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Effective Communications Improves Outcomes

Practicing strategic internal communications means looking at how communications enables and improves the ways your organization functions. One of my favourite examples of how this works comes from a study published this year in the New England Journal of Medicine. To see if they could improve surgical outcomes, researchers created a checklist for the operating room that improves how surgical teams follow best practices. They reported some incredible findings from the study:

“… a year after surgical teams at eight hospitals adopted a 19-item checklist, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, the researchers reported.” (Checklist Reduces Deaths in Surgery, NYT, Jan. 14, 2009)

I’ve included a link to the checklist here because I think it is an illuminating piece from an internal communications perspective. The key themes for me are:

  • the way it builds team alignment towards accomplishing the objective,
  • how it institutes top-of-mind awareness of critical information and activities, checking in with key roles before each stage of the operation, and
  • the steps taken to create a communications environment that makes everyone’s voice an asset.

This is a great example of strategic communications furthering a corporate objective and maybe I’ll write about that next time. Today, though, I want to look at an example of how strategic communications makes the intelligence and perspective of your whole team more accessible.

On the surgical checklist, the team takes a “time out” just before the first cut is made and everybody introduces themselves by name and role. A simple step, but I imagine it goes a long way towards clearing up confusion about who is doing what. More important than that it institutes through practice that all team members in the room have a voice and have used it. Everyone from the head surgeon to the second year med student who is just observing have had to clear their throat and make themselves known in that room. In an NYT interview with the senior researcher of the study, Dr. Atul A. Gawande noted “junior members of the team [are] sometimes hesitant to speak up”; “Giving them a chance to say their names allows them to speak up later.”

So imagine a surgery that doesn’t go as planned. Everyone acts like stone-cold pros and deals with the emergency, but now they’re exhausted. That med student kid spends the whole time on the sidelines stunned and shaky with the stress and trying to stay invisible. But just before she came to the OR, she went to a lecture on the number of times gauze is left in the patient, goes septic, and kills them. She’s been counting the pieces as they went in and came out and now, as they get ready to close the incision, she’s got that anxious feeling that one piece is still in there. No one else seems to notice but she’s pretty certain.

If that’s you on the table, you want her to speak up, right now. Maybe you’ve always thought “empowered voice” is kind of a silly, overblown term for feeling like you can say something but, at that moment, in that room, you hope she’s feeling empowered as hell.

That’s why one of the descriptive terms for “two-way” or “symmetrical” communications is “excellent” (Grunig et al, 2002). Relying exclusively on top-down communications robs the team of the full intelligence and perspective of its members. Laying there open on an operating table, you really want your surgical team to be at their most excellent.

You probably also want that from the people who are interacting with your customers, building your products and managing your business. That’s why you institute two-way communications, you do it early, you listen to it, and you act on the insight it provides. When one of your employees sees something that should be fixed or could be done better you want them to already feel they have a voice in how things run. You want them to have already used it, and to feel confident their voice will be respected. Then you can feel confident people won’t watch dumbly as operations fail at a critical moment.

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  1. Amanda Laird

    Thanks for sharing, this is fascinating. And incredible. Introducing yourself in advance of a meeting, brainstorming session, etc. is a great way to enable sharing.

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