Communication among the Hospital Staff of Pinewood Hospital - Essay Example

Proposal for More Effective Communication Among the Hospital Staff of Pinewood Hospital Introduction Pinewood Hospital has been known as one of the finest facilities in rehabilitative medicine dealing with patients suffering from long-term and permanent disabilities. Patients enjoy quality care from the best doctors, nurses, physiotherapists, psychologists, occupational and speech therapists, social workers and even special resettlement officers to ease their discharge to the outside world after a long period of confinement in the hospital. The intensive and multi-disciplinary approach in the treatment of patients necessitates that each professional worker be aware of their patients’ cases including the treatment being done by other professionals on the case. However, due to the high stress level in the hospital environment where pain and agony abound from the patients, workers are usually left with no choice but to concentrate on their own discipline in providing therapy, care or help for their patients. Add to that, the obligatory meetings set up by management to ensure that things are flowing smoothly, create resistance among the staff, as they are anxious to be questioned about their cases in detail. Such a scenario prevents effective communication to flow within the workers, staff and management of the hospital. This is a cause for concern, as the situation may bring about more problems that can affect the quality of treatment afforded to the patients that has gained recognition for Pinewood Hospital. Objectives This proposal intends to: study the current organizational situation of Pinewood Hospital to identify the roots of a possible proliferation of communication problems among hospital staff and management. encourage staff groups to be diligent in communicating to other groups what they do with their patients to achieve a more holistic therapy for the patients. Come up with an effective strategy to lessen the stress in the workplace Project Proposal The clinical director, Dr. Baxter has hired an internal consultant to help improve communication within the hospital. The following are proposed steps the consultant may make to gain a better understanding of the problem and to find appropriate solutions for it. A. Immersion The consultant needs to be immersed in the hospital to get a better perspective of the culture of the organization and the flow of movement and communication. He needs to attend all meetings himself to keep track of the agenda and see if there is overlapping information and investigate how these may be minimized to save time and effort. As a consultant, he is available to anyone who would be in need of his advice regarding concerns about communication, be they rank and file or in the administrative staff. Being so, he would have access to information that may able to help the organization. B. Conducting surveys Another way to gather information is to conduct a survey on communication among all the hospital workers from the management to the professionals to the staff. “Staff surveys that provide a thorough understanding of staff attitudes and perceptions are the first essential step in developing strategies that really can improve staff motivation, reduce staff turnover, increase innovation, and lead to better customer retention - all of which will increase productivity, reduce costs and improve profitability. By commissioning staff surveys employers are sending a positive signal to their employees that they are listening organizations, but this must be matched by a commitment to follow-up on the findings.” (Knowles, 2004). Surveys need not be complicated. These must be simple to answer and must be reflective of the true views of the respondents. Questions are posted and respondents are supposed to rate their answers on a scale Sample questions and answers are the following: In general, how would you rate the verbal communication skills of all individuals in the development area? 1 Very Good 2 Good 3 Adequate 4 Poor 5 Very Poor How often would you say that the poor communication skills of individuals lowers development productivity? 1 Very Often 2 Often 3 Occasionally 4 Rarely What increase in productivity do you think would be realized if all development staff had exemplary communication skills? 1 Substantial - 2 Moderate 3 Small 4 None Is, or has, training ever been provided to enhance communication skills? For management: 1 Yes, ongoing 2 Yes, occasionally 3 Yes, once 4 No For non-management: 1 Yes, ongoing 2 Yes, occasionally 3 Yes, once 4 No -Adopted from “State of the Practice: Politics and Communication” Similar surveys may be conducted on other concerns such as working conditions, work expectations and stress management. Results of the survey will be the basis of designing solutions to present problems. Observations On the outset, working in a specialist rehabilitation unit dealing with patients suffering from long-term and permanent disabilities is in itself stressful, considering the agony of pain patients experience. The hospital staff will always be on high adrenaline trying to help these people and comforting them and their families. The consultant may find appropriate ways to ease this stress for a more productive working environment. Of course, it helps that the hospital is well-staffed with professionals from different disciplines so patients are ensured of all the services they may need in relation to their illnesses. However, as the saying goes, “too many hands spoil the soup”. Since there are several people working in different units serving the same patients, conflicts and ethnocentric values may prevail, as they may have different interpretations and intervention ideas for their patients. Add to that the numerous meetings set up for different groupings. This may further add stress as each specialized group may be questioned and