presentation

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CHAPTER 8 Health Care Organizational Communication

For the purpose of this text, we are going to use the following as working definitions:

■ Human behavior theory: Theoretical perspective that focuses on the employees and their motivations

■ Interdependent: Elements of an organization (individual or group) that work independently but contribute collaboratively to assure effective task/goal outcomes

■ Organizational communication: Information sharing that is internal (employees/members) and external (customers, stakeholders)

■ Scientific management theory: Theoretical approach to organizing that takes an objective/scientific perspective

■ Stakeholder: A person or group that contributes to the work and/or goals of an organization, which may be an employee, stockholder, group, or organization; for example, a group of orthopedic surgeons who are not paid by a hospital but who do surgery and treat their patients there, would be nonemployee, group stakeholders

■ Stockholder: A person or group who owns stock in an organization and expects to earn dividends on his or her or their investment

■ Vender: A person or group who does business with an organization (e.g., hospital-bed manufacturer)

■ O R G A N I Z A T I O N A L C O M M U N I C A T I O N

At its most basic level, communication is required for organizing. Therefore, the way we think of organizations: family, school, corporation, nonprofit, health care, and so forth, are based on how communication is used to both

C o p y r i g h t 2 0 1 7 . S p r i n g e r P u b l i s h i n g C o m p a n y .

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144 Health Communication for Health Care Professionals

create the company/entity as well as inform others— internal and external— about its particular mission, values, and goals. Consequently, the way we view one health care organization versus another is based in large part on how it communicates. For example, St. Jude Children’s Research Hospital is similar to many other hospitals in its commitment to health care delivery; however, its mission is to research and treat children’s illnesses without charging par- ents for the cost of their child’s hospital visits. The Connecticut (CT) Hospice is an inpatient health care organization, but unlike St. Jude, the CT Hospice is organized around the goal of focusing on enhancing dying patients’ and their families’ quality of life and death. For providers, health care organizations may have similar goals but very distinct values, beliefs, and missions. One hospital might be a nonprofit, whereas another is a for-profit institution. Therefore, providers need to understand the difference between nonprof- its—whose goals are to spend whatever income remains after paying bills within the organization (salaries, equipment, construction, etc.) and not have a profit. However, for-profit companies’ goals are to make profits (monies remaining after all bills are paid). Generally, both nonprofit and for-profit organizations have stakeholders; however, only for-profit organizations have stockholders who expect to be compensated for their investments.

As you have likely surmised, if you are a health care provider who is seeking employment at a health care organization, it would be important to understand whether it is a for-profit or nonprofit institution. The organiza- tion’s economic focus will tell you a lot about the institution’s values, beliefs, and goals—all of which will impact communication—provider–patient, provider–provider, and provider–organization. Keep in mind: All health care organizations are trying to generate income (from services, donations, products, etc.). However, for some businesses/institutions generating max- imum income for stockholders and stakeholders is their highest priority. For others, bringing in enough money to cover bills and meet customers/ clients/patients’ needs is critical. As discussed in Chapter 7, health care in America is predominantly organized using a business approach—making

Reflection 8.1. Think of two organizations (family, school, health care, religious, etc.) of which you are a member. How do you see the communication (internally and externally) being different in the two organizations, from your perspective? How does the internal communication impact your perceptions of the organization? Is one better at communicating internally (with members) than the other? If so, why?

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8 Health Care Organizational Communication 145

money, regardless of whether it is a for-profit or nonprofit entity. Therefore, whether you intend to work in a hospital, private office, public health clinic, pharmaceutical company, and so on your communication from and with the organization will, in large part, be related to its business/economic goals and values. But the organizational communication realities for providers and patients are related to the theoretical foundations of a health care orga- nization as well as its financial goals.

■ O R G A N I Z A T I O N A L C O M M U N I C A T I O N T H E O R I E S

Throughout history, organizing, maintaining, changing, and succeeding in the development and attainment of group goals fundamentally depended on one constant—communication. Without effective interpersonal, small-group, organizational, and mass communication—organizations cannot succeed. Therefore, as you think about health care organizations ( regardless of their mission and/or goals: private, public, for profit, or nonprofit), they are linked by the need for effective communication—internally and externally.

