should be highly aware of the key issues to emphasize in the cross-functional process review approach namely: the identification of key patient/ service flows; a cross-functional team; an awareness of technical and customer components to improvement and the objectives to enhance quality and reduce risk/ adverse events (Koch, 1995). Lastly (4), using data display to motivate. Visually prompting staff the procedure of high quality care provision will indeed assist them in their tasks, not to mention there is no excuse for non-compliance. Also, seeing their progress charted out for everyone to see makes one more aware of his or her responsibility to the patients and to the organization. In the hospital setting, it would help if the professionals such as nurses have access to the patients’ history and medical chart which indicates all of the therapy treatment they are being provided. It would be upsetting to recommend a certain exercise that would strain injured muscles or prescribe medication that triggers allergies, but these may happen if information provided to the workers is not adequate enough. To monitor each patient’s case thoroughly, it is suggested that there is one chart per patient for diagnostic and treatment purpose, and all involved professionals write in their remarks on the chart. These charts of the patients’ cases shall be copied for all the professionals concerned for easy reference during case evaluation meetings and for their own files. Despite a growing understanding of the importance of open communication and knowledge transfer, the sharing of information within organizations remains a challenge. Burgess (2005) reasons that “one impediment to developing successful knowledge transfer initiatives seems to be the tendency of practitioners and researchers to focus on tools (e.g., technology) and tasks (e.g., routines), with less attention paid to knowledge-transfer among people (Argote & Ingram, 2000; Cabrera & Cabrera, 2002; Davenport & Prusak, 1998; Huysman & de Wit, 2003). Some practitioners do not have the patience entailed in discussing the technicalities of their expertise someone from another discipline or unit. “Motivational barriers to knowledge transfer included a lack of extrinsic rewards, stronger levels of group versus organizational identification, reciprocity norms, and the view of knowledge as a means of achieving upward organizational mobility.” (Burgess, 2005). Workers will be more encouraged to transfer knowledge to another professional from another discipline if this sort of behaviour is rewarded by management either by external means such as merit or salary increases or internal means to boost their self-esteem such as praise or simply appreciation. A sense of loyalty to the organization is also necessary for workers to be motivated to go beyond just doing their job. Mostly, it takes above average standards of personal and professional characteristics to uphold such company integrity. This is something to think about as a worker, and for management to evaluate the kind of worker they really want. In order to succeed working as a team, organizations must be aware of relational power, or the give and take of power and knowledge. Hence, this would involve knowledge transfer from individuals who possess it to those who do not. In healthcare institutions, this may be in the way of sharing expertise in various disciplines which must be transferred and shared among units. Indeed, companies that are more effective at knowledge transfer have been shown to have a greater likelihood of organizational survival and higher levels of productivity (Dart et al., 1995; Dyer & Nobeoka, 2000; Galbraith, 1990). The foregoing discussion on communication in organizations has great implications to the Nursing profession. Nurse leaders should be vigilant in their supervision of their staff. Miscommunication due to wrongly administering medicine or dispensing mistaken medical advise may result in negative consequences that may even entail lawsuits. The good name and credibility of not only the professional concerned but also the hospital or health service provider becomes at stake. These are to be avoided at all costs and some simple ways to prevent them are recommended as follows. Surveys & Consistent Evaluation: A standard evaluation of communication survey within the hospital staff and management is to be designed and reviewed with everyone on an agreed schedule. Staff surveys providing thorough understanding of staff attitudes and perceptions may be helpful in determining necessary steps to be taken in the improvement of communication in the organization. In addition to this, it can enhance staff motivation, reduce staff turnover, increase innovation, and lead to better customer retention - all of which will increase productivity, reduce costs and improve profitability. (Knowles, 2004). Employing staff surveys send the positive message that management is interested in hearing the voice of the employees and it becomes a venue for staff to express their opinions, suggestions, needs and