Articles

Communication Challenges, Their Impact on Employee Satisfaction, and Recommendations for Improvement

Author: Tatiana Abigail, M.A. Ed. 

Organizational communication has been a subject of great interest and research by healthcare leaders in the last century. The complexity of modern healthcare systems, due in part to advancements in informational technology, has resulted in constant changes in healthcare structure and has created a challenging environment for leaders to distribute information effectively, efficiently, and to appropriate audiences. 

Effective internal communication was critical during the COVID-19 pandemic as it informed frontline staff of the most recent updates in clinical workflows. Even though the pandemic has officially ended, the volume of communication received by the average healthcare worker has not decreased. In fact, it has become so burdensome that it affects their productivity, results in burnout, and impacts their job satisfaction. Understanding factors that contribute to communication challenges will help leaders find better ways to communicate.

Direction of communication

Traditionally, the healthcare industry has utilized vertical top-down communication to distribute information to its stakeholders. During the COVID-19 pandemic, this was the most effective way to quickly disseminate policy updates and new workflows. Outside of times of crisis, however, leaders must remember to use all available directions of information exchange.

Vertical bottom-up communication approaches are useful in receiving feedback from the frontline staff and middle managers. Leaders should encourage their teams to share feedback to help improve the current processes and the healthcare environment. By promoting the message that ‘every voice matters’ and then taking action upon receiving their feedback to ‘walk the talk’, leaders will ensure that employee feedback is valued and employees will trust that THEY (themselves) act as change agents in their organization. Leaders must be careful to not solely rely on yearly employee surveys, but instead actively seek feedback during team meetings, huddles, 1:1s, and offer virtual tools to provide timely recommendations for improvement.

A diagonal communication approach may be beneficial in situations where information needs to be clarified or precise information is needed from a specific individual or department. In such situations, it is beneficial when an organization’s culture supports circumventing a traditional ‘chain of command’ approach for needed information. For example, if a manager or a supervisor needs to get some specific information from a director from another department and her own director does not have the necessary information, it should be acceptable for this manager to reach out to the director who has the information foregoing the usual chain of command. This approach of communication reduces unnecessary email burden to those who do not have the answer and it helps eliminate waste (of time).

Finally, a horizontal communication approach is appropriate for peer-to-peer or leader-to-leader communication when sharing best practices or looking for common solutions. It helps break down silos and allows groups to learn about one another.

Redundancy of communication

Due to the large size and complexity of healthcare organizations, many organizations may rely heavily on emails to keep employees informed. Middle managers often receive a continuous stream of emails from their leaders. They often combine several communications into one in order to decrease the time needed by frontline teams to review information and to continue allowing teams to focus on providing quality patient care. In many cases, this process of combining communications may alter the meaning of the original message.

To understand the degree of communication redundancy in their organizations, managers/leaders might ask themselves the following:

1. In the last week, how often did I receive cascading communications with the same information, but from different leaders? 
2. Did these emails fail to identify to whom the message was addressed? 
3. Did other leaders forward this communication to me because they weren’t certain if I was part of the original distribution group?

Redundant communications contribute to email fatigue, take away valuable time from other projects, and lead to job dissatisfaction. As a response to job stress and limited time, employees may withdraw psychologically without actually quitting, rejecting personal responsibility for their performance¹.

When I recently met with the communications manager at my own organization to discuss communication redundancy, we came up with a quick and simple remedy: to avoid repeating emails, the sender must identify the distribution list at the beginning of the group communication. This was a small, but very effective win for the ambulatory department where I now see this recommendation in practice.

Know your audience

As an advocate for equality and diversity in the workplace, I truly believe in building teams that consist of many cultures and backgrounds, various levels of education, and economic status. It is our diversity that makes us stronger. However, because of our inherent communication preferences, not every team member processes information the way it is offered. Transformational leaders should know their audience and use storytelling as a way to teach values and norms.

I recall a recent team meeting where our group was discussing the value of teamwork. I started the discussion by presenting the story of “The Miracle on Ice” from the Lake Placid Olympic Games in 1980. As I was narrating the story about a group of college students who put their heart and soul into their team and beat the famous USSR Red Army hockey team, I could see the sparkle in the eyes of my team and the inspiration that arose from the context of the story. Another example of storytelling comes from our Patient Experience team where during presentations they used a segment on “A Walk in Their Shoes”. By sharing examples of being patients, Patient Experience Champions used narration that is relatable to people, practices, and visions, which allows them to effectively engage with the team. The value added by sharing stories and metaphors can be significant because stories provide a personal touch to communication and allow understanding and connections that statistics alone may not achieve.

In summary, organizations must have a well-functioning information exchange process to have a unified culture and align employees with the strategy and the vision. Successful organizations should utilize all available directions of information exchange, identify their distribution group and know their audience to effectively and efficiently share important information that provides education, reinforces priorities to all levels of stakeholders, and drives results.

References

¹Georgetown University scholar Michael Lipsky: Street Level Bureaucracy: Dilemmas of an Individual in Public Services

About the author

Tatiana Abigail, M.D. Ed. currently serves as a Practice Administrator overseeing several ambulatory clinics at UCHealth’s University of Colorado Hospital. She is pursuing a Doctor of Education in Leadership for Organizations degree at the University of Dayton. Tatiana is also a Certified Professional Coder, and she holds a Green Belt certificate in Lean Six Sigma. Tatiana is passionate about international travel, learning new cultures, and sharing new knowledge with her teams.