In America, with the industrial revolution and the need to organize indi- viduals to work interdependently, early theorists Frederick Taylor, Henri Fayol, Max Weber, and later Mary Parker Follett and Douglas McGregor, among others proposed a variety of communication approaches. Evolving from a primarily independent, largely agriculture-based, rural society to an urban, codependent coculture required a new approach to organizing and communi- cating. In health care, for example, prior to 1910, the delivery of health services was frequently at the patient’s home/farm or in the provider’s office. To move from a largely unorganized health care delivery method to the highly struc- tured system we have today required the communication of the organization’s mission, goals, and values, but also its members’ roles, responsibilities, status, and hierarchy.

The early organizational theorists proposed that companies should be approached as if they were a machine—with a variety of different parts—all of which work independently but also collaboratively with the rest of the machine to accomplish its goal. The success of the (machine) organization depends on all employees (parts) working interdependently. Just as a car needs wheels, a chassis, seats, steering wheel, engine parts, and so forth all working in a standardized and replaceable way for the car to start, run, stop, and repeat all of those functions—organizations need similar processes and outcomes. Therefore, based on 100-year-old theories, the overwhelming majority of U.S. professional establishments utilize this mechanistic view of organizing in hiring, firing, evolving, brand building, and communicating. As a result, health care providers need to understand the importance of standardization, rules, replaceability, status, and hierarchy in hiring, promotions, and in successfully attaining institutional goals and outcomes.

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146 Health Communication for Health Care Professionals

Have you ever stopped to think about how a hospital is organized? Let’s put on our mechanistic lenses and examine how communication impacts the way hospitals are organized and operate.

1. Employees are hired based on their roles.

2. Employees’ roles are standardized (administrator, doctor, nurse, tech, custodian, etc.).

3. Employees are replaceable (if one leaves, his or her role is filled by another qualified/standardized person).

4. There are clear policies and procedures—rules—that govern behavior.

5. Hospitals generally follow a vertical hierarchy, communication flows predominantly downward from the board of directors to chief executive officer to medical and nursing directors, and so forth to employees (nurses, doctors, quality control, maintenance, housekeep- ing, etc.).

6. Status is very apparent in most hospitals: the administration have offices and titles that illustrate this; professions intra- and interprofessionally use titles, licenses, specialization, and so forth to demonstrate their vari- ous status distinctions.

While there are countless ways we could deconstruct the organizing of hospitals or other health care institutions, if we just use these six criteria we should readily see how important organizational theories and communica- tion are to the effective operation and goal attainment of health care deliv- ery systems. For example, from a health care organization perspective, it is critical to have standardized roles and responsibilities. Therefore, doctors and nurses clearly do have specific roles and/or are responsibilities for sim- ilar, but diverse aspects of health care delivery and patient communication,

Reflection 8.2. Why do you think medical, nursing, and physician assistant (PA) schools, for example, have specific, but differing, requirements to be accepted? And why do they not all teach health information from one perspective? How does this illustrate the role of organizational communication in providers’ lives from earliest entry into the disciplines/professions?

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assessment, and treatment. However, if one RN in the neonatal intensive care unit (NICU) decides she or he wants more money or more vacation time off, the hospital can evaluate that request but not feel coerced to honor those wishes. Because health care providers (MD/DO [doctor of osteopathy], RN, advanced practice registered nurse [APRN], physician assistant [PA], etc.) have standardized education and training that is state/federally regulated and leads to either licensure or certification, most can be replaced based on their profession/certification (cardiologist, orthopedist, NICU RN, etc.). Therefore, as with almost all professional U.S. organizations, standard- ization and replaceability are critical both to the interdependent nature of 21st- century business/health care goals, but also to the efficacy of human resource management. Consequently, every day new members of a hos- pital are not just acculturated into the organization, but for the most part seamlessly take over a role and responsibility previously done by someone else. As you can see, and theorists recognized 100 years ago, the benefits of standardization and replaceability for organizations, especially in today’s health care system are undeniable. However, over the past 100 years, the more standardized and replaceable health care providers became vis-à -vis consistent, codified, and mandated education and clinical training, the less individualized and autonomous health care providers and insti- tutions have become. If you were a cardiovascular surgeon, operating room nurse, or pump technician in the 1960s and 1970s as this new spe- cialty began to grow—you could communicate your uniqueness and irre- placeability in numerous organizational ways, but definitely in your salary, role, and other demands. However, 50 years later, countless cardiovascu- lar and other specialty physicians, nurses, PAs, and so forth are educated and trained, so while still a prestigious coculture, like most other hospi- tal staff, they are replaceable and therefore now have less power and control related to their unique roles and responsibilities. As you likely have deduced, although the value of standardization and replaceabil- ity are crucial for health care organizations, they are less valued by some providers—who still see themselves as independent practitioners who are for the most part irreplaceable. But as we progress with the business model approach to health care in the 21st century, providers are becom- ing more organizational based than ever before. In fact, the latest trend in modern health care is for hospitals to buy physicians’ private practices so that the physicians become hospital employees and the organiza tion can bill the physicians’ office patients and/or their insurers at the higher hospital rate for services. But standardization, replaceability, and sta- tus are only part of the way communication is used by health care orga- nizations to impact employees’ work and goal attainment efforts. Policies, procedures, and rules help impact how a health care organization functions, how providers and others work interdependently, and how infor- mation flows throughout the organization.

