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Sample Dissertation Proposal Paper on Workplace communications framework for a new organization of primary care practice

Workplace communications framework for a new organization of primary care practice


The focus of this paper is to identify and discuss the elements of a workplace communications framework that are essential and valuable to facilitate productive operations in a new organization of primary care practice. The paper's analysis of communication processes and barriers illustrates that a communication system in an organizational setting is a bundle of various components that work with and alongside one another. For the communication system of the new healthcare facility to function effectively and competently, the management and leadership have to focus on creating and sustaining an enabling and supportive environment for all staff to participate and contribute actively to decisions and changes in policies concerning these components and their functions.



Communication is one of the most important and integral parts of life, without which survival and the fulfillment of human needs are impossible. Scholars contend that communication is necessary not only for the transmission of knowledge and information to one another but more significantly for the inter-relations of human beings in society. Additionally, it occurs commonly in the context of families, relationships, nature, and organizations (Mahajan, 2015). The fact that communication is a natural and involuntary action among human beings makes it easy to overlook the importance of facilitating and enhancing its effectiveness, especially in healthcare settings. While nursing science focuses mostly on efforts to meet the health needs of society members as spiritual and bio-psychosocial beings, nursing practice ought to recognize the critical role and value of effective interpersonal communications in supporting the delivery of quality, effective, and timely care that meets the needs of patients effectively since the effectiveness of interpersonal and communication skills among the providers of care occupying different points and roles in the healthcare system are vital determinants of the quality of coordination and timeliness of care that can improve patients’ satisfaction and health outcomes at the population level.

Importance and Challenges of Communication in a Healthcare Setting

In the effort to design and sustain an effective and productive framework of communications in an organizational setting, it is essential to remember that human beings are holistic, consisting of mind, body, and spirit. This assessment implies that individuals need to take care of themselves in relation to their whole beings, especially because individuals can only offer what they have (skills, abilities, competencies, views, knowledge, etc.) to others and the society. Individuals have the responsibility to understand themselves and their capacities, abilities, attitudes, characteristics, skills, limits, strengths, and weaknesses in communications in order to identify the areas that are vital to improve and the competencies that they could exploit and apply in interrelations with others and communications with them(Mahajan, 2015). The development of an in-depth understanding of effective skills and roles of communication, as well as challenges and barriers, is essential to improve holistic and client-centered care.

Communication describes the process of transmitting information and common understanding from an individual to another. It concerns the creation and exchange of ideas, emotions, thoughts, and understanding between individuals, which are vital in building and sustaining positive and productive relationships in the workplace. As a process, communication features the encoding of information in a language and the receiver's decoding of the message into meaningful information. Individuals send messages to others through channels or mediums, which serve as carriers of communication (Adu-Oppong&Agyin-Birikorang, 2014). The importance of communication in an organizational setting relates to the fact that its members (employees and the leadership) come together to work towards the same goals despite differences in their social and professional backgrounds. The failure of an organization and its leadership to create an environment that can support clear and open channels of communication has adverse repercussions on the motivation and productivity of employees and work culture. Some of the essential ways in which communication is important in an organizational context are (Sadia et al., 2016; Blaschke&Scoeneborn, 2016):

·       Helps in lessening the occurrence and significance of conflict as employees utilize mutual discussions to solve disagreements.

·       Improves productivity and job satisfaction as employees offer feedback to management and engage actively in decision-making, which in turn promotes loyalty, trust, and employees’ perceptions of valuation in the organization.

·       Influences proper allocation and utilization of resources owing to open, timely, and efficient communications of needs and plans among employees in coordination with the management.

Among professionals in the healthcare environment, effective communication is challenging owing to various inter-related dynamics (Dingley et al., 2014):

1.     Healthcare is a complex and highly unpredictable profession and practice because of the spread of different professionals across different roles and points in the system of healthcare and providing different services. The professionals serving in a healthcare environment also have different backgrounds in terms of disciplines and knowledge and are involved in the provision of care at different times across the day. These factors influence the development of spatial gaps with limited and disconnected opportunities that limit the regularity and synchronization of interactions among them in a professional environment (Dingley et al., 2014; Coiera, 2006). In effect, these professionals and different points and roles of care have to coordinate with one another competently if the healthcare system is to ensure that the services that it delivers are useful, timely, and of high quality to contribute to effective treatment, management, and fulfillment of patients' health needs.

