HCS 321 Week 1 Effective Communication in the Health Care Workplace Example

One Email, Forty Staff and a Protocol Nobody Followed: What a Failed Triage Rollout Teaches About Communication in a Health Care Workplace

[Student Name]

University of Phoenix

HCS/321: Business Communication for Health Care Managers

Week 1 Assignment

[Instructor Name]

[Date]

The medical group, its staff and the rollout are composites written for a model paper; research findings come from the sources listed.

A composite primary care group with four clinics and 40 clinical and front desk staff introduced a new protocol for telephone triage. Nurses would use structured questions for symptoms such as chest pain and fever, medical assistants would route calls by urgency and front desk staff would transfer certain calls immediately. The operations manager announced the change in a two-page email on a Friday afternoon. A month later, a chart audit found the protocol had been used on 3 of 60 triage calls. This paper analyzes why the communication failed and how it should have been done.

The Communication Process

Communication moves from a sender who encodes a message, through a channel, to a receiver who decodes it and responds with feedback. Noise can distort the message at any point. In this case the sender was the operations manager, the message was a complex change in daily work, the channel was email, the receivers were four groups with different roles and there was no planned feedback.

Noise at Every Stage

At encoding, the email used terms such as acuity routing that front desk staff did not know. In the channel, it arrived among dozens of Friday emails and was read on phones between patients. At decoding, each group looked for its own part and missed the rest. With no feedback loop, the manager assumed silence meant understanding.

Choosing the Channel

Daft and Lengel (1986) ranked media by how much meaning each can carry at once: whether it allows instant feedback, conveys tone and body language, uses everyday speech and feels addressed to one person. Talking in person sits at the top of that ranking and formal written or numeric documents at the bottom. They argued that ambiguous tasks, where people must interpret and agree on meaning, need rich channels. A new triage protocol is exactly such a task, full of judgment calls, so announcing it by email alone chose the leanest channel for one of the most ambiguous messages the clinic would send that year.

What Was at Stake

Telephone triage is a safety process. Leonard et al. (2004) described communication failure as a leading cause of inadvertent patient harm and argued for structured tools, such as briefings and the SBAR format, that make communication predictable across professions. A caller with chest pain routed to a routine callback is the kind of harm the protocol was built to prevent.

Audience One: Nurses

Nurses needed the clinical logic: why these questions, in this order, and when to override. They needed practice with scripted scenarios and a chance to challenge questions they thought unsafe.

Audience Two: Medical Assistants

Medical assistants needed clear routing rules, examples of borderline calls and permission to ask a nurse without penalty.

Audience Three: Front Desk Staff

Front desk staff needed a short list of words that trigger immediate transfer, such as chest pain or trouble breathing, posted at each phone, and no jargon.

Audience Four: Physicians

Physicians needed a summary of the change, the evidence behind it and a request to support it when nurses followed the protocol.

Why the Email Seemed Enough

The manager was not careless. She had written clear policies by email for years, and most of them worked. Those messages were routine: a new form, a holiday schedule, a change in supply ordering. The triage protocol looked like another policy but was really a change in clinical judgment spread across four roles. Recognizing when a message has crossed from routine to complex is a skill managers build, and the rollout gave her a clear lesson in it.

The Messenger Matters

Staff also weigh who sends a message. An operations email about clinical questions carried less weight with nurses than a message from the medical director would have. In the relaunch, clinical leaders explain the clinical content and the operations manager handles logistics, so each part comes from the person staff trust on that subject.

Listening for Feedback

The manager later learned from a medical assistant that staff had doubts about two questions they found confusing and had quietly skipped the protocol. Feedback existed; there was no channel for it.

Nonverbal and Written Signals

The Friday timing and the email's length signaled, unintentionally, that the change was routine. When the relaunch came, the manager attended each clinic's huddle in person, which signaled that it mattered.

The Relaunch Plan

Week one: the medical director and nurse lead present the protocol at a lunch meeting for nurses, with scenario practice. Week two: 15-minute huddles at each clinic for medical assistants and front desk staff, led by a nurse, with a one-page guide and a phone card. The same week: a short message from the medical director to physicians. Week three: go-live with a nurse available to answer questions at each clinic. Written materials follow the conversations and are stored where staff work.

Building in Feedback

Staff can raise questions in a shared message thread monitored daily. After two weeks, the nurse lead meets each group for 10 minutes to hear what is not working, and the two confusing questions are rewritten with staff input.

Measuring Success

The clinic will audit 20 triage calls a week for use of the protocol, aiming for 90% within six weeks, and will review any call where a patient with urgent symptoms waited more than 30 minutes.

Lessons for Managers

Communication is one of the competency domains shared across major health care leadership associations (Stefl, 2008), and this episode showed why. The manager drew three lessons. Match the channel to the complexity of the message. Tailor the message to each audience. Build feedback in from the start rather than waiting for an audit to reveal silence.

Conclusion

The triage protocol failed not because it was a bad protocol but because it was communicated through a lean channel, in the wrong words, to audiences with different needs and no way to answer back. Rich channels, tailored messages and planned feedback turned the relaunch into a change staff understood and used.

References

Daft, R. L., & Lengel, R. H. (1986). Organizational information requirements, media richness and structural design. Management Science, 32(5), 554-571. https://doi.org/10.1287/mnsc.32.5.554

Leonard, M., Graham, S., & Bonacum, D. (2004). The human factor: The critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care, 13(Suppl. 1), i85-i90. https://doi.org/10.1136/qshc.2004.010033

Stefl, M. E. (2008). Common competencies for all healthcare managers: The Healthcare Leadership Alliance model. Journal of Healthcare Management, 53(6), 360-373. https://doi.org/10.1097/00115514-200811000-00004