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148 Health Communication for Health Care Professionals

All organizations use rules to help organize employees’ behaviors. Those rules in health care organizations are more than just starting and quitting work times, vacation, and so forth, they are most often formal policies and procedures cod- ified in bound (or electronic) volumes that are not just part of the institutional archives, but a required part of new employee orientation, in-service/continuing- education courses and evaluations. In fact, to obtain/maintain national accredita- tion with The Joint Commission, one of the requirements is well-documented and effectively communicated hospital policies, procedures, and rules. Therefore, one of the more critically important organizational roles/departments for American hospitals is the field of risk management (see Chapter 12). One of the key goals of risk management is to work with the appropriate staff of the hospital to iden- tify potential problems or analyze and strategize solutions for adverse events in order to develop new and/or revised policies and procedures to help avoid future problems/medical errors. Clearly, from a health care organizational perspective, policies, procedures, and codified rules are needed to help members/employees’ work interdependently and communicate effectively in order to provide the most safe and productive health care delivery possible. However, as you know, poli- cies, procedures, and rules are only successful in goal attainment, effective patient care, and positive outcomes if employees have read/heard them, assimilated the information, clarified any misperceptions, and follow them. Organizations are constantly reminded that without effective policies, procedures, and rules that are understood by employees and adhered to—safe and successful patient care goals are nearly impossible to accomplish. But employees’ roles, responsibilities, status, hierarchy, and rules are only part of organizational communication. In addition, both internally with employees and externally with clients/customers/patients, as well as others stakeholders and/or potential donors, health care organizations also need to clearly communicate their mission, values, and goals.

■ M I S S I O N , V A L U E S , A N D G O A L S

The purpose of an organization is found in its mission statement, its raison d’être. This is a communication between a company/institution/entity and

Research Exercise 8a. Do you know what a hospitalist is and what that role is in modern health care/hospitals? If so, please describe both, if not, please research and describe both. From communication, clinical, and eco- nomic perspectives, how do you think the organization uses hospitalists, instead of the patient’s provider, to better meet the hospital’s goals?

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8 Health Care Organizational Communication 149

its stakeholders, stockholders, customers, and vendors. Organizations, espe- cially health care organizations, want their employees as well as their potential patients and families to recognize the way the organization views its purpose and its commitment to fulfilling that purpose vis-à-vis its organizational val- ues and goals.

Research Exercise 8b. Go to the websites for at least two different major American organizations, one that is health care related (e.g., hos- pital, manufacturer, nonprofit) and one not in health care (e.g., Ford, Apple, Harvard, etc.). Research the organization’s mission, values, and goals statements, often found on the home page or under “About.” Once you’ve read these declarations, analyze how they impact your perceptions of the organization? Hypothesize if you think that was the intent of this communication? Based on these statements, is the orga- nization a place where you would like to work and/or be a consumer; why or why not? Also, what are differences in how the health care orga- nization portrays itself versus the non health care company? What are your thoughts on how their organizational communication affects your responses to the different entities and their products/services?

