If the eyes are the windows to the soul, then communication is the key to action. As a healthcare leader, you will find staff engagement through communication to be linchpin to all of your activities. As we discussed generally in the preceding chapters, the strength of your communication will directly reflect the effectiveness of your performance efforts.

Communication training and development for a healthcare manager must go beyond platitudes and clichés to become a style that is both comfortable and natural and one that will provide maximum impact. It is also vital to use a communication strategy that allows you to get information on a timely basis and to provide needed work direction in an efficient manner.

This chapter will explore the essential dynamics effective to healthcare management communication and the interpersonal dynamics essential to the healthcare leader’s role. The use of the title the C-Formula and its handy alliteration of the letter C will assist you in the practical application of proven strategies that can help you maximize the communication process with your staff and other important players in your sphere of influence. Also provided will be insight on specific communication dynamics, including written communication, group communication, and interactions between yourself and your superiors. By exploring both the virtues of good communication and the pitfalls of poor communication, this chapter will provide you with valuable guidelines as you undertake your management role.

In your role as a healthcare or physician leader, you must master four essential dynamics of communication: climate, community, content, and challenge. Climate refers here to the workplace environment, which you help define, and the overall atmosphere throughout the healthcare workplace. The term community as used in this chapter relates to the team orientation of your department and to the overall organization in which you work, including all lines of communication within the organization. Content refers to the way you deliver messages—the style, message, elements, and manner in which information is provided and direction is given. Finally, challenge refers to how critical communication, vital work parameters, and directives are delivered to appropriate members of the organization.

In each of these four areas, a set of essential components comprises the dynamics of communication in the healthcare environment. These components are summarized throughout the following subsections and offered as guideposts for your own approach to effective communication in your new role.

The Climate of the Work Environment

For a work climate to be prosperous and produce good results on a regular basis, a certain amount of coaching must take place as the leader acts as a mentor to his or her staff as a unit and as individual staff members assist one another in attaining growth and development. In effect, coaching entails encouraging others to perform better, pointing out their mistakes constructively, and providing ongoing direction as needed to all members of the department. Too much coaching (micromanaging) leads to a leader becoming needlessly too detail oriented by failing to allow individuals enough professional liberty. A total lack of coaching within the department will arrest staff development and, consequently, work progress.

Accordingly, a consultative environment must surround the work group. This involves the sharing of expertise among the staff and the provision of technical acumen by the department leader. The healthcare manager must be a leader in becoming a consultant within the department, as well as a consultant throughout the organization on key technical issues. Technical information provided to others in the organization must be clear and direct and conveyed in a manner that will be readily understood and useful to the receiver. The risks with consultative communication are overuse of jargon or technical terms or loss of the essential message due to failure to understand the requester’s needs. When acting in a consultative role, first ask a series of questions to determine the specific nature of the problem; next, determine what technical assistance the individual needs; and then provide that assistance in a clear-cut manner while pledging any further assistance as needed.

The fourth attribute of workplace climate in terms of communication is candor. The worst liability you can be faced with is to be perceived as a phony or as disingenuous. Strive to be forthcoming and direct in all your communication efforts. Be forthright in dealing with individuals and in providing information; let people know that you do not have all the answers in all situations and state your dedication to finding the answers to questions and the solutions to problems. By providing false or misleading information, inconsistent or inaccurate communication, or by doing anything that can be perceived as dishonest or an attempt to con department members, you risk being judged untrustworthy or incompetent leading to a lack of trust that could be irreversible.

The fifth element of communication in the workplace is collaboration. It is essential that as a team all members collaborate on common goals and objectives. Individuals must feel comfortable working together striving toward a mutually beneficial end. Stressing the individual talents of department members is a great first step for creating a spirit of collaboration. Publicly recognizing the contributions of all team members, particularly on joint efforts, is the second step toward fostering a collaborative atmosphere. The third step is to remember the axiom, give the good news in public, but give the bad news in private. Thus, positive gains the department has made should be shared in public, while any performance deficiencies or problems should be discussed individually in private with those involved. This approach ensures that a positive spirit is generated throughout the group and that collaboration and joint efforts are always encouraged and rewarded.

