The use of some anecdotes may mean differently to a faction of the group members. This is highly witnessed when employees get used to abbreviations. Language barrier is common especially due to the different age groups in the work place.
This results to inefficient flow of information, and at times, it may result in misunderstanding among the employees. Silence Any rational employer should not ignore silence since it means absence of information on the ongoing operations in an organization. Therefore, it is important for the management of the organization to encourage feedback from its members regarding client satisfaction, job satisfaction, and other feedbacks with respect to their notices and press releases.
Silence means no communication at all. Employees, who decide to go silent about what they are going through, may also suffer psychological stress. The senior management should encourage downward communication, job satisfaction and to solve the problem of intimidation. It is apparent that silence is less where the management holds the opinions of the minority with high esteem Robbins and Tim Poor communication channels Members of a given group can send and receive information in several ways; different types of messages need different types of communicating channels, with factors of time and distance.
Some communication media are more effective compared to others; given the situation. Some channels of communication may deem slow hence untimely delivery of the information. Normally, the face-to-face FTF medium of communication is the most reliable means to ensure the correct perception of the information. California Pizza Kitchen scenario The effectiveness of communication has been significantly interfered with, at the California Pizza Kitchen, which is an established fast food company.
It is apparent that the company is a global leader in fast foods. Recently, the company has reported a significant decline in its profits owing to decreased customers. The main cause of this is that the company has not been able to meet the demands of their customers because its employees are drawn from the USA and thus do not understand the expression of its customers whose native languages are not English with regard to tastes and preferences.
It is also evident that there is a gap between the management of California Pizza Kitchen and its junior employees. This is attributed to poor communication channels between the top management of the company and its junior employees. This is ineffective in the sense that its employees hardly find time to check on the notice boards.
This has led to the failure of the employees to respond to the demands made by the management through the issuance of the notices. Therefore, the development of cold relationship between the management and the junior employees is simmering hence denting the performance and reputation of the company Robbins, Judge, Millett, and Waters-Marsh Overcoming the barriers Lack of trust In order to address miscommunication that accrues because of this barrier, the management of the organization should capacity build its members by carrying out education workshops on a regular basis.
This fosters the team building and inculcation of trust among the group members. By engaging the members in get-together parties and motivational trips, the members will be able to share ideas hence gain trust amongst themselves. During these meetings, the junior members will be able to interact with their managers hence get rid of the allayed fear whilst gaining trust.
Communication in this case will be smooth and effective due to high level of trust amongst the group members. Silence and poor communication channels Silence means there is a lack of feedback to sender regarding disseminated information.
The management of the organization should encourage its members to acknowledge the reception of the information disseminated and to provide feedbacks promptly. In order to avert silence, the management should involve all members in coming up with the most appropriate channels of communication that deems fit for members to receive the information and provide the feedback in a timely manner.
By involving all members, the management will identify and do away with the poor communication channels. Language barrier The management of the organization should enact policies regarding the employee behaviors and the formal language embraced by the company.
The full understanding of the formal language recommended by the company should be part of the hiring requirements. This will alleviate miscommunication resulting from the language barrier. Emotional factors and information filtering Depending on the nature of the information to be disseminated, the management of the organization should monitor the moods of the intended recipients before passing the information.
In some cases, guidance and counseling of the intended recipients is necessary to prepare them for the negative impacts the information may have on them. Information filtering is therefore, not necessary. Therefore, the development of cold relationship between the management and the junior employees is simmering hence denting the performance and reputation of the company Robbins, Judge, Millett, and Waters-Marsh Overcoming the barriers Lack of trust In order to address miscommunication that accrues because of this barrier, the management of the organization should capacity build its members by carrying out education workshops on a regular basis.
Order a custom written paper of high quality Professional Writers only. Diagnosis errors are among the most difficult to address because despite system changes, they remain devastating in terms of their overall high frequency of occurrence and potential to harm patients. Furthermore, diagnosis is mainly the responsibility of physicians.
One technique already being used in the training of symptom identification is a behavioral checklist. A variation of the behavioral checklist for training is the behavior-based observation and feedback process, which has dramatically reduced injury rates in numerous industrial applications. Subsequently, the checklist is used to conduct systematic peer-to-peer behavioral observations, followed by a review of the checklist data.
Both the observer and the person observed learn valuable error-reduction information throughout this peer-to-peer coaching process. Some types of treatment errors may lend themselves to direct observation and feedback.
Many complicated surgical procedures, which are problematic in terms of frequency and severity, provide a clear opportunity for peer-to-peer coaching. Often, observation is already sought for highly complicated cases among surgeons and for hands-on training of caregivers. However, there are no known reports of the regularity with which such strategies are used for more common types of health care procedures performed by experienced caregivers.
Peer-to-peer coaching can also ensure compliance with recommended practices and offer opportunities for corrective feedback.
In the context of a patient safety culture looking for success, this is a learning opportunity rather than an event to be dreaded and avoided. The observation and feedback process also fits with the burgeoning team approach to health care. Failure-to-rescue errors seem to warrant a call for increased vigilance among all levels of caregivers.
Once these behaviors are defined, they can be observed and recorded, and once a baseline level of performance is established, they can be targeted for OBM intervention. Continued data collection indicates whether the intervention is effective and should be continued. Other types of monitoring errors may be addressed adequately by using process-based data for group feedback, which would also compliment a team-based approach. Group data allow for the diffusion of responsibility so individuals do not fear personal consequences from disclosing an error.
Infection errors are best addressed by targeting behaviors, such as hand washing, glove use, sterile operating room entry, and other specific infection control practices e. The pinpointed behavior of hand washing is widely linked to infection rates in hospitals.