Once an organization has determined its purpose, the next logical step is for it to both decide on and then communicate the organizational goals that will be needed to fulfill its mission. These goals will help employees, as well as potential applicants and others understand the major focus of the organization’s efforts. Furthermore, many institutions also communi- cate their values in order to inform stakeholders, stockholders, customers, and others how the organization perceives itself from an ethical perspec- tive. The mission, goals, and values statements are important to employees because most organizations expect their members to both know them and practice them. But often, they are even more important to potential appli- cants. For example, if you are going to send a résumé to or interview for a position at a hospital you would be wise to carefully analyze the institu- tion’s mission, values, and goals statements to assess where your values and goals are congruent with the organization’s. Based on this analysis, you would want to be sure you communicate your congruence in your cover let- ter and interview. In organizational communication, we know that hiring, although often described as “ purposefully diverse,” is still frequently biased by what has been termed “the principle of similarity.” This theory suggests that we often choose our friends, lovers, and coworkers based in large part on how similar they are to us. Organizations are no different. Therefore, the

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150 Health Communication for Health Care Professionals

more your goals and values are not “I focused,” but organization-centric, the better your chance of being perceived as similar in goals and values to the organization and its members. Think about hiring from the employer’s perspective, do you want to bring in a person who does not share your vision for the company? And how much more time and effort will be needed to help someone who has to be acculturated not just into a new role, but into a new coculture with its own set of goals and values? But health care organi- zations use more than their mission, values, and goals to communicate with stakeholders, stockholders, customers, and vendors—like most nonhealth care organizations—many rely on marketing and the media to spread their messages, as well as differentiate them from the competition.

■ M A R K E T I N G A N D T H E M E D I A

In 21st-century America, most organizations use a wide variety of marketing strategies and tactics to get messages about their brands, including the orga- nization, to their consumers. Marketing includes advertising, public relations (PR), and the research efforts that support both of those, as well as various aspects of mass (TV, print, radio, Internet) and/or social media (Facebook, Instagram, Twitter, LinkedIn, etc.). Although marketing is generally not a major focus for health care providers, it is important that you recognize the role it plays in modern health care delivery. For example, many estimates suggest that the cost of numerous brand-name drugs may be driven as much, if not more, by marketing (advertising and PR) expenditures as they are by research and development (R&D) costs. Consequently, the marketing of U.S. pharma- ceuticals and medical devices not only impacts patients’ (direct-to-consumer [DTC] advertising and PR) and providers’ (professional advertising, PR, and educational materials) perceptions of the brand, but also its cost (for patients and/or insurers). But it is not uncommon today for hospitals and other patient- focused health organizations to use marketing to help educate consumers/ potential patients–providers about their employees, mission, technology, and so forth in an effort to differentiate themselves from their competition. Similarly, hospitals and other health care organizations are using social media, websites, and targeted e-mails to market themselves to potential employees and patients. The impact of marketing and media on the public’s perceptions of health care, as well as on escalating health care costs, cannot be overstated. For example, if the hospital across town gets the latest robotic surgical device, a competing institution in the same town or nearby will likely feel compelled to buy a similar, or more expensive piece of technology to illustrate their value to the community. As discussed previously, this purchase may often times be more related to marketing issues than clinical ones, but in a business- model- driven health care environment, moves are made frequently for advertising and PR purposes rather than because of clinical acumen, safety, and positive outcomes. However, this increased marketing effort is generally driven by hos- pital administration, not health care providers.

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8 Health Care Organizational Communication 151

■ H E A L T H C A R E A D M I N I S T R A T I O N

One significant way health organizational communication is impacted is through administration–provider communication. Although we explore the specific role and communication related to leadership in Chapter 11, it is important to recognize that administrators’ verbal and nonverbal behav- iors have a huge effect on the morale and functioning (or dysfunctioning) of an organization, as well as frequently being the spokespersons/face of the institution with stakeholders, customers/patients, and the public. Unlike the 20th century, when many if not most hospitals had doctors or nurses in the most executive positions, today those roles—president, chief executive officer (CEO), and so forth—are dominated by nonclinical, often business school professionals whose focus is on the functioning, income versus losses, and marketing of a hospital as much if not more than on health care delivery.

Current hospital administrators need to not only raise money and promote the institution, but adopt a business-model/competitive approach that focuses not just on the clinical expertise of the staff, but also on the technology and breadth of services available. This business mind-set can sometimes create communication obstacles for providers, who feel that patient care should be the primary, if not the only focus for everyone in the institution. In addition, the need to raise funds, assure sufficient income to meet costs, and so forth may confuse hospital employees who see the organization’s stated mission, values, and goals as being more humanistic and patient centered. Therefore, it is important for providers who work at these facilities to recognize that admin- istrators are working interdependently with clinical staff to assure the organi- zation’s safe and effective operation, as well as the need for income to further enhance the institution’s health care delivery system.