All department members should feel they are comrades in arms, working together, and living by the adage, “Nobody wins unless we all win.” Thus, camaraderie is a key element of the workplace climate. Certain key words can help establish camaraderie across the department. For example, in stressing the value of working together, the word team and the pronoun we are verbal strengtheners that reinforce the virtue of camaraderie. Without camaraderie and collaboration, groups become disjointed and the individual is focused on at the expense of the group.

As emphasized throughout this book, the focus of communication in a progressive work climate should be on identifying and implementing solutions, not constantly reiterating and exacerbating problems. The key notion in this respect is finding a cure, an appropriate metaphor, given that the essential mission of a healthcare organization is to seek cures. Cures must be sought for everyday problems that arise in your department. Always ask your staff’s advice on how a problem might be solved. Encourage them to provide cures to problems and reward them, either verbally or tangibly, for any successful solution. Special recognition such as employee of the month or paid time are two examples of appropriate awards. It is imperative that the workplace climate be geared toward providing cures and that the positive generation of progressive ideas be recognized and rewarded.

Character is another essential dimension of the workplace climate and is essentially to the work personality demonstrated and embraced by all members of the department. Any communication should be delivered in a way that is thoughtful, tactful, and ethically sound. This precludes publicly berating any employee who is not performing up to standards. Thoughtful delivery also mandates the use of tactful language and appropriate courtesy when discussing key issues. Furthermore, character defines to what extent each individual in the department interrelates with dignity, class, and basic compassion. Lack of any of these positive attributes within the work climate will result in an environment that breeds discomfort, threatens individual dignity, and abets negative aspects of performance and poor team interaction that will soon surface.

Change takes place in the healthcare environment every day. The clear delineation of change elements should be provided by a healthcare manager whenever appropriate. How your department reacts to change and positively addresses the characteristics of change should also be discussed. Each member should be given the opportunity to discuss how change will affect his or her particular segment of the business and how the worker might positively address the change at hand. Failing to recognize and communicate change or to identify solutions and strategies toward reacting progressively to change can lead to departmental regression.

Finally, circumstance denotes specific conditions under which the department must labor. Conditions might include a change in physical environment, new organization requirements, or regulatory or legislative issues that affect the department. The specific dynamics under which each employee works should also be recognized and discussed, with input garnered from the employee on how best to deal with the particular situations imposed by the job role. Both the morale and overall mission of the department can be bolstered easily and at no cost when the leader credibly and constructively acknowledges the unique contribution of individual team members.

The Work Community

Any healthcare department is a unique community, and it services a community of customers/patients and professionals within the organization who rely on the department to achieve its mission.

The first component of communication as it relates to communal and team orientation is counsel. Counsel refers to the ability to provide technical expertise and related needed action throughout the organization. In another sense, counsel refers to the provision of guidance for employees who need specific direction in key areas such as stress management, time management, and family relations. Both you and your human resource department must keep your counselor roles at the forefront of strategies when dealing with all members of the organization.

Commitment is dedication to reinforcement of the healthcare mission. All essential organizational messages should be underlined by everyday actions and incorporated in internal communications. This priority of commitment mandates putting the customer/patient at the top and putting service to affiliated members of the organization and to colleagues as a close second priority. Failure to reinforce commitment to the healthcare organizational mission, although a rarity among managers, can occur given everyday hyperactivity of any healthcare organization. Therefore, a savvy healthcare leader will attempt to consciously underscore his organization’s commitment to the customer/patient at every opportunity.

The construction of a message is very important in community-based communication. In essence, you must know your audience when you construct a message. Some individuals have a high comprehension of medical terms; others do not. For the latter group, construction of any message should be based around concepts the receiver can easily understand. Messages can sometimes be overloaded, containing information not essential to the desired outcome. In other cases, messages can be too abbreviated and fail to provide essential information. Ensure that your message is well constructed and well measured, given your receiver(s).

Confidence is critically important in delivering any message throughout the healthcare environment. If you lack confidence in what you are saying, you will lose your audience and your credibility. Without credibility, you can be seen as a nonplayer and will have a difficult time gaining respect for your ideas and input. On the other hand, avoid the appearance of being arrogant. Most individuals in the healthcare environment assume you know what you are talking about and that you are capable of making the right decision. There is no reason to oversell your ideas, and the risk of doing so is that people will think you are trying to sell them a bill of goods.