criticized and transfer of knowledge from one group to another may be hindered. Presenting Problems Three major problems were apparent to the consultant on his initial visits which will be discussed in detail: a lingering communication problem within the staff of the hospital, which was the main reason why Dr. Baxter brought in the consultant; transfer of information from one staff group to another regarding the patients’ cases making the workers unable to contribute productively to the staff meetings; and finally, the high stress level in the work environment which may be the reason for the quick turnover of staff over a short period of time. Communication in the Organization 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.” There are six functions that seem to dominate communication in the organizational context. The functions are to inform, regulate, integrate, manage, persuade, and socialize. “Much of the informative communication in organizations is conducted in a written format. This way, a whole group of employees can be informed with one message and at one time. This is an effective method to disseminate information quickly. On the other hand, managers may decide to call a meeting once each week (or month) which is primarily of an informative nature.” (Richmond & McCroskey, 2005). Employees are aware that most meetings are informative in nature and must be prepared to raise questions regarding their concerns which need more information for them. The function of regulating is usually directed toward regulatory policies within the organization or messages about maintenance of the organization. “The integrative function of communication is focused on 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 that the "left hand knows what the right hand is doing." It is an attempt to get people to work together and make things run more smoothly.” (Richmond & McCroskey, 2005). It is in this area where Pinewood Hospital seems to be not faring well, as each staff group seems only concerned with doing their assigned tasks and not so much inquire about what the other groups are doing to their own patients. 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. At Pinewood, management function may be held by a staff group’s team unit (ex. Chief Physiotherapist in the staff group of physiotherapist) and the general management of the hospital. 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. “The socialization function of communication in the organization is the one that can determine whether an individual survives well, or not at all, in an organization. Socialization doesnt mean being "buddies" with everyone. It means being integrated into the communication networks in the organization.” (Richmond & McCroskey, 2005) 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. 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 therapists 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. For Pinewood Hospital, 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 managers 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. Transfer of Information “Within the unit, a major consideration is the coordination of patient care across the different staff groups: nursing teams, physiotherapists,, social workers, psychologists and the resettlement officer. Each patient will be receiving care and treatment from most of the groups simultaneously and therefore it is important that each group knows what the others are doing. Consequently, a major concern for the staff is efficient and effective communication within and between staff groups. Over the years, a proliferation of documents and meetings have been developed to effect timely communication. However, the Clinical Director, Dr Baxter, believes that the methods are largely ineffective.” -from the case Physiotherapists do their therapy with the patients not necessarily being aware of the psychological interventions or medication the patients are undergoing. Most of the time, it is deemed irrelevant since their concern is mostly to do the job they are called to do. However, holistic treatment is best for the patient, so it is essential that the workers are aware of the whole case to come up with the most appropriate therapy for each patient. “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. “Because sharing knowledge can be a time-consuming task that leaves employees less time to pursue their own work, it is important that organizations send clear and consistent messages about the types of knowledge-exchange activities that they want to encourage, and provide adequate credit, recognition, and time for employees who engage in those activities.” (Burgess, 2005) In the hospital setting, it would help if the professionals 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. Management must be consistent in communicating to each worker its philosophy of providing the best quality 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. “Creating the conditions that engender knowledge transfer entails significant structural and cultural changes by top leadership, which will require leaders to be convinced 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. Leaders should be cautious about publicly touting the virtues of "knowledge sharing" without a substantive commitment to change, as this may result in the failure of well-intentioned knowledge transfer initiatives, bringing with it lowered employee morale and the potential for resistance against future knowledge-transfer initiatives.” (Burgess, 2005) High Stress in the Work Environment Hospitals are innately prone to stressful situations. The fact that patients are usually in pain and in need of immediate relief makes people around them anxious to help. Health care professionals are not immune to stress even if they face it everyday. Their practice requires that they are able to handle stress in order to lower its levels in the patients in their