How do you communicate within a large organization?

It has been a very interesting (and at times humbling) week for me. I have spent a lot of time reviewing what our people think from sources like the Employee Satisfaction Survey, the Physician Satisfaction Survey, the Senior Team Survey, the thoughts of our wonderful Employee Relations Council and people at this week’s employee lunch forum, questions from our first Town Hall meetings, and comments on this blog.

Our healthcare system is strong in large part because of its diversity in so many dimensions, one of those being its diversity of opinion. In the various formats that I listed above, many people have stated their opinions. I believe that we generally get to a consensus belief about most things when there is a free flow of information between the “front line” and the “front office”. But some of the thoughts expressed by people in our family are quite startling and underline for me how important it is to try to communicate with everyone. Some of our hard working physicians, nurses, and others believe things about what we “administrators” (and me in particular) are trying to do that are literally the opposite of what we are trying to do.

My reflection on how to continually improve communication such that people believe that someone is listening to them and they get to hear what our senior leaders think has to begin with me. The effective question is: what can I do to improve direct, open, and honest communication? It is clear that I need to make myself more available and I need to reach out to members of the family who are less likely to be physically present at on-campus forums like many of the members of our medical staff, both private practicing and employed. I also need to continue to work with our senior team to continue to make decision-making easier. I need to get better at listening. When you are passionate about something, you cannot let your passion run away with you.

But I also realize that a big part of the dilemma of making sure that everyone feels that they have a voice and that someone cares about their opinion is just a characteristic of large complex organizations. It is hard to get the message down and around to everyone without the final received message getting distorted. I am sure that the readers of this blog have played the game where someone whispers a message in a person’s ear and then that person passes the message down the line until the last person repeats what he or she heard. 

Everyone laughs when they hear the difference between what the last person heard and what the first person said. For example, a message that starts “We need to build a big robust primary care enterprise within our company to better coordinate care for patients and to send more patients to our surgeons when they need surgery” becomes:  “We only care about primary care physicians and we don’t need excellent surgeons, excellent OR teams,  and  strong  surgery departments”.

I also know that the world continues to change rapidly and it may be that sometimes people have heard the message but they don’t like it. In this instance, the challenge is to make sure that people are appropriately reassured, their fears are addressed and that people like me try to look out for their interests when they are in line with the interests of our patients and the GBMC system. 

I am very interested in hearing people’s ideas on how we can communicate better and truly give people a voice. Please share your ideas either by commenting on the blog, or if you would like me (or another member of the senior team) to come and visit your practice, your department, or your unit please email me at Jchessare@gbmc.org.  

Thanks for going “above and beyond”

Last Friday I was the senior executive on call for our hospital. Dr. Dave Strauss, one of our outstanding Emergency Medicine physicians, called me about a case that got me annoyed very quickly. The larger healthcare “system” and the patient were making it very hard for our team to do what I and more than 99% of rational thinkers would want done for themselves or their loved ones. Dr. Barry Waldman, one of our medical staff orthopedists, stepped forward and treated the patient according to his wishes and took care of his immediate medical problem under very difficult circumstances. I would like to publicly acknowledge Dr. Waldman and thank him for helping this patient.