Prevent Communication Breakdowns in the Workplace

October 7, 2020

Communication is such an important skill for professionals to possess however very few communication courses are taught to employees. Many organizations underestimate the necessity of possessing and training employees on communication skills. It can often make the difference between a profitable bottom line or not. It is incumbent on Learning and Development Professionals to assess the communication needs of an organization and develop and facilitate regular professional development opportunities in this topic. They need to be champions in advocating for, developing, measuring and facilitating improvement in communication skills among all levels of an organization. If not, an organization could be doomed to fail, even more so during pandemic times.

Prevent Communication Breakdowns in the Workplace

What Causes Missed Communication?

Many organizations miss the opportunity to develop employees in this area and are quick to write up someone who isn’t performing up to a standard that is clearly perceived only by the Human Resources department or upper management. Often, the reason for the disconnect in performance standard and demonstrated behavior is simply a miscommunication. Below is a current, real-life situation in a Physical Therapy department of a large metropolitan area hospital. It is no secret that hospitals are experienced decreased revenue for many reasons during this pandemic. One of the causes of loss of revenue is due to the loss of elective surgeries and subsequent loss of rehabilitation services. Less rehab services provide, mean less billing, less reimbursement, and lower revenue. In a misguided attempt to increase revenue, management levied quotas on the PT department. Satisfying the quotas would increase revenue. When an employee fell short of the quota, harsh consequences were administered. Aside from the dictatorial way the quotas were communicated to the department, this seems to be unfair, unrealistic, and a harsh way to treat valuable human resources and talent.

The Issue

Some of the highest performing Physical Therapists in the industry work in this department. Their awards were conferred based on exceptional patient care and outcomes. These employees are skilled and dedicated, giving selflessly of their talents and time. They are feeling unheard, marginalized, unappreciated and feel that their ability to provide quality patient care is now severely compromised. They feel they need to become ‘clock watchers,’ and take short cuts in patient care and in progress notes write up. They will be punished if they stay even 5 minutes past shift end and will be reprimanded if they don’t achieve their quotas. Several of them are upset about the situation, afraid to talk with their HR business partner or department manager. In my opinion, this is a failure in communication, as well as a serious failure in departmental operations. Therapists constantly feel rushed and find themselves making little mistakes and not writing as thorough notes as they feel necessary to maintain good patient care. In a healthcare setting, some patients require more time for various medical conditions. In essence, the PT providers are being put in a compromising and stressful situation and being asked to provide assembly line patient care. Satisfy the quota and provide (in their professional opinion – substandard patient care) OR provide good patient care and miss the metric causing their job to be put into jeopardy. Either way, the departmental culture is set up as an ‘us vs them’ situation and clearly a lack of communication between the two is exacerbating the same problem that management misguidedly, unilaterally, dictatorially tried to solve. 

Most likely, middle management thought they were doing a good thing when they set up the quotas. The problem is that there was no input from the clinical providers in setting these numbers. A cardinal rule in gaining acceptance and good performance is total engagement and buy in of the desired behavior. Input is required from the people performing the behavior. Two-way communication is necessary to jointly problem solve the revenue reduction issue and an effective brainstorming session would result in win-win solutions to accomplish the goal. After discussion with the proposed solution with upper management, a team meeting needs to be held to present and discuss the finalized quotas.

Set Up For A Disaster.

This current situation is set up for a disaster. Therapists are stressed. Stressed therapists make mistakes and don’t provide good patient care. Several ‘previously high-performing therapists’ have already received 2 writeups. One has been terminated. Managers are stressed because they are writing up more employees than usual, causing their other job duties to be neglected. The morale of the entire PT department has dropped to unacceptable levels. Quality of patient care has been reduced as clinicians scramble to make their numbers. Short cuts in care are taken. Patient notes are not written as thoroughly as pre-quota time. Overall, the solution of imposing quotas by upper management on the employees has not resulted in increasing revenue. Quite the contrary. The department is currently minimally understaffed and threatens to become more understaffed. Less providers mean less billing, less reimbursement, less revenue. Wait a minute?!! This is exactly where we started with this situation. Except that needless stress and angst has been placed on the employees and the department culture is now eroded into one that is toxic.

This department will have difficulty recovering from this. 

  • One thing for certain is that the employees need to be given a forum to air their concerns. (communication issue) 
  • Management needs to become aware that high performers are in jeopardy of taking their talent to different health care delivery organizations. (communication issue). 
  • Sadly, patient care will suffer until it becomes so poor that Medicare and other 3rd party billers find out about it (communication issue). 

At that point, there may be an impact on departmental operations. But that will take many months and probably an entire department will ‘turnover’. Surely a preventable situation. 

This current communications disaster continues to unfold at the press deadline.

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