Everyone agrees that technology, including high-speed computers, e-mail, cell phones, and text messaging, has made it easier to stay in touch with one another, regardless of the day or time. But in this age of instant communication, many managers of biomedical engineering departments find that old-fashioned face-to-face communication is necessary to keep employees on track and their departments running smoothly. Experts in the field stress that the most effective employee communication programs infuse these tried-and-true techniques along with electronic technologies.

With 60 employees spread out over 11 campuses in six New England states, Henry Stankiewicz, MS, chief clinical engineer, Veterans Integrated Service Network 1 (VISN 1) of the Department of Veterans Affairs (VA), stresses that employee communication is challenging both within his expansive department as well as with other departments throughout the different hospitals. “We couldn’t live without technology when communicating with our employees and clinical customers, but at the same time, problems often develop when you rely on technology exclusively to disseminate information,” Stankiewicz says.

Face to Face

Research indicates that the number one reason people leave jobs is due to poor supervisory behavior, and that one of the biggest factors cited in poor supervisory behavior is poor communication skills. “The one-to-one relationship with a supervisor is key,” explains Dan Collard, senior coach for The Studer Group, Gulf Breeze, Fla, an outcomes consulting company that specializes in the health care industry. The Studer Group uses a model called evidence-based leadership to create specific outcomes for an organization. In most cases, the Studer Group finds that employee communication is the area within most hospitals or independent service providers that needs the most improvement. While focusing on patient care, many hospitals and health care companies overlook the fact that communication ultimately determines how well patient care is delivered.

“We find that the best communication starts when leaders are able to communicate the priorities of the organization,” Collard explains. “This promotes a sense of alignment between departments, which gives employees on the front line a sense of how they connect with the institution as a whole.” The Studer Group helps hospitals accomplish this by working with administrators to establish five “pillars,” which are words describing the most important objectives of the organization. Among the most used pillars are service, people, quality, finance, and growth. Communication bulletin boards promoting the five pillars are set up in visible areas such as lobbies. Specific goals are also listed under each pillar. A smaller version of this type of communication board is displayed in each department and includes department goals as they relate to the pillars. The department boards are updated each month by showing the progress made related to these goals.

“On any given month, an employee can look at the communication board and determine if their department is getter better, worse, or staying the same,” Collard says. He adds that most department managers end up having their employees draft their own goals related to the pillars, which creates an atmosphere in which the entire organization is communicating and working together at all levels to achieve common objectives.

Making the Most of Meetings

In a day and age when e-mail has become such a dominant communication tool, old-fashioned staff meetings have taken on greater importance. Yet, in many instances meetings are poorly run and overly time consuming. The Studer Group advises its clients to develop an agenda using the organization’s five pillars. “When you lend structure to meetings like this, the meetings become more efficient and are potentially shorter,” Collard says.

Stankiewicz values regular staff meetings and conducts teleconferences with his managers at 9 am each day. Agenda items focus on patient safety, problem areas, and equipment issues, as well as some good-humored discussion about the Red Sox and Yankees. “My challenge is to keep them working both as a team and as individual branch managers,” he says. “The ongoing dialogue that takes place in these meeting helps make this happen.”

One of the biggest transitions for the VA system was its restructure in the 1990s from an independent hospital network to the country’s largest integrated delivery system with 1,400 hospitals, clinics, and nursing homes. “For many of us who’ve worked in the VA for 25, 30 years, it was a big change when we suddenly had to work with physicians and clinical departments from different hospitals,” Stankiewicz says. “Communication has become extremely critical in this new environment.”

In addition to daily videoconference meetings, Stankiewicz also leads face-to-face meetings once per month at the corporate office in Bedford, Mass. “As technical people, we are not known for our social skills, so these meetings are extremely beneficial, even if one or two employees need to drive 2½ hours to attend,” he says.

The Pitfalls of E-mail

Stankiewicz adds that it is much easier for biomeds to use e-mail as their primary communication tool, but he tries to prevent them from overusing this technology. “I can walk into a department and find four clinical engineers all e-mailing each other,” he says. “I quickly tell them to get off their computers and talk to each other.”

Michael Kauffman, CBET, assistant director of facilities, The Reading Hospital and Medical Center in Reading, Pa, also believes biomeds rely too heavily on e-mail and that this often creates a breakdown in communication. “I have found that many e-mails don’t end up being received in the way they were intended,” Kauffman says. “People can emphasize the wrong word, and you can end up with a situation in which a person takes offense to what you wrote when you instead were trying to give them a pat on the back.”

Kauffman recommends that one should never send an e-mail when the slightest level of controversy is tied to the message. Employees can find themselves in hot water if they write something snide or catty about a colleague in an e-mail and then accidentally send it to the wrong person. Or the recipient of the e-mail, for political reasons, might forward it to the person the sender was talking about. In other instances, an employee might get caught accidentally putting inappropriate information in an e-mail, revealing critical organizational or departmental information. These are all e-mail blunders that not only seriously impair communication, but could also cause an employee to lose his/her job.

