Friday, October 12, 2012

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  

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. 


  1. The communication between departments are terrible. There is no better way of saying this. Despite how we feel, each department depends on one another to get information across whether it deals with giving a report for a patient or communicating the needs of the unit for distribution and enviromental services. We need a better way to communicate with one another and administration about our concerns and opinions. Although this may not take effect right away it is something that is in dire need of attention. Calling certain departments may cause you to get the "run around" treatment. Also, upper management needs to be more clear and more informative to their managers and supervisiors and also their employees about what is going on within the departments and the hospital.

    Employees should not have to go through the rumor mill and search and investigate something that should be clearly explained to them in an e-mail, department meeting, or even individual conversations. GBMC needs to work on talking with their employees and not at them. Dictation is not a effective thing to do. I believe we need to work together to better ourselves and our hospital. We need to get it to a point where it is easy and second nature.

    1. I agree that people in general that have leadership or supervising roles should be able to speak to employees as their equal and not someone under them. I and my team have to deal with this almost on a daily basis via email and in meetings. There is no respect for other people's knowledge to help better a task or environment within the organization and this gets boring after awhile.

  2. Since I have been at GBMC, I have found it very difficult to work together with other departments. It seems we have no "protocols" for how to do things. The wheels get reinvented each time we do something, even if we've done it before. People seem to not stay here long, and when they leave their job title and responsibilities change. So something that was done 6 months ago may now have to be done completely differently because the person who had that job left and now no one knows who does it. It's very frustrating. Other hospitals where I have worked are not like this. Job titles and responsibilities don't change, even if the person holding that job does. And if someone can't help you, they always made an effort to find someone who could. That does not happen here. Ownership of one's job responsibilities does not appear to matter here. I'm not sure what does matter, other than the new buzzword "metrics". They seem to be of the utmost importance, even though they may or may not reflect what is really happening.


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