Provider–administrator communication, like provider–patient and provider– provider communication is interpersonal and the more providers can work to

Reflection 8.3. Think about an ad—a billboard or a newspaper, radio, TV, or Internet ad for a hospital. How does the organization’s marketing of its mission, goals, and values in the ad impact your perception of the hospital? Does the fact that it is promoting certain aspects of its health care delivery make you more likely to consider it when you need hospital-based services? Or do you find it problematic in terms of your views of American health care delivery and organizational communication? Why?

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152 Health Communication for Health Care Professionals

use their verbal, nonverbal, and written communication to build relationships, share information, and seek input into decision making, the more likely it is that providers and administrators will both find the collaboration reward- ing and beneficial for all, but especially for the organization. In addition, it is especially important to highlight a few key reminders for providers regarding organizational e-mail (written communication). As in all professional orga- nizations, employees (providers) need to pay close attention to the following potential e-mail communication issues:

■ For potentially problematic e-mails, do not list any names in the “To” line until you have finished editing and proofreading the e-mail, thereby avoiding accidentally sending the e-mail prematurely or to unintended recipients.

■ Double or triple check that the “To” line indicates only the person(s) you intend the message for.

■ Copy (cc) only people who need to know the information you are sending.

■ Avoid “Reply to All” in responses to e-mails with several/numerous recipients unless it is critically important that all recipients need to know your reply.

■ Be sure you consider that everything you send on an organization’s servers (either work or private e-mail) is saved and cannot be deleted— consequently, if you do not want the CEO, your director, and/or a patient’s attorney to have access to what you are e-mailing—do not send it.

■ Remind yourself that whatever you put in an e-mail (text, photos, etc.) has the potential to be forwarded, sent to anyone, anywhere—so unless you want your message and/or attachments seen by unintended others, use a different communication format for sensitive communication.

■ Never respond in an e-mail when you are angry—nothing good will come of it. If you receive an e-mail that upsets you, or someone says or does something, that is upsetting—try to take some time to process what hap- pened and consider your possible communication/response options. In general, if you need to have an emotional or potentially unsettling inter- action with another person it is best done face to face. Always remember that what you put in writing, especially in e-mail, will not go away—even if you delete it from your computer.

■ When you need to attach a file, photo, and so forth always do it first, even before you put in the recipient’s e-mail address. That way you will not forget and require the other person to have to write and ask for the attachment.

■ Finally, whenever possible, consider taking a “you-” (the reader) centered approach in writing your e-mails. If you want the reader to review your message, assimilate it, and concur with you, then make the reader feel that you understand his or her needs/expectations. Use more “you,” than

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“I, me, my.” Even “we” is more reader focused that starting every sen- tence with “I.” Clearly, when you are taking responsibility for something, or agreeing to do something, “I” may be most appropriate, but whenever you can, try adopting a you-centered writing style and your readers are more likely to reward you with thoughtful, timely, and—perhaps more often than usual—positive responses to your requests.

Consequently, providers who are working in health care organizations as employees, consultants, contractors, and so forth need to recognize the crit- ical role organizational communication plays in the success, not just of the institution, but in positive health care delivery outcomes. Furthermore, the recognition of how interdependent and mechanistic organizational structures, processes, and roles are—especially in health care entities—will be enormously beneficial to providers who need to work in teams to accomplish both clinical and organizational goals. The role of provider congruence with a health care organization’s mission, values, and goals is also critical to the effectiveness and morale of both the provider and the rest of the organization with whom he or she works. Even though providers may have a limited role in the marketing and media aspects of a health organization’s communication with stakehold- ers, customers/patients, and the public—it is vital that providers understand the reasons for these efforts and how they will enhance employees’, providers’, and patients’ efforts to attain clinical and institutional goals.

R e f l e c t i o n s ( a m o n g t h e p o s s i b l e r e s p o n s e s )

8.1. Think of two organizations (family, school, health care, religious, etc.) of which you are a member. How do you see the communication (internally and externally) being different in the two organizations, from your perspective? How does the inter- nal communication impact your perceptions of the organization? Is one better at com- municating internally (with members) than the other? If so, why?