2.     As human beings from different cultural and social backgrounds and with different personal and professional experiences, the providers of care have differing viewpoints, worldviews, and disciplinary views of their practice and the needs of patients. Confronted with the same circumstances, needs, and objectives in the processes of interacting with patients and delivering care to address patients’ needs, professionals in the healthcare environment reach different decisions and adopt different perspectives of the problem and potential solutions. The significance of these differences increases when one considers that individual professionals in the healthcare environment have ambitions to reach the heights of their careers by demonstrating their skills and securing individual recognition for their performances. These objectives tend to influence the inclinations of professionals to act independently or prioritize activities, roles, and objectives in which they act independently and that individual yield value from the perspective of their careers (Hussain, 2018; Ablonczy-Mihalyka, 2009). This focus is likely to present challenges in interrelations among the professionals and in terms of the quality of coordination of their roles and work to contribute to a high quality of delivered care to patients.

3.     Facilities of healthcare typically adopt a hierarchical organizational structure. This structure presents significant challenges in interrelations and communication models among professionals and across the organization owing to the power distances that it creates between professionals and employees serving in different levels of the organization and the leadership and management structure. Differences in levels of responsibility and oversight and supervisory roles among some employees tend to promote a culture of inhibition and significant restraints in communication because the establishment and sustenance of significant power distances among employees undermine the psychological safety that is vital for open communications (Dingley et al., 2014).

4.     Differences in the training and education of different professionals in the healthcare organization and system foster differences in the styles and methods of their communications because the healthcare organization brings together different professionals with different backgrounds of training and levels and varieties of training (O’Daniel& Rosenstein, 2008). These differences complicate the scenario of the delivery of healthcare services in the organization by making effective communications difficult.

5.     The focus of most educational curricula for healthcare professions is primarily on the technical skills of individuals. While technical skills represent an essential part of the requirements of healthcare professionals in the performance of their duties, this focus in educational curricula for healthcare professions neglects communication and teamwork skills. Neglecting these skills promotes the inabilities and incompetence of these professionals to engage actively and effectively in interpersonal relations and communications with one another in the healthcare environment.

Review and Application

of Theory

From the perspective of theory, communication systems are informal and formal structures that organizations utilize to support their communication requirements. They involve people, the messages to convey, the technologies that serve to mediate the communications, and structures of the organization that serves to define, facilitate, and constrain the communications that the organization allows to occur. The channel of communication is essentially the "pipe" along which the message travels from one individual to another, including face-to-face, computational channels, and telephone communications. The structure of messages has the role of achieving a particular task through the utilization of accessible resources to suit the receiver's needs (Coiera, 2006). In contrast with informal messages (such as email and voice messages), which have variable structures, formal or structured messages in the healthcare setting (such as computer-generated alerts, discharge summaries, EHR records, and laboratory results) typically assume a format that complies with a particular standard.

Another vital element of a communication system comprises the policies of communication, which are the formal procedures that bound the communication system. As an example, owing to the needs for confidentiality and ethical considerations, a healthcare environment may have the policy to forbid general practitioners to obtain medical records directly from the records department without the authority of a hospital clinician. Agents are the people involved in different transactions of information. In a busy healthcare unit, the organization may require a ward clerk to field all calls from clients and stakeholders(Coiera, 2006). This would imply that the clerk would occupy a special role in the communication system that the structure of the organization has created to support a policy aimed at minimizing interruptions in the work of clinical staff, who would otherwise have to answer the calls.

