How to Recover after a Communication Breakdown

• How to Recover after a Communication Breakdown (613.2 KB)

We’ve all had it happen. Somehow communication breaks, which makes explanation, reiteration, or subsequent communication more difficult and less effective—leaving us caught in a loop where one error perpetuates another and team dynamics suffer.

Here’s an example from my past: When I was working as a licensed paraprofessional in human medicine, a call came in to set up stabilizing skeletal traction on a 10-year-old prior to surgery. The surgeon I worked for said that child protective services had been contacted, too, because there was a suspicion of abuse.

The patient had multiple long-bone fractures and was receiving very little narcotic analgesia until the extent of the head injuries could be determined. As a result, setting up traction soon became more torture than treatment. Nonetheless, it proceeded well.

Upon leaving the patient’s room, I was approached by a nurse in uniform whom I knew personally. She asked what the situation with the patient was and I dutifully gave her a brief report, including the call to CPS. As it turns out, the nurse was also the patient’s aunt. I don’t think we need to describe the resulting bomb blast further.

What went wrong? Knowing the people involved, a busy day that stretched into a long night of assisting in surgery, and a patient wracked with pain led me to minimize critical thought before communication. Quite simply, I should have asked, “I’m sorry, what is your interest in this case? Will you be caring for the patient tonight?”

Anatomy of Communication
Recovery requires being able to objectively analyze a failure, which requires a basic understanding of the “anatomy” of communication. To start, consider the basic five-component structural representation of communication:^1,2

1. Sender: The person or organization with the message to deliver
2. Coding: The language of the intended communication
3. Channel: The medium of transmission
4. Decoding: Translation of the message
5. Feedback: How the receiver responds

Notice the “receiver” is missing from this construct. That’s because the receiver is omnipresent for any communication to be initiated and can be either known or unknown to the sender. When one speaks to a team member, the receiver is known. Conversely, a highway traffic sign is communication intended for a singular body of drivers. No one may ever take that road and see the sign but nonetheless, the communication has been initiated and it awaits transmission.

When Failure Occurs
When communication fails, the person responsible for picking up the pieces must ask where in the structure the failure occurred. Consider a simple example where some team members fail to show up for a mandatory staff meeting. There are a multitude of combinations that could have resulted in this failure, including:

• Was the message composed effectively? Was it in clear, concise language?
• Was the message sent? Oops, forgot to tell them, or hit “send.”
• Did the channel fail? The sticky note fell off the refrigerator door in the break room.
• Was it decoded properly? Team member says he saw the notice and the word “Thursday” but didn’t realize it was this Thursday.
• Did appropriate feedback occur? Did the employees not realize this meeting was mandatory, or did they choose to stay on duty to conduct a perhaps more critical task at this moment?

Next, consider outside forces that could have derailed even the best communication. Ironically, in difficult or risk-rich environments such as medical and veterinary offices, when communication is most essential, breakdowns are common.

As stakes go up, the level of nonessential “noise” that can clog a channel also rises. Roy Berko³ further defines noise into multiple categories:
 

1. Indifference among the receiver(s). This can be as simple as, “Oh, he always asks us to do that and we never do,” and can affect whether a message is received.

2. Was the sender or receiver distracted? Having a sick child at home or a sudden emergency case coming in the door always adds distraction.

3. Did emotion play a role in the failure? Two employees do not get along so one or both do not want to appear at a staff meeting where the other will be.

4. Were there physical risk factors at play? One feverish, sneezing employee can make others not want to go in the same conference room for fear of infection.

Analyze the Problem
The process of breakdown analysis to facilitate repair is one that has to be learned and practiced with low-stakes events so that it is effective when the stakes are high. Going back to the mandatory staff meeting, a stepwise approach organizes thoughts and ensures possible causes are not overlooked, making success more likely.

For example, suppose two key team members did not show up. Start by asking questions similar to these in an objective fashion; some to the group and some to yourself:

• Sender: Did I see everyone or just rely on the note on the refrigerator? Did any of the other employees advise others? Where are these people now?

• Coding: Was the message clear? Were the date and time correct? Did I stress the importance of this meeting?

• Channel: Did I use only one medium (note in the break room)? Why didn’t I use multiple media and repetition/reminders for such an important meeting? Or did I overly communicate the message so it became refractory?

• Decoding: Did the employees understand what I was trying to convey? If not, why would that happen? If they did decode the message properly, were they displaying a lack of interest or other blockers?

• Feedback: Okay, the message got to the employees and I verified they knew when the meeting was, so now I need to ask in private if I could have done more or if there is something they need to tell me. Once the failure is analyzed, now what? Again, a stepwise approach is the key. If the stakes are raised by circumstance and emotions run high, this will require more work.

If, for example, someone burst into tears in the office, find out what is causing the behavior without causing more damage. Start by empathizing without placating, determining why the person is emotional —is she ill? Angry? Upset? Playing a game of passive-aggressive behavior? Speak to the individual, giving her a chance to explain. Whenever possible, extend an offer to meet at the office or at a location of the person’s choosing.

Next, assess your own emotion. Ask yourself, “Am I angry, upset, depressed?” etc. Often, the sender’s emotion plays a role in the communication collapse. Did you react to another person’s misperception? If you recognize you are harboring an inordinate level of emotion, put off addressing the problem until you are calmer, and by all means discuss the situation with the other person in private.

The worst communication failure to overcome is one in which one or both parties has lost trust through intentional acts. Some say that lost trust can never be regained.⁵ By applying forethought, you