While everyone will have very different responses to this reflection, it is important to consider how one organization, family, for example, might be per- ceived to have goals that are more member focused (children) and the internal communication therefore would be about how the kids needs to do certain things to enhance their mind-and-body growth, as well as their social matu- rity. This would be compared to a corporate organization in which the focus is on making profits and how the communication is intended to remind mem- bers ( employees) of the organization’s goals, the importance of keeping cus- tomers happy, and meeting deadlines, and so on. Or, if you considered a health care or religious institution, you may have perceived the organization’s com- munication as being more collaborative and/or nurturing toward its members, but, in the case of a hospital, also its patients. However, based on your hospital experiences, you might have thought the organization was much more money/ managed-care focused, not employee or patient centered, and consider the

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organizational communication not supportive of safe and effective health care delivery. How organizations communicate, internally especially, makes a huge difference in how much employees want to support the leaders of the institu- tion, but also its mission, values, and goals. Employees/members, regardless of the organization, want to feel that they are similar to others, valued for their contributions, and working interdependently and collaboratively with others, including organizational leaders, to achieve common goals.

8.2. Why do you think medical, nursing, and physician assistant (PA) schools, for example, have specific, but differing, requirements to be accepted? And why do they not all teach health information from one perspective? How does this illustrate the role of organizational communication in providers’ lives from earliest entry into the disciplines/professions?

As diverse cocultures in the health care culture, medical, nursing, and PA orga- nizations are focused on not only educating and supporting their members, but also helping them assimilate into the profession/coculture. Consequently, each discipline has developed its own pedagogical approaches, curriculum, and acculturation methods to help its members adapt to their new career. For medical and osteopathic schools, there is a rigorous 4 years of study, most often postbaccalaureate, comprised of 2 primarily didactic years and 2 mostly clinically based years. However, with a doctoral degree, the provider has to get a state license to practice medicine (treat patients) and still needs to com- plete at least 1 year of a residency/internship program at a hospital, and pass a medical licensing exam. Nursing schools (2 and 4 years), on the other hand, have required students to focus on nursing education as the majority of their under- graduate studies. Although associate degree in nursing (ADN) programs con- tinue to offer opportunities for students across America, a vast number of RNs are graduated each degree with a bachelor of science in nursing (BSN) degree from 4-year colleges and universities. These nursing programs differ from med- ical schools in diverse ways, from the degrees they confer on their graduates to the curricula they offer. In most nursing programs, the focus is on the biopsy- chosocial and consequently students are often introduced to clinical/patient care earlier than medical students and clinical care is continually interspersed across courses throughout their education. Upon graduation from a certified RN pro- gram, ADN and BSN students can take the national licensing exam. In order to work as an RN, a provider must pass the licensing exam. The education of PAs and APRNs is different from both RNs and MD/DOs. All of these organizational differences are intended to both continue the coculture (MD, DO, RN, etc.) and provide the knowledge and expertise students will need to function effectively and safely in their particular professions. However, from the application infor- mation materials to the verbal and nonverbal communication used in the class- rooms and clinical training sites, each organization works to assure that its members are fully acculturated and understand the organization’s as well as the coculture’s mission, values, and goals.

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8.3. Think about an ad—a billboard or a newspaper, radio, TV, or Internet ad for a hospital. How does the organization’s marketing of its mission, goals, and values in the ad impact your perception of the hospital? Does the fact that it is promoting cer- tain aspects of its health care delivery make you more likely to consider it when you need hospital-based services? Or do you find it problematic in terms of your views of American health care delivery and organizational communication? Why?

Generally speaking, health care organizations use advertising, regardless of the format, just like non health care organizations. The goal of advertising is to promote a brand, provide information about it, and offer some call to action (purchase, promote, inquire, etc.). The question for most health care advertis- ing is do we highlight our people, services, technologies, and so on? How a health care organization answers that question is often based on its mission, values, and goals, but may also be driven by a marketing analysis that perceives a competitive message more important than a patient- or provider-centric one. However, your responses to a health care organization’s advertising is usually a good indicator of your congruence—from an employee or patient perspective—with the organization’s communication of its mission, values, and goals. Because advertising is expensive and usually involves a significant amount of critical thinking, reflection, and analysis, the verbal and nonverbal messages are generally what the organization wants viewers/readers to know about itself and its health care delivery services.

S k i l l s E x e r c i s e

Think of an organization you belong to (family, school, religious, professional, etc.) and select what aspects of the chosen organization’s purpose, goals, and values you think would be important for a person to know in order to perceive the organization positively. Based on that analysis, create a script for yourself to use in communicating to a friend, colleague, or peer who is unfamiliar (not a part of) with the organization you are discussing. Share your information about the organization with the other interactant. Use feedback to assess his or her understanding and further explain, or, if clear, ask what the other person thinks about such an organization? Would he or she want to work there, be a customer, or a member in some way? How does assessing an organization and communicating about it help you understand the way organizational commu- nication, if done effectively, can benefit both the institution and its members/ employees, stakeholders, customers, and so forth?

