A study of communication and decision making patterns in a hospital

The purpose of this study was to identify and determine the effectiveness of patterns of communication and decision making in the nursing service department of a medium size (500 beds) hospital.

The sample group consisted of 54 persons in managerial and non managerial positions in the department. Participants were chosen by a stratified systematic sampling technique. The managerial sample included persons from all levels of administration. The non managerial group consisted of registered nurses, licensed practical nurses, nursing assistants, nurse technicians, and unit secretaries. Participants were interviewed using a semi-structured questionnaire.

The data were analyzed using content analysis methods. Categories and sampling units were established. Frequencies of responses were recorded and tabulated according to position and shift of each participant. The data were analyzed to identify patterns of communication and decision making. Effectiveness was determined by comparing the identified patterns to criteria which had been established from the literature.

As a result of this study, the nursing service administrators gained information which, when applied, could improve communication and decision making practices in the department. The study provides a questionnaire and a methodology which administrators in other hospitals can use to evaluate communication and decision making in their institutions. The data from this study can be used by researchers for comparison studies in other hospitals.

Several conclusions were made from the study. Communication processes in the nursing service department were effective. The majority of respondents felt they were well informed. The department utilized a variety of communication methods. Managers had access to information from the informal communication network. A large majority of the participants reported they were willing to pass unfiltered information to their superiors.

Decision making patterns were partially effective. The department had a committee structure with participatory decision making. Individuals tended not to use a systematic decision process. The majority of the sample participated in decisions related to patient care and to scheduling their personal work time. Approximately one-half of the non managerial personnel did not participate in formulating departmental policy and/or procedure decisions. A large majority of the sample was satisfied with their role in making decisions in the areas upon which this study focused.