Because health care is a people-oriented field, a certain amount of compassion should be appropriately omnipresent in all your communication efforts. Lack of compassion can suggest that you do not truly care for a patient, a staff member, or whoever is the receiver of your message. However, one can go to extremes in any dimension, so try to avoid being too compassionate—that is, considering the humanistic elements in a manner that is disproportionate to the business elements of your objective. However, it is always better to err on the side of being overly compassionate than being perceived as not being compassionate enough in a given situation.

Care must be exhibited in everything you do throughout the healthcare community. You should be careful not to offend others needlessly or unwittingly by any communication you provide. Furthermore, patient care should be a driving force in all communication, so ask “How will this communication affect our customers/patients and the quality of care?” Failure to exhibit care in communication can earn you a reputation as being too blunt, brusque, or unfeeling and insensitive toward the needs of others, principally the customer/patient.

Confidence is defined as the net effect of many actions resulting in a increased sense of group competence. A positive confluence occurs when several positive factors, such as several departments working cohesively together or several employees working toward common goal in a progressive fashion, result in a positive outcome. Conversely, a negative confluence occurs when several negative events produce an overall negative net effect. A strong healthcare organization (and at the department level a strong healthcare team) should seek to create a positive confluence of factors whenever possible. From a communication perspective, this entails continuously identifying and developing positive factors and positive attributes of these factors and pointing them out to all members of your team. As a healthcare manager, you should make this an essential part of your everyday activities.

Any communication process must have comfort as an essential dynamic. The more comfortable someone is, the more he or she will communicate and the more information will emerge. From an organizational perspective, all individuals should feel comfortable in providing information, giving their opinions, and stating their viewpoints freely and without fear of negative retribution. As a healthcare leader, try to impart these same ideals throughout your department. Strive to maintain a comfortable environment in which you discuss issues with individuals in a nonthreatening manner. By asking questions, you open up channels for vital communication; let people know that your office has an air of confidentiality and comfort by closing the door and allowing visitors to sit down and relax while relating problems and situations to you. Without comfort, communication becomes abbreviated and contrived.

Sensitivity to cultural diversity is a major management concern. Invariably, you will be challenged with managing culturally diverse individuals along all demographic lines. Cultural conflict can take place in the way individuals communicate. For example, some cultures disapprove of direct eye contact as a sign of disrespect. Other cultures communicate in what may be perceived as a very emotional fashion; others may be perceived as less expressive in their communication style. Recognize these differences objectively, and communicate in a style that is most comfortable for you. Do not try to adopt the cultural norms of others, lest you run the risk of appearing phony or condescending. Communicate in a direct, straightforward manner. Your comfort with your own communication style will be acknowledged by the individuals with whom you communicate and thus will not become a negative issue.

A few guidelines can assist you in making response to cultural diversity a positive attribute of your communication strategy:

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  Never refer to a staff member’s cultural background, even if it is from what you might think is a positive or humorous perspective; you could unknowingly and unintentionally offend the person or make him or her feel uncomfortable.

  
  
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  Immediately address any clashes that might stem from cultural differences among your staff. If allowed to fester, these situations will create immense problems.

  
  
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  Do not allow individuals to make cultural differences an issue in any departmental interchange.

  
  
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  If ever in doubt or even uncomfortable with a cultural communication or engagement issue, get an assist immediately from someone in human resources or senior management.

  
  
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  If any staff member focuses on using cultural difference as a stumbling block in working with others, consult your human resource department as well as your supervisor to resolve this conflict positively and quickly.

Finally, contact is essential in community-based communication. The more contact you have with your employees, the more knowledge you will attain about their activities and aspirations. The more contact you have with customers/patients, the greater your knowledge will be of their expectations of the organization and, specifically, their expectations of your department. The more contact you have with your superiors in the organization, the more you will learn about leadership and organizational norms. Finally, the more contact individuals have with you, the more comfortable they will be with relating their ideas and options to you and recognizing you as a leader within the management team.

The Content of Messages