Effective Communication

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HCS/325

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For nearly the past decade, I have been employed by an organization that has gradually evolved from a combination of functional and line structure to that of a matrixed environment. According to an article published 12/19/2011 by Khushnuma Irani, line structure “follows a very specific line of command.” It works well in smaller organizations because there are fewer departments and decisions can be made more quickly and with fewer formalities. Functional structure classifies staff based upon job function. The combining of the two produced a structure that consisted of staff that followed a specific chain of command but were classified departmentally based upon title or job function. A matrix structure, according to Irani, is “a structure which is a combination of function and product structures…” combining the best elements of the two structures to make a more efficient structure. However, the matrix structure is not without its challenges. According to an article published by Eric Krell (Managing the Matrix, 04/01/2011) “It requires constant education.”

With my current organization, I started out in registration, which was its own department. It did not matter if an employee worked in outpatient services, emergency services or one of the nursing floors. Registration clerks reported to a supervisor who reported to a manager who reported to the director of Health Information Services. When I transferred to Information Services I learned that every job function pertaining to providing technological support of any kind was related to the IS department. In our case, it was a small shop that consisted of two desktop support technicians, a business analyst and a director. We reported only to our director and no other member of management possessed the authority to modify our workload.

In 2009, my organization began to restructure and chose a matrix structure based upon the established success of the nation’s leading health care organization. It has been neither an easy nor a smooth path to a full-blown matrix structure, but organizational leaders envisioned the long-term benefits of choosing this evolutionary direction. Previously, all of the IT analysts and support staff were scattered throughout the region and provided support only to their respective areas. Knowledge was “siloed” and out of sheer necessity, most members of an IT shop at an affiliate level were cross-trained to be able to provide support for most technology-related issues. Unfortunately, these IT shops were staffed with a minimal crew, and since that crew was responsible for supporting an entire hospital (and usually its outlying clinics as well) they had only enough time to “put out fires” but not to become specialized in the skill sets that would have greatly benefited them in their jobs. Once the organizational restructure began, all analysts were gathered under one particular umbrella of IT. Included in this group were imaging analysts, clinical analysts, and various applications analysts. All desktop support, servers, voice operations and network operations were gathered under the technical services umbrella of IT. Everyone non-management was uncomfortable with the change in structure until they began to see how the restructure would help them. For instance, employees were now able to take time off and not worry that there would be only one person – or nobody – to cover for them in their absence.

Sharing of knowledge is an ever-evolving process and the organization is continually encouraging staff to share and implement ideas that will make access to information more efficient – and the information itself more thorough. Currently, web-based knowledgebases are used, along with collaboration SharePoint sites. On a quarterly basis, “Town Hall” meetings are held in which company challenges are discussed and management gives staff the opportunity to suggest potential solutions. Additionally, the organization developed a Lean Six Sigma team who selects various employees to participate in a Kaizen event. In these types of events, employees, supervisors and managers are brought together to address a challenge – typically a broken or inefficient process – and are required to come up with a solution, document it, pilot it and implement it. Once a process improvement is implemented, the group must be able to measure its success and present the indicators of success at the Town Hall meeting. This structure is believed by management to promote transparency across the organization.

While the aforementioned techniques are utilized within a health care environment, the same techniques and principles can be applied to many large organizations because whether the business is healthcare, trucking, fast food or law enforcement, the need for communication is always present, as is the need for processes to evolve and improve.

Prior to Town Hall meetings and Kaizen events, department management met once a quarter to discuss the status of department projects, challenges and successes. While helpful information was shared during these meetings, this information was rarely brought back to the staff so major changes within the organization blind-sided employees, causing a drastic decrease in morale and an increase in turnover rate of employees in both clinical and non-clinical departments.

The sharing of knowledge throughout the organization has been greatly impacted by the use of evolving technology. We use technology numerous times each day, often in ways we are not even conscious of. For instance, electronic charting took the place of paper charting in our emergency rooms eliminating tons of paper waste as well as all but eliminating the possibility of a printed patient record being left in an unsecured area risking a breach of PHI. We use technology to auto-fax clinical information to specific providers, cutting down on the time it takes to provide family doctors with their patient records. Technology is used by physicians to do video consults with patients, family and other physicians. At times, there seems to be no limit to the type of information that can quickly be obtained when technology lends a hand to the sharing of knowledge.

According to Tony Jackson, IT Director for one of our regions, “Communication can be considered the circulatory system of an organization, and the success of the company depends, in a large part, on the health of that circulatory system.” If this is true, the effectiveness of communication depends on factors such as audience, content and presentation – and the understanding that technology is merely a tool of communication. Whether communication is effective or not depends upon how the tools are used.

References

Jackson (2013) - IT Director of Sutter Physician Services

Types of Organizational Structure – Kushnuma Irani http://www.buzzle.com/articles/type-of-organizational-structures.html (05/26/13)

Managing the Matrix – Eric Krell http://www.shrm.org/publications/hrmagazine/editorialcontent/2011/0411/pages/0411krell.aspx

(5/26/13)