¶ … Renal & Transplant Unit (Renal Directorate)
Mary's NHS Trust
I am the Personal Assistant to the Chief of Service, and also act as Administrator for the Renal Directorate, St. Mary's NHS Trust. The Directorate is a well established and busy Regional Renal Unit in North-West Thames. We offer haemodialysis, continuous ambulatory peritoneal dialysis, and Renal Transplantation / Simultaneous Renal Pancreas Transplantation to patients, in addition to a comprehensive inpatient and outpatient service. We currently have approximately 800 patients on our dialysis programme, 400 transplanted patients, and we see around 1200 patients in outpatient clinic each month. The Service has 5 Consultant Nephrologists, 2 Transplant Surgeons, 1 Service Manager and 1 Business Manager.
There is a Renal Ward, a laboratory to carry out assays, a Haemodialysis Unit, Acute Dialysis Team, a Peritoneal Dialysis Unit, a Renal Outpatients Department, and 3 Satellite dialysis units and outpatient cilnics.
Communication is the backbone of any organization and effective communication can mean the difference between efficiency and failure as a group. The manner in which communication occurs within an organization is one element that helps to define its corporate culture. The corporate culture is more than the actions of persons within an organization; it encompasses the prevailing logic, a set of social rules for maintaining order and coherence within the organization (Edwards, 1996). The following precis will examine the informational needs and communication structure within the Renal Directorate. It will examine the current situation and any measures that have been undertaken to correct communications deficiencies within the system.
Being the Personal Assistant to the Chief of Service of the Renal and Transplantation Medicine and Administrator for the Directorate, several deficiencies in communication became obvious soon after my appointment. St. Mary's NHS Trust stands as London's leading teaching hospital. Prior to my current position, I had the opportunity to work at several NHS Trusts and have several good examples for comparison. (Griffiths, D.M. 2000).
Communication is essential in any organization. However, nowhere else is it more essential than in the health care industry. Effective organizational communication not only affects an organization's ability to operate efficiently, it also has a significant effect on job performance and job satisfaction; and indeed, contributes to staff's well being. (Ajax, 2000).
Dialogue is an element, which is often removed from the managerial environment and usually only occurs when a crisis necessitates it (Barge and Little, 2002).
Through previous positions at other NHS Hospitals prior to my employment at St. Mary's, I know that the organizational culture of the system thrives on the effective assimilation and dissemination of information, both within the hospital and outside of the hospital to various organizations. A service delivery system that needs to be able to respond quickly and positively to customer preferences needs well-informed, motivated people (Boddy, 2002). Upon starting in the Directorate, it became painfully obvious that this Directorate suffered from poor communication skills, a lack of appropriate technology for proper job performance and communication, a disregard for its people, and a misuse of power by its management.
A found almost immediately that the Business Manager was unable to answer most of my questions during the first few months. The secretaries lacked adequate equipment necessary to perform their jobs and as expected, suffered from a high degree of job dissatisfaction. They were unable to maintain the necessary records such as leave of absence, meeting schedules, etc. There was no Internet access or inter-departmental e-mail system in place.
Meeting notifications and minutes were not distributed to the proper people. Communications were not passed on to the appropriate personnel in a timely manner. Key personnel on major projects, such as the Sister in charge of the opening of a new clinic, did not know essential information, e.g. when the new clinic would open. Personnel were not informed of meetings to which they were supposed to attend.
Corporate culture was such that Department heads would feel that they could say nothing about it for fear of repercussions. The communications environment was hostile, at best. Departments were territorial and hierarchical in nature. Most departmental heads ruled by authoritarian rule and exhibited a degree of protectiveness regarding information about their department. This environment created many errors due to a lack of communication. Staff felt threatened and expressed unhappiness in their positions. This severely affected their attitudes and job performance. Changes were needed fast.
As a new person in this protectionist environment, one must be careful in their approach to the situation. If a person feels threatened their first reaction may be to remove the threat. Walters...
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