JCI Standard GLD.3.2 – leadership role in the dynamics of communication within a hospital, Part 2

effective communication

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Effective communication throughout the hospital occurs when individuals possess high-level competency to perform their communications role and when information or meaning has been shared by at least two people.

To perform their communications role with high-level communication competence, they must possess a cluster of related knowledge, skills, and attitudes or motivation. High-level communication competence is to possess the knowledge to know behaviours that are effective and appropriate for a given situation, the skill to apply the behaviour in the given context with the ability to be sensitive to the perspectives of others, and to have the attitudes or motivation to communicate in a competent manner. For example to have the attitude or motivation to communicate in a competent manner when we leave voice mail, the effectiveness of the communication is when two parties (the receiver and the sender) are responsible. The receiver is responsible as he or she responds back to the sender, as the sender cannot know whether the message has been conveyed as intended if there is no feedback from the receiver.

High-level communication competency is also accomplished by choosing communication behaviours that convey messages clearly and precisely, by offering and seeking clarifications to ensure a high probability that messages are interpreted as intended leaving interpretation less open to chance.

We already know that hospitals are most frequently and typically divided into cohesive subgroups such as departments, services, or units for effective and efficient daily delivery of clinical services and management of the hospital as an organisation. These subgroups consist of clinical departments such as medicine, nursing subgroup(s); diagnostic services or departments such as radiology, pharmacy services, and ancillary services such as transportation, among others.

Leadership of these subgroups to collaboratively guide the hospital in meeting the hospital’s mission, strategies, plans, and other relevant information is distributed among a group of leaders collectively accountable for their expectation(s). Each subgroup is managed under the direction of a department/service leader(s) and assisted by a manager(s) as found at most larger hospitals.

Each hospital will have its unique set of hospital leadership individuals with a variety of responsibilities and accountability. Hospital leadership individuals usually consists of an individual to represent the medical staff of the hospital, a chief nursing officer representing all levels of nursing in the hospital, senior administrators, and any other individuals the hospital selects.

In order to set the parameters of effective communication, there must be coordination of clinical services which comes from an understanding of each department’s mission and services and collaboration in developing common policies and procedures, understanding the hospital organisational goals, and to be aware of their responsibilities to patients and other employees among all subgroups of the hospital.

Given this understanding about effective communication within a hospital setting, I think the hospital leadership is the most suitable to be given the responsibility to ensure effective communication throughout the hospital.

In exercising effective communication, the hospital leadership must understand the dynamics of communication between professional groups; between structural units, such as departments; between professional and nonprofessionals groups; between health professionals and management; between health professionals and families; and between health professionals and outside organisations.

One example of facilitating co-ordination between the above mentioned groups is the case in medicine for the patient medical record making information about patients available to the increasing number of personnel involved in treatment and payment. Alison, Jon and Virginia (2010) recognised the importance of medical records which operate as important ‘boundary objects’ crossing “organisational boundaries and which can be accessed by a variety of users, including doctors, reimbursement agents, insurance companies, legal professionals, medical researchers, billing coders, audit contractors, and the patient.” (eds. Alison, Jon and Virginia 2010, p. 134 ). Alison, Jon and Virginia (2010) also noted from findings of a study of record – keeping practices in a psychiatric clinic, that hospitals must enforce ‘institutional accountability’ to ensure their medical records are competent accounts of a given medical encounter. This accountability covers formatting of medical records to widely recognisable standards so that they are recognisable and meaningful to other healthcare professionals and to the increasing number of potential ‘witnesses’ to the event increases when the encounter becomes an accessible record crossing organisational boundaries.

Hospital leadership also serves as role models with the effective communication of the hospital’s mission, strategies, plans, and other relevant information to staff, ensures that processes are in place for communicating relevant information throughout the hospital in a timely manner, and develops a culture that emphasizes cooperation and communication among clinical and non-clinical departments services and individual staff members to coordinate and to integrate patient care.

If you are reading this post as a Health Information Management (HIM) / Medical Records (MR) practitioner department/service leader of your hospital, I am sure you are already automatically selected to be a part of the hospital leadership. This means you need to be trained and learn a cluster of related knowledge, skills, and attitudes or motivation to possess a high-level communication competence for your communications role.

And, if you are indeed this HIM / MR practitioner I referred to above and working at at a hospital which is already Joint Commission International Accreditation (JCI) accredited or seeking JCI accreditation status or undergoing re-survey for accreditation status, then you need to be aware that you will no longer be working with the “Management of Communication and Information (MCI)” team of your hospital to coordinate and monitor the JCI Standard MCI.4 and Standard MCI.5, simply because the MCI Chapter not found in the 5th edition JCI as it was in the previous edition (4th edition). The MCI Chapter is now known as the “Management of Information” (MOI) chapter in the 5th edition as I have posted in the post JCI Standard GLD.3.2 – leadership role in the dynamics of communication within a hospital, Part 1 (this link will open in a new tab of your current browser window).

To reiterate, the Standard MCI.5 now combines with MCI.4 in the Governance, Leadership, and Direction (GLD) chapter of the 5th edition “to better align hospital leadership requirements; revises standard, intent, and MEs to clarify expectations” (JCI 2013, p.161) to form the Standard GLD.3.2 in the 5th edition which states that “Hospital leadership ensures effective communication throughout the hospital.

Perhaps you as a HIM /MR practitioner have been recently active in ensuring effective communication in your hospital as been part of (i) formal activities for example as a leader or member of standing committees and joint teams, and (ii) informal activities for example publishing newsletters and posters as methods, for promoting communication among services and individual staff members of the hospital.


  1. Joint Commission International, 2010, Joint Commission International Accreditation Standards For Hospitals, 4th edn, JCI, USA
  2. Joint Commission International, 2013, Joint Commission International Accreditation Standards For Hospitals, 5th edn, JCI, USA
  3. Pamela McHugh, S & Linda.N., 2010, Communication for nurses : how to prevent harmful events and promote patient safety, F. A. Davis Company, Philadelphia, PA, USA
  4. Ricky, WG & Gregory, M, 2014, Organizational Behavior: Managing People and Organizations, 11th edn,, South-Western, Cengage Learning, Mason, OH, USA
  5. Alison, P, Jon, H & Virginia, TG (eds), 2010, Communication in healthcare settings : policy, participation, and new technologies, Wiley-Blackwell, West Sussex, United Kingdom

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