There's a famous line from an old movie that goes something like this: “What we have here is a failure to communicate.”
Communication, as it happens, is something all academic medical centers struggle with. I know this because it's a recurring theme at national meetings I attend.
There are several reasons why effective communication is so challenging for us and others like us.
One is the sheer size and complexity of the organization. UMMC, for example, has grown to 10,200 employees, in multiple locations, and has upwards of 200 departments and units. “Getting the word out” consistently to such a large, diverse group is no small undertaking.
A second reason is that we tend to communicate vertically rather than horizontally. By that I mean information is shared more readily within departments and schools but not across the span of the organization. This is the classic problem of “silos,” and academic medical centers have no shortage of those.
Finally, the culture of the organization influences the style of communication. In some institutions, top-down, one-way communication predominates. Others try to distribute more actionable information to front-line employees and to encourage meaningful, two-way communication, not just up and down but across the organization.
This latter style is one I prefer and the one we've been working steadily to instill at UMMC. I want our faculty, staff and students to know what's going on and to feel engaged and empowered to carry out their work. Nowhere is this more crucial than in the patient-care setting, where effective communication between members of the health-care team is vital to patient safety.
It's important to note that to be effective, our communication has to exhibit certain characteristics:
- It has to be timely. If the rumor mill is in full swing long before the facts arrive, then we didn't get the job done.
- It has to be credible. Though we sometimes have to make accommodation for confidentiality or legal concerns, our communication should never misrepresent the facts or shade the truth.
- It must foster dialogue and be open to questioning. Nobody has a monopoly on the right answers, including me. Everyone's opinion matters and there's no such thing as a “dumb” question.
The overall leader of the organization sets the tone for communication, but it's not just my responsibility. Leaders at every level of the organization have to buy in to and support this commitment, and I expect them to do so. And employees and students have to hold up their end of the bargain by being attentive and responsive.
To support effective communication, we try to foster a rich and robust communicative environment. This is facilitated by a number of activities:
- What I would call “chain-of-command” communication that occurs from department chair to faculty member, manager to staff member, teacher to student. Although there is a clear hierarchy in place, ideally these relationships should involve dialogue in which there is a true exchange of information.