With reported levels of hand washing varying from one institution to another, and self-report being an inflated estimate of compliance with hygiene protocol, OBM is called for at both group and individual levels.
While not directly referring to OBM practices, some research reported in medical journals suggests hospitals have been implementing OBM strategies to increase the occurrence of appropriate hygiene behaviors among caregivers.
Regardless of advances in information technology, medical care will continue to involve direct communication between individuals. Providing all relevant patient care data to oncoming physicians and nursing staff is an obvious target for OBM.
With signs in the locker room or other salient locations, oncoming caregivers might be prompted to ask end-of-shift coworkers about each patient. Communication errors with the patient may also be addressed with a number of specific behavioral approaches. Patient education is one way to prevent medical errors. Effective communication between the empowered patient and receptive caregiver not only helps alleviate patient concern about experiencing a negative outcome, 73 it also adds a patient-centered, customized set of cues to prompt the occurrence of critical safety-related behaviors.
Patient rating data gained from discharge surveys may also lead to pinpointing caregiver behaviors in need of OBM intervention. Much of the patient safety improvement literature calls for moving away from a negative, punishment-governed culture of blame to a more empathic, interdependent, and positive context for discussing and preventing medical errors. However, for optimal patient safety improvement, the culture of health care needs to be modified so caregivers and their patients feel safe reporting and learning from medical mistakes observed or anticipated.
OBM can increase and maintain desirable behavior, but it is necessary to define the behaviors that need to be avoided and those that need to be increased. If medical errors are to be fully understood and adequately addressed, a health care culture of interpersonal trust, success seeking, and positive behavior change is needed.
The effective and achievement-focused technology of OBM enables the development of this type of culture within the context of continuous learning and beneficial behavior change. Turn recording back on. National Center for Biotechnology Information , U. Organizational Behavior Management in Health Care: Author Information Thomas R.
Introduction Organizational behavior management OBM focuses on what people do, analyzes why they do it, and then applies an evidence-based intervention strategy to improve what people do.
Table 1 Two widely used taxonomies for patient-safety incidents and medical errors. Preventing Errors in Health Care As depicted in Figure 1 , patient safety outcomes are influenced by a number of factors, including several sources external to the hospital e.
Figure 1 An overall model of patient safety. Errors Addressed by System Change Medical mistakes caused by latent errors, such as similar sounding drug names or delays in treatment due to lack of staff, are best addressed by system change. Organizational Behavior Management OBM is defined as the application of behavior analysis to organizational settings.
Behavioral Maintenance Establishing desired behavior change during an intervention phase is not sufficient. Organizational Applications for Large-Scale Change The OBM perspective has informed an innovative people-based patient safety approach to health care, 31 which strategically integrates behaviorism and humanism in the design of interventions to benefit patient safety.
This comprehensive approach to patient safety is based on the following evidence-based guidelines, which are derived from applied and experimental behavior analysis see Geller 17 for a comprehensive description and analysis of these guidelines: Safety-Related OBM Research in Health Care Settings Intervening to Improve the Safety of Health Care Workers Several successful applications of OBM in health care settings, based on the seven guidelines listed above, provide the foundation for designing interventions to initiate and maintain behaviors relevant for patient safety.
OBM for Patient Safety In one study, 40 providing feedback to caregivers on their frequency of hand washing led to an increase in hand washing following patient contacts from 63 percent at baseline to 92 percent post-intervention. Education, discussion, and feedback on proper laboratory tests reduced the overall number of tests ordered without any decrement in patient outcomes. Standardizing the handoff communication procedure using antecedent reminders and feedback improved patient satisfaction, medication administration record-keeping, completion of cardiac enzyme regimens, and patient transportation without a cardiac monitor, thereby making an additional Health Care Organizational Structure Within the vertical hierarchical structure that tends to be the norm in health care settings, differences in levels of authority contribute to many communication errors.
Medical Errors to Target with OBM Errors Remaining After System Change It is acknowledged that several types of errors are already being addressed by well-informed system-based changes, but a number of categories of errors persist.
Also, given the aim of proactive measurement and intervention, they are process- rather than outcome-based and include: Diagnosis errors, such as using the wrong test, delays in diagnosis, and failing to act as indicated on test results.
Treatment errors, such as ordering a wrong drug or dosage, accidental puncture or laceration, and incorrectly executing a procedure.
Infection-control errors, such as failing to wash hands, lack of glove use, and compromising sterile-field maintenance. Communication errors, such as failing to inform other caregivers of acute risk, changes in care, and critical hand-off information, as well as ineffective communication with patients. OBM Interventions to Address Medical Errors Behavioral antecedents, including prompts, pledge cards, and communication strategies, as well as consequences, are the primary types of OBM intervention techniques for a comprehensive description of available OBM techniques, see Geller et al Table 2 Proposed framework of behaviors to target for error prevention.
System-Change Participation Much of the patient safety literature calls for improved incident reporting systems that include less focus on finding fault and greater attention to the context in which the error occurred.
Diagnosis Errors Diagnosis errors are among the most difficult to address because despite system changes, they remain devastating in terms of their overall high frequency of occurrence and potential to harm patients. Treatment Errors Some types of treatment errors may lend themselves to direct observation and feedback.
Monitoring Errors Failure-to-rescue errors seem to warrant a call for increased vigilance among all levels of caregivers. Infection Control Errors Infection errors are best addressed by targeting behaviors, such as hand washing, glove use, sterile operating room entry, and other specific infection control practices e. Communication Errors Regardless of advances in information technology, medical care will continue to involve direct communication between individuals.
Conclusion Much of the patient safety improvement literature calls for moving away from a negative, punishment-governed culture of blame to a more empathic, interdependent, and positive context for discussing and preventing medical errors.
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