Video Discussion Exercise Analyze the video

■ Lorenzo’s Oil (1992)

Interactive Simulation Exercise Pagano, M. (2015). Communication case studies for health care professionals:

An applied approach (2nd ed.). New York, NY: Springer Publishing Company.

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156 Health Communication for Health Care Professionals

■ Chapter 30, “How Safe are Generics?” (pp. 293–300)

■ Chapter 38, “Health Insurance Portability and Accountability Act (HIPAA)” (pp. 367–374)

■ Chapter 42, “What’s an Interdisciplinary Meeting?” (pp. 399–406)

Health Care Issues in the Media Hospitals hiring doctors http://health.usnews.com/health-news/hospital-of-tomorrow/articles/ 2015/10/07/whistleblower-doctor-warns-about-hospitals-hiring- physicians

H e a l t h C o m m u n i c a t i o n O u t c o m e s

Health care organizational communication impacts all areas of health care delivery in America. Whether it is a hospital, hospice, pharmaceutical or medical device manufacturer, or health insurance company—all are organized by and require effective internal and external communication to succeed. In health organizations, there are numerous communication demands; however, the most common is interpersonal communication—for providers and patients, providers and providers, as well as providers and administrators. However, provider–provider communication frequently needs to be team focused, rather than dyadic, and, in order to share information, it is often necessary for provid- ers to be public speakers, especially at hospital grand rounds conferences or in various continuing-education and training contexts. Furthermore, administra- tors and some providers may also be expected to use mass communication and educate the stakeholders, customers/patients and families, as well as the gen- eral public about the organization and its health care delivery services. These mass-media formats can include print, TV, Internet, and/or radio, as well as various social media possibilities. Regardless of to whom or how an organi- zation’s message is delivered—to be most effective the institution needs to not only have a clear and consistent mission, goals, and values statements, but communicate them in all forms of internal and external organizational messages. Sharing the organization’s culture with external sources is best managed using carefully assessed and developed advertising, PR, and media marketing campaigns. Finally, the evolving role of senior administrators in hospitals and other health care organizations highlights the potential com- munication challenges for providers who feel that these institutions should be more patient focused rather than business focused. Consequently, providers need to strive to enhance their interpersonal relationships with administra- tors vis-à-vis their effective verbal and nonverbal interpersonal/organizational communication.

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8 Health Care Organizational Communication 157

■ B I B L I O G R A P H Y

Apker, J. (2012). Communication in health organizations. Cambridge, MA: Polity Press.

Borkowski, N. (2016). Organizational behavior in health care. In Part IV, intrapersonal and interpersonal issues (3rd ed., pp. 251–329). Burlington, MA: Jones & Bartlett.

Borkowski, N., & Deckard, G. (Eds.). (2014). Case studies in organizational behavior and theory for health care. In Case seventeen: Working toward collaborative care (pp. 113–136). Sudbury, MA: Jones & Bartlett.

Kenney, C. (2010). A journey to Japan. In Transforming healthcare: Virginia Mason Medical Center’s pursuit of the perfect patient experience (pp. 13–32). New York, NY: Taylor & Francis.

Mick, S., & Wyttenbach, M. (Eds.). (2003). Understanding health care markets. In Advances in health care organization theory (pp. 99–141). San Francisco, CA: Jossey-Bass.

O’Shea, E., Pagano, M., Campbell, S., & Caso, G. (2013). A descriptive analysis of nursing student communication behaviors. Clinical Simulation in Nursing, 9(1), e5–e12. doi:10.1016/j.ecns.2011.05.013

Shi, L., & Singh, D. (2015). Delivering health care in America: A sys- tems approach. In Inpatient facilities and services (6th ed., pp. 291–335). Burlington, MA: Jones & Bartlett.

Shockley-Zalabak, P. (2015). Fundamentals of organizational communica- tion: Knowledge, sensitivity, skills, values. In Communication implications of major organizational theories (9th ed., pp. 70–83). Boston, MA: Pearson.

The Joint Commission. (2016). Hospital accreditation. Retrieved from http:// www.jointcommission.org/accreditation/hospitals.aspx

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