Communication Between Leaders in a Health Care Organization and Its Health Care Providers
Health care administration problems can arise in the work place and must be addressed and remedied as quickly as research will allow for the best evidenced-based discovery and decision to be possible according to author Franz (2006). Such an example has been in health care administration communication. A problem recognized across the board has been verbal, written, audio/visual, and non-verbal body language in communication or the lack of communication. Positive communication between executive leaders in a health care organization and its health care providers is important for the continuity and quality of health care. Lack of positive communication can be detrimental to the organizational structure but most of all to the patient population it serves if communication barriers are not recognized, evaluated and planned on how to successfully overcome barriers (Borkowski, 2010). Leadership and style of communication are keys to the success of a health care organization.
This paper will discuss researching the key factors of communication between health care organization’s medical providers and what may happen if strong and positive communication is not present. Research question on why medical equipment and services needed to support quality and continuity of health care for patients is important and why if no communication between providers may be costly or even the loss of health care business. Specific to why and how communication problems may arise and suggesting positive solutions based on how communication can be implemented will be developed and referenced to influence the research of this paper.
The research material will be specific to health care communication and how legislations and other peer-reviewed scientific literature bring about the formulation of the discussion and research of this paper. Having insight to various communication materials, identification of communication problems and applying scientific evidenced based material will be included to further the argument and discussion.
Addressing a problem arose out of a recent concern on how and why at least three federally operated hospitals lost a large number of medical providers. News media brought about the health care concerns in Native American Communities and how patients, staff, medical providers and Tribal Health Board looked for solutions to a specific identifiable problem – lack of communication to and from health care leadership and medical providers on the need for medical equipment to perform services and to communicate with their colleagues and other health professionals. Research material will include various organizational websites, documents and peer reviewed articles to support the need for communication and medical equipment and services.
First, evidence-based practice guidelines must be fully understood to start the research of understanding how communication or the lack of communication may or may not support the relationship between the leaders and the health care providers. Specific professional organizational guidelines are utilized in the field of writing about the research topic. However, since most scientific organizations have six (6) similar and general guidelines, these will be utilized in developing the process of research for communication in health care (Franz, 2006).
The six (6) tasks involved in the evidence-based practice include:
- 1) identifying a problem;
- 2) researching different and several types of scientific literature;
- 3) critiquing the evidence(s) found;
- 4) developing a recommendation(s);
- 5) implementing practice changes and,
- 6) evaluation.
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A Problem in Communication
A problem in communication between upper management including the Chief Executive Officer (CEO) and the Health Board to which the CEO answers to, and the clinical practitioners within the inpatient/outpatient services of a health care entity, such as the Indian Health Services is crucial (IHS.gov, 2012). Several concerning circumstances such as non-communication or a breakdown in communication process can hinder the health care service that is supposed to be provided to the intended population. Other concerning factors ranged from lack of communication between the provider and the secondary or supporting services the physicians needed to continue the care of patients because the supporting departments did not have the resources in place to access and to give services as prescribed by the physician(s).
The Lack of an Electronic Health Record
One identifiable cause of the breakdown in communication is the lack of an Electronic Health Record (EHR) system having a limited inter-connectivity to all medical information in other clinics. The EHR program can be accessed by physicians at the outpatient clinic and inpatient departments that have inter-connectivity with EHR. But, if not all departments have access, such as emergency room (ER) and x-ray departments, then a physician needing to access medical health care records will be limited. This has caused major medical concerns with requests and results when a physician needed to have x-ray information to continue treating patients in a timely manner. These concerns were communicated by the physicians to the administrative echelon including the CEO and the health board but communication processes in written and verbal form was slow or lost to follow up along the way. To further this lack or slow communication of needed services, many requests were further slowed or dead ended with the freeze of federal funds.
This slow or loss of communication process impacted the patient population the physicians served and frustrations increased as access to EHR implementation for inter-connectivity requests went unfulfilled.