One of the essential elements of a communications system in a healthcare setting is security protocol. In the healthcare environment, concerns for the privacy and confidentiality of patients represent an important factor in ensuring that individuals without relevant authorization do not access clinical records. In effect, to protect privacy and confidentiality, the encoding (encryption) and scrambling of messages and information are suitable strategies to prevent unauthorized individuals from interpreting and intercepting them. These measures mean that in effect, only the individuals who can understand the encoding can read the messages. One of the most common ways of encoding messages in a healthcare environment is through the use of Public Key Infrastructure. Communications and messages that are highly important have extremely strong security protocols that are exceedingly difficult to crack, thereby preventing individuals with the time and resources to attempt to “hack” the systems of information from accessing them and reading privileged information. The use of encryption methods in the healthcare facility’s environment would enhance the security and protection of the information(Coiera, 2006). The choice of security protocol that the healthcare facility utilizes reflects the scale and extent of risk that associates with unauthorized access and use of the content of messages in its systems of communication.

This assessment implies that a communication system is a bundle of various components, such that the effectiveness and utility of the entire system are dependent on the appropriateness of the components both individually and collectively. The inappropriateness of one of these elements to the setting of the communication system would imply underperformance of the entire system of communication.

Barriers to communication and potential ways to overcome them

Barriers against effective communications in the healthcare system involve challenges for or in any of the elements of communications discussed above (medium/channel, the message itself, the encoding and decoding processes, communication policies, and the structure of messages). As noted above, a system of communication is essentially a bundle of different aspects that contribute, individually and collectively, to the utility and effectiveness of the entire system. Failure or problems in each of these elements affect the quality, effectiveness, and utility of the entire system, thereby acting as a barrier against effective communication. Barriers are aspects of communication processes that filter, block, distort, or otherwise undermine the quality and effectiveness of the processes of communication (Van Servellen, 2009).

Barriers against effective communications in a healthcare environment are basically of two types: organizational or environmental and personal. Personal barriers arise owing to the frame of reference of individuals or owing to their values and beliefs(Borkowski, 2015). The basis of these barriers comprises the prior experiences and socioeconomic backgrounds of individuals, which together affect how they encode and decode messages. Cultural backgrounds have an important influence on the perceptions, interpretations, and experiences of individuals in communication systems because of the influences of the shared meanings that individuals obtain from their cultural backgrounds on their assignment of significance to others’ behaviors and messages. Individuals also tend to interpret communications and messages based on their evaluations of the sender (stereotypes). The lack of empathy is also an important barrier against effective communications at a personal level since insensitivity to the emotional states of others (the inability to evaluate, know and understand the circumstances, world views, and experiences of others at a time) informs ignorance of their perspectives, and hence the lack of assignment of appropriate weight to their communications (Borkowski, 2015)..

The way to address these barriers is through intercultural education and the development of appropriate human resource procedures and policies to enhance cooperation among individuals in the healthcare organization (Borkowski, 2015; Ardalan et al., 2018). Members of the organization have to consider diversity (in terms of not only racial, ethnic, and cultural diversity but also diversity in individual perspectives, world views, levels of experience, education levels, etc.) as a source of strength and positive influence on their creativity, competence, and skills. Such diversity in the healthcare environment would enable staff to view and understand problems, issues, opportunities, and problems in multiple perspectives as each of them engages in discussions and contributes personal input and perspectives (Rice, 2015). These advantages would influence creativity and innovative ways of addressing problems and issues in the healthcare environment.

Environmental barriers against communication are characteristic of the organization, including the influence of multiple, simultaneous demands on the incorrect decoding of messages. The managerial philosophy in an organization is an important factor in promoting or inhibiting effective communication. A leadership and managerial culture that fails to promote intra-organizational communication both downwards and upwards promote organizational and procedural blockages in the processes of communication. Requirements for communications to follow a chain of command and the lack of attention and concern towards employees are signs of a managerial philosophy that restricts the flow of communication. The unwillingness of leaders to act on feedback from employees in subordinate positions also spurs the unwillingness of these employees to communicate upwards with time(O’Daniel& Rosenstein, 2008). Status and power relationships are also a vital source of problems in transmissions of messages. Relationships between seniors or supervisors and subordinates can interfere with the flow and content of communications. Another element of the organizational environment that interferes with the quality and effectiveness of communications concerns the use of particular technologies that are unfamiliar with receivers, or that influence the complexity of messages (Bello, 2017). The use of words and terminologies that are highly specialized may present challenges in the understanding of communications among members of the organization.

