The dangers of getting it wrong on communication and engagement

May 15, 2023

Most of us take communication for granted, and at our peril. History is littered with examples of how routes of communication are far more fragile than we think, with disastrous consequences.

A case study of this is found in Charles Duhigg’s book The Power of Habit. Duhigg interviewed nurses who worked in the early 2000’s at a hospital in Rhode Island. While the hospital’s technological capabilities were the envy of many, its calamities were not.

The book records how public scrutiny descended upon it after a series of negligent errors. Fines amounting to hundreds of thousands of dollars, followed a series of surgical accidents, including operating on the wrong part of a patient’s anatomy and leaving a surgical instrument in a man’s head.

Duhigg argues a toxic culture arose where doctors refused to listen to concerns which would have prevented those accidents. Nurses said they felt “worthless”. They used a colour coding system on their documents, alerting to each other to those doctors who were considered pleasant or unpleasant to work with. There were clear communication failures and a lack of humility in the hospital’s leadership culture.

Duhigg’s book illustrates the importance for leaders to demolish all barriers to clear communication and how not doing so risks the performance of the firm, as well as the satisfaction of staff who may leave to join a different employer. It recounts how a new Chief Quality Officer overhauled hospital working practices. Intensive training, emphasising teamwork and empowering staff, was made mandatory for all. The head of neurosurgery resigned. CCTV monitored all operations. Checklists were required for every surgery. A new system let staff report issues anonymously. Duhigg goes on to explain how, in the following twelve years following the overhaul, no surgeries were performed on the wrong part of a patient’s anatomy, and the hospital won awards for its nursing care.

Leaders can break down barriers by developing a culture of openness, trust and respect for colleagues. Sometimes a subordinate will know ‘the ground’ better, sometimes they will have more sensible ideas. The greatest leaders draw their strength from their collaboration with those who report to them, not their supremacy over them.

Have you had meetings which reinforce the need and benefits of collaboration between all levels? Does your firm provide training which fosters better collaboration and does it provide opportunities for staff to develop a rapport among each other? Are there opportunities for staff to speak-up when they think an idea needs improvement – do they feel comfortable doing this? Are there appropriate mechanisms for them to speak-up (such as having an advocate they can speak to or an anonymous system)? There are examples of employers which have successfully taken positive steps to create inclusive cultures that encourage open dialogue and feedback vertically and horizontally throughout their organisation.

To discuss any of the points raised in this article, or for how MM&K can help your business foster a healthy culture, please contact James Sharp.

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