care. Hospital workers also need to contend with the demands of their jobs. They cannot escape paperwork, performance evaluations and a series of meetings. Living a life full of stress in a prolonged period may cause harm to one’s health. It can also dampen his motivation on what used to be something that impassioned him. This is called ‘burnout’. Burnout obviously affects a person’s productivity and quality of life. Losing the flame for something that used to excite and fulfill him may cause depleted physical energy, emotional exhaustion, lowered immunity to illness, less investment in interpersonal relationships, increasingly pessimistic outlook, increased absenteeism and inefficiency at work. (Scott, 2007). Burnout may also be the cause of the fast turnover of hospital staff at Pinewood Hospital. Management must be able to come up with ways to reduce it like arranging less demanding schedules. This may include less frequent but more thorough, well-planned meetings that meet its goals. The people in charge of facilitating meetings must draw up a written agenda and estimated time spent for each item. During the meeting each item must be thoroughly discussed and it should be made clear to everyone in the meeting. Suggested is one case evaluation meeting a week for the specialists and one meeting for the admin/ upper management with Dr. Baxter. It would also help if workers are given adequate breaks within the work day for rest and rejuvenation. Summary of Consultant’s Recommendations Upon careful and thorough investigation of the problems, the consultant has come up with the following recommendations: 1. General Assembly for Revisiting Philosophy: The clinical director, Dr. Baxter calls for a general assembly to reorient everyone about the philosophy, mission/vision and values of Pinewood Hospital. It should be made clear to everyone what the hospital stands for and that their cooperation and support is essential in upholding its high standards. Workers are encouraged to reassess their values and level of commitment to the hospital. This general assembly also signals that changes in the system are to take place for the betterment of the hospital. 2. 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. 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. 3. Working with Team Leaders: Team leaders from each group may represent their group to work with the internal consultant. They are assigned responsibilities to keep their teams or units harmonized. Gaining their rapport and trust may in turn provide the consultant with their confidence in sharing their concerns and listening to suggestions to implement in their respective groups. The consultant will now take on the role as a conduit of communication that goes horizontally as well as vertically within the organization. 4. System of Information-Sharing: Since team leaders will be working very closely, 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. 5. Trainings on Effective Communication: The consultant 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. 6. Stress Management: Strategies to manage and minimize stress also need to be designed and implemented. Examples are organizing schedules of the staff to have more breaks, lessening time for redundant meetings, proper and equitable delegation of tasks, and time for non-work-related fellowship. Following the consultant’s recommendations to the letter will significantly increase work motivation and productivity in the hospital. Since effective communication is key to success in organizations, it is anticipated that workers will be more cooperative in attaining its goals. Possible Barriers and Ethical Considerations Of course like in any major change, this may be met with criticisms and possible barriers. Many will be resistant to change, as they have already been accustomed to old policies, routines and standards. The idea of information-sharing may be interpreted differently among different professionals. Some disciplines may be more wary of dispensing information to others, as they may deem it confidential. Implementing great changes entail more effort on the part of upper management as they need to be more organized in their work and decision-making processes. This may mean more intensive planning and more paperwork. More supervision of staff is also called for to ensure that the changes are carried out for the better. This heightened attention may not be welcomed by the ones being supervised. The consultant needs to be aware of some ethical considerations when implementing a ‘better communication’ program. One is going beyond the boundaries of privacy. The possibility of divulging confidential information is high. Sharing of information about patients’ cases may not be ethical with some disciplines, and more importantly, with the patient concerned. Like in everything else, proper discernment in making choices and alternatives is always called for to avoid making rash and regrettable decisions. Acknowledgment The author would like to extend heartfelt thanks to Kisane Prutton & Chris Smewing, as this paper would not have been possible if not for their support. References Burgess, D. (2005) What motivates employees to transfer knowledge outside their work unit?. The Journal of Business Communication. Volume: 42. Issue: 4. Knowles, P. (2004) Staff surveys - how to follow good practice. Retrieved on March 8, 2007 from http://www.teamtechnology.co.uk/surveys.html Richmond, V.P. & McCroskey, J.C. (2005) Organizational communication for survival: making work,work. Retried on March 8, 2007 from http://www.ilstu.edu/~llipper/com329/mccroskey_chapter.pdf Scott, E. (2007) Stress and burnout: burnout symptoms and causes. Retrieved on March 8, 2007 from http://stress.about.com/od/burnout/a/stressn_burnout.htm\ State of the practice:politics and communication. Retrieved on March 8, 2007 from http://www.acrhq.com/surveys/politics/politics.htm Read More