According to Kauffman, the other major problem with e-mailing is that rapport cannot be established as effectively as in person or by phone. “Facial expressions, gestures, tone of voice—all these social cues are missing in e-mail,” he says. But because messages travel almost instantly from computer to computer, people act as if they are in a face-to-face conversation. Because of this illusion of proximity, many people are duped into thinking they can communicate about sensitive subjects, including disagreements or criticisms, and that the tone of their writing will be perceived correctly.

Anthony Campos, biomed department manager, Memorial Hospitals Association (Sutter Health), Modesto, Calif, points out that just because employees can send an e-mail message any time does not mean someone is there to receive it. “One of the things I find with e-mail is that employees don’t all check their e-mails the same way—some check it first thing in the morning, and some don’t check it for 2 days,” he says. “I might be trying to communicate about something that has been scheduled, but some employees end up not knowing anything about it.”

Rounding for Outcomes

To help Sutter Health improve its employee communications, the Studer Group introduced rounding for outcomes, which is a technique in which in-house “leaders” are selected to interact closely with employees to develop strong working relationships. In the past, this might have resembled management walking around, but rounding is structured more formally and does not simply involve walking and observing employees. The leaders typically ask four questions when making these visits: 1) What is working well? 2) Do you have everything you need to do your job? 3) What are the things you can do to improve upon today? 4) Who in your department is doing a great job lately?

According to Collard, most managers are not accustomed to conducting such structured visits with employees. To help them, they are given rounding logs to actually document the employees’ responses. “Most employees state that when they see their supervisor writing down their replies, they know that they will do something about it.”

Collard points out that when his consulting company first talks to hospital managers and supervisors, they often comment that much of their day is spent putting out fires. “What we find is that with rounding for outcomes, these leaders of departments are placed ahead of the fires or, in other words, if you use a sports analogy, they switch from playing defense to playing offense.” This is because these regular face-to-face visits help build relationships and trust between supervisors and their employees.

“It’s not that leaders don’t talk to their employees,” Collard stresses. “We simply fall victim to e-mails and memos.” But as he points out, performing rounding for outcomes once per month “creates a huge emotional bank account between the employee and their immediate supervisor.”

External Communications

Communication with other departments is every bit as important as communication within a department, and there are many techniques that can be employed to strengthen that area. Kauffman has introduced a new task for his biomeds that involves distributing a master equipment list to the manager of a given department. “In the past, some of the staff would do this voluntarily, but now we’re requiring it, and it’s certainly helping improve communication between the biomed departments and other departments within the hospital,” he says. “We make departments accountable for their PM completion rates. If 95% is not reached for general equipment, the department head is responsible (or their designate) for finding equipment—100% for life-support devices.”

Kauffman adds that he stresses to his staff the importance of presenting a friendly attitude and demeanor. Over the years, this has definitely paid off. “We are loved by every department we service, probably because of the friendliness of our shop,” he says. Biomeds at Reading are known for their helpfulness, as evidenced by the department’s lead biomedical technician, Charles “Chuck” Donmoyer, CBET, who recently received a Character of Excellence Award from the hospital for being a superior communicator.

Sometimes, communication can be a problem in large hospital systems when employees are unaware of the functions of different departments. Stankiewicz notes that as equipment has become more computerized, employees throughout his hospitals have become confused about whether a device is serviced by clinical engineering or IT. He solved this problem by developing eye-catching labels that are now placed on all devices, indicating who to call for repairs and servicing.

Campos has also experienced situations in which employees in different departments were confused about the role of biomedical engineering. But now, thanks to rounding for outcomes (which is employed across department lines), staff in other areas know when to contact biomedical engineering for different needs.

“As part of this program, I try at least once a month to meet with other department managers and supervisors to obtain feedback on how we’re doing as a department,” Campos says.

Despite the effectiveness of face-to-face meetings and phone calls, the reality is that most hospital systems need the latest communications technology to get the job done. Stankiewicz is quick to point out that his department’s shared database has gone a long way to improve staff communication and motivation. All policies, reports, and equipment listings are posted onto the department’s Web site, which all employees are able to access. “At the end of the day, we can post and save information that’s critical to our success, and this avoids having to send out separate e-mails to everyone,” he says.

Sharing this type of information via the Web site also serves as a motivational tool. “Biomeds can be very competitive, and if you post performance information on a shared database, they’ll see that some divisions are doing better than them, which makes them work harder,” Stankiewicz says.

In some ways, communication is a very simple concept, but it can also be one of the most challenging areas within an organization. Computers, cell phones, pagers, and BlackBerrys certainly make a difference in improving employee communication, but sometimes, little things have the most impact. Kauffman says that his twice-weekly department lunches instill camaraderie among the biomed staff, which greatly enhances communication. “We have one employee who brings in delicious homemade Vietnamese egg rolls for the entire staff every once in a while for lunch,” Kauffman says. “I can’t think of a better way to get people talking and sharing within a department.”

Carol Daus is a contributing writer for  24×7. For more information, contact .