Although Human Resources (HR) department, policies and procedures, mission statements, licensure, credentialing, accreditation and legislations on communication for intact continuity and quality of health care for the population it serves, everyone within the scope of providing health care or the administration of the health care entity must have knowledge of communication on several levels. Communication is a process that must support how a physician listens, assesses and then determines how health care services will be given to the patient while addressing and adhering to specific health care guidelines as mentioned, including medical morals and oaths (APOGEE, 2012). For example, a physician working in a federally operated Indian Health Services hospital must be culture and language sensitive as federal and tribal legislations demands by making sure quality and continuity of health care is carried out by having certified interpreters in place for positive communication to happen between medical provider and the patient (IHS.gov. 2012). The legislation may be referenced in how the mission statement and even accreditation may apply.
According to the American Hospital Association (AHA), it provides forums for its members about policy issues on communication (AHA, 2012). The AHA has as its focal points on Quality and Patient Safety, tool kits and presentation of the utilization of information on an array of medical issues, one of them being communication. Valuable information on policies and supporting data is offered to assist health care providers on how to implement quality health improvement for their patients and also includes how communication can be a key to a successful working relationship between different providers within the health care organization to the recipients, the patients they serve.
The Blue Cross/Blue Shield Organization
The Blue Cross/Blue Shield (BC/BS) organization has online services and offers incentives that encourage both medical providers and patients to utilize in their communication on monitoring health care issues and educational health care programs (BC/BS, 2012). When a health care organizations’ computer has no connectivity to BC/BS online services or other such services a breakdown in communication for resources for the patient to improve their health care or knowledge is limited. From the perspective of the medical provider, the communication of further educating their patient is hindered. With these types of communication hindrance, quality and continuity of health care becomes limited, especially for the patients who have a computer and are willing to work on improving their health with their physician guiding them in the utilization of alternative health care monitoring. A good example would be the diabetic patient who is encouraged by his physician to expand his knowledge on their disease and to better understand nutrition could utilize such communication services with nurses that will help them monitor their food intake. Another example is how a medical provider will be able to utilize the internet to monitor their patients’ usage of tools on the health care websites.
The Blood Services
One area of health care services that is impacted by the limitation of communication is the blood services information for health care providers who need to research more about their patients’ blood anomalies and needs. Medical providers and laboratories utilize online blood services such as The Memorial Blood Centers, for information and in-depth research or to communicate with specialists (Memorial Blood Centers, 2012). The Memorial Blood Centers utilizes the Centers for Medicare and Medicaid Services (CMS) guidelines and is accredited by the Joint Commission (JC) and many physicians utilize this online service because it adheres to strict guidelines assuring them they can access in-depth blood service information as the need arises. In addition to the blood services for their patients, the medical provider can also access online durable medical equipment that can support the dialysis patient’s treatment (US DHHS, DME, 2012). End stage renal disease need many facets of health care services and the medical provider will need to access on-line services while utilizing a compatible computer system within the health care facility or clinic to expedite the quickest and safest possible health care services to the patient.
Veterans Administration Hospitals
Veterans Administration (VA) hospitals is a huge contributor to disseminating medical research information both online and in publications on quality care and safety climate within the organizational culture of health care interest (VA.gov, 2012). Health care providers are constantly on the lookout for updated ways to keep their patients and themselves safe within the health care environment. The VA hospitals and its’ medical researchers are constantly collecting data to compare to the safety outcomes for randomly selected patients within randomly selected hospitals to see if there is uniformity and strength in the safety environment. The data from these studies are valuable information for physicians and other health care providers to be aware of in their scope of practice. While accessibility to publications in hard copies is available in a few days after publication, access to internet information far outweighs positively by comparison.