preferences. Surveys need not be complicated. These must be simple to answer and must be reflective of the true views of the respondents. Suggestions and resolutions are solicited from everyone concerned. These suggestions may be carried out and evaluated after a period of time. Resolutions are likewise evaluated after two weeks and on a regular basis after that. System of Information-Sharing: Assignment of team leaders in various units who will be working very closely with each other makes transfer of knowledge from one discipline another will be much more manageable. For example, the team leader of the group of psychologists may share some psychological interventions they are implementing on certain patients and justify why such interventions were chosen over the others. This would entail discussing the symptoms and circumstances of the concerned patients. On the other hand, the team leader of the physiotherapists may explain certain therapy methods used on some of their patients. The team leader of nurses may share the medication being administered to said patients, and even the observed behaviors and personality quirks that the other professionals must be aware of. This information shared among the representatives of different disciplines may now be disseminated among their respective staff groups. This information may come in handy when case reviews of the patients are discussed. Concerned professionals from each group working on a particular patient may now be confident in writing their own remarks on the patient’s case chart so the other members of the team may be adequately informed too. Trainings on Effective Communication: Management may bring in communication specialists to give seminars and workshops to the management and employees. These aim to develop skills in horizontal and vertical communication among the hospital management and staff and even among the workers and the patients. The success of these trainings will be manifested in practice. Implementation of the recommendations is envisioned to bring about positive outcomes for the staff and the whole hospital system. This would translate to high quality service aimed for the customers. Customer satisfaction brings about more business for the organization. Consequently, effective communication boosts the morale of the employees knowing what they need to express is heard and acknowledged. Likewise, management would find it easier to accomplish goals set for the organization. No matter what angle is analyzed in organizational management, critiques are easier said than done. In the case of healthcare institutions, what is essential is the commitment of managers, clinicians, nurses, staff and everyone else in the team to work together as a cohort group in providing the quality of service their clients deserve. More important than the business that comes back to them due the efficient implementation of their jobs is the fulfillment that they are contributing to making people healthier. That, in itself, is a wonderful and empowering vision that must be commonly shared by everyone. References Argote, L., & Ingram, P. (2000). Knowledge transfer: A basis for competitive advantage in firms. Organizational Behavior and Human Decision Processes, 82, 150-169. Leadership. Retrieved on April 7, 2011 from: http://www.answers.com/leadership#top Burgess, D. (2005) What motivates employees to transfer knowledge outside their work unit?. The Journal of Business Communication. Volume: 42. Issue: 4. Cabrera, A., & Cabrera, E. F. (2002). Knowledge-sharing dilemmas. Organisation Studies, 23, 687-710. Dart, E., Argote, L., & Epple, D. (1995). The acquisition, transfer and depreciation of knowledge in service organizations: Productivity in franchises. Management Science, 41, 1750-1762. Davenport, T., & Prusak, L. (1998). Working knowledge: How organizations manage what they know. Boston: Harvard Business School Press. Dyer, J. H., & Nobeoka, K. (2000). Creating and managing a high-performance knowledge-sharing network: The Toyota Case. Strategic Management Journal, 21, 345-367. Huysman, M., & de Wit, D. (2003). A critical evaluation of knowledge management practices. In M. S. Ackerman, V. Pipek, & V. Wulf (Eds.). Sharing expertise: Beyond knowledge management (pp. 27-55). Cambridge, MA: The MIT Press. Isaacs, W.,(n.d.) Taking flight: Dialogue, collective thinking and organizational learning. Organizational Dynamics Knowles, P. (2004) Staff surveys - how to follow good practice. Retrieved on April 7, 2011 from http://www.teamtechnology.co.uk/surveys.html Koch, H.C.H. (1995) Motivating staff through teamwork: process review and data display. Health Manpower Management 21 (4) 32–36 . Lee , T.J. (2008) Actions speak loudly, Communication World , July-August 2008 LeFebvre, K.B. (2008) Strengthen Your Verbal and Nonverbal Communication Oncology Nursing Society CONNECT September 2008 Richmond, V.P. & McCroskey, J.C. (2005) Organizational communication for survival: making work,work. Retrieved April 6, 2011 from http://www.ilstu.edu/~llipper/com329/mccroskey_chapter.pdf Read More