The ways to overcome environmental or organizational barriers against effective communication in the healthcare facility involve the development and application of a management philosophy that prioritizes the interests of employees and has a basis on the objective of promoting cooperation and harmony across the organization. The management needs to encourage an unrestricted flow of information and reduce the number of links or steps that communication has to go through to reach the receiver. Constant and open relationships between seniors, supervisors, and subordinate staff in the healthcare facility are vital to promoting a supportive environment for genuinely free and effective communications across the organization (Norouzinia et al., 2016). Decision-making and processes of incorporating communication technologies have to be inclusive by allowing the active participation and contributions of all employees, such that they can feel as valued parts of the processes and any changes to procedures, policies, and models of communication in the organization.


The review above has illustrated that a communication system in an organizational setting is a bundle of various components that work with and alongside one another to yield efficiency and effectiveness in the transmission of information and common understanding among individuals. This assessment implies that the effectiveness and utility of an entire system of communication are dependent on the appropriateness of each of these components individually and collectively. The inappropriateness of one of these elements to the setting of the communication system would imply underperformance of the system of communication. In this context, for the communication system of the new healthcare facility to function effectively and competently, the management and leadership have to focus on creating and sustaining an enabling and supportive environment for all staff to participate and contribute actively to decisions and changes in policies concerning these components and their functions.


Ablonczy-Mihalyka, L. (2009). Business communication between people from different cultural backgrounds. Conference of the International Journal of Arts and Sciences 1(10) 121-129.

Adu-Oppong, A., &Agyin-Birikorang, E. (2014). Communication in the workplace: Guidelines for improving effectiveness. Global Journal of Commerce and Management Perspective 3(5): 208-213.

Ardalan, F., Bagheri-Saweh, M., Etemadi-Sanandaji, M., Nouri, B., &Valiee, S. (2018). Barriers of nurse-patient communication from nurses’ point of view in educational hospitals affiliated to Kurdistan University of Medical Sciences. Nursing Practice Today 5(2): 290-298.

Bello, O. (2017). Effective communication in nursing practice: A literature review. Thesis. Retrieved from:

Blaschke, S., &Schoeneborn, D. (2016). Organization as communication: Perspectives in dialogue. London, UK: Taylor and Francis

Borkowski, N. (2015). Organizational behavior: Theory and design in healthcare. New York, U.S.: Jones and Bartlett Publishers.

Coiera, E. (2006). Communication systems in healthcare. The Clinical Biochemist Reviews 27(2): 89-98.

Dingley, C., Daugherty, K., Derieg, M., &Persing, R. (2014). Improving patient safety through provider communication strategy enhancements. Agency for Healthcare Research and Quality. Retrieved from:

Hussain, S. (2018). Managing communication challenges in multicultural organizations. International Journal of Media, Journalism, and Mass Communications 4(2): 44-49.

Mahajan, R. (2015). The key role of communication skills in the life of professionals. IOSR Journal of Humanities and Social Science 20(12): 36-39.

Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M., &Samami, E. (2016). Communication barriers perceived by nurses and patients. Global Journal of Health Science 8(6): 65-74.

O’Daniel, M., & Rosenstein, A. (2008). Professional communication and team collaboration. In Hughes, R. (Ed.). Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality.

Rice, M. (2015). Diversity and public administration: Theory, issues, and perspectives. London, UK: Routledge

Sadia, A., Salleh, B., Kadir, Z., &Sanif, S. (2016). The relationship between organizational communication and employees’ productivity with new dimensions of effective communication flow. Journal of Business and Social Review in Emerging Economies 2(2): 34-39.

Van Servellen, G. (2009). Communication skills for the health care professional: Concepts, practice, and evidence. New York, US: Jones and Bartlett Publishers

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