The Heart Health Services
Another area of health care that is impacted by precise, state-of-the-art medical equipment utilization is the heart health services and treatment in hospitals and clinics. The communication between hospitals and health care providers is a huge part of a successful treatment of heart care (SJRMC, 2012). The providers in each health care entity need to have the ability to communicate via the most up to date telemedicine equipment. To provide adequate referral services for heart surgery, the attending physician and the heart specialist must be able to send echo cardio grams and other heart data so the heart specialist may be able to know in advance how to proceed with the surgery. When the necessary medical equipment is not in place for this type of referral services, it could mean a devastating effect on the patient. However, when the right type of telemedicine communication equipment is available for patients who need to be transferred to another facility who can further assist the first attending physician, the patient outcome could be a successful one. The same equipment utilized for telemedicine can continually be used for follow up services for the patient as needed.
Health care related improvements ranging from medical equipment and services to telemedicine and health care education are a few of the reasons communication in every form is important and vital in many cases. For these reasons website listings include easy accessibility for health care providers to communicate with their peers, colleagues, research centers, services for inquiries and other data bases are vital to the success of quality and continuity of health care (HRET, 2012). However, when equipment and services as simple as an EHR system for in-house purposes of documenting or researching history of patients’ health care services, or follow up results, is not in place, then quality of health care can drastically decline quickly and even the loss of lives. When further communication barriers between health care providers and their upper management, including the CEO and health board, continues to increase, the purpose of the hospital or clinic falls short of its’ goal and mission statements (Liebler & McConnell, 2008).
The Health Research and Educational Trust Organization
HRET is an organization that utilizes seven recommendations to improve quality health care for patients by: 1) Collecting race, ethnicity and language preference (REAL) data; 2) Identifying and reporting disparities; 3) How to provide culturally and linguistically competent health care services; 4) Developing culturally competent disease management programs; 5) Increasing diversity and minority workforce pipelines; 6) Involving the community and, 7) How to make cultural competency an institutional priority (HRET, 2012). HRET also recommends and includes a self-assessment checklist for the hospital, clinic and professionals to guide in the areas of need to communicate with the population they serve as well as among their peers or colleagues. A list of cultural competency resources that are relevant to specific cultural disparities, such as communication, will guide health care leaders in how to improve quality, efficacy and equity of health care. HRET is an example of how some organizations are helping bridge a communication gap not only between provider and patient but also among peers, colleagues and management of health care entities. The self-assessment tools this organization and others like it, are easily accessible online, faxed, or by hard copies. These self-assessment tools can be helpful in identifying the breakdown of communication between the health care providers and upper management for the request of communication services or medical equipment for the utilization of improving or acquisition of such services and equipment.
Types of Communication
Communication is a mandatory skill that is developed early in a health care career and can make or break an individual health care provider or a whole health care entity. Different types of communication skills can be explored and presented by written, step-by-step instruction and practiced to perfection to increase quality of health care between providers, patient to provider, to colleagues and others (Lieblier & McConnell, 2008). Non-verbal communication includes body language, such as facial expressions or stance or hand gestures and can contribute to how individuals further express their views. Written language has a variety of ways on how health care can be communicated between patient to provider and vice-versa. When continued health care services are impacted in a negative manner and the patients complain along with the provider for better services then, providers have no choice but to inform their superiors or supporting departments to remedy the problem by providing the needed services or by purchasing equipment.
It is important to know how to properly communicate the need for medical supply, durable medical equipment and services to the proper chain of command. Documentation of a needed service(s) or equipment with a justification sent via email or letter, along with a person-to-person conversation may assist in providing solid communication on the subject. Further follow up with a phone call or email with a reasonable time frame could also remind others of the importance of remedying the problem. The frequent but reasonable follow up conversations will allow for continued communication for a positive outcome rather than a loss of value on the subject and requests.
This paper addressed the single-sentence problem statement “Communication breakdown between top leaders and medical providers for medical equipment and services in a health care environment” and the single-sentence hypothesis statement “Successful delivery of health care when leadership and health care providers communicate.” When both health care providers and their CEO, health board members and other interest parties communicate on a positive level, an understanding of the medical need is better understood and if the requested medical and communication items are acquired, everyone including the outcome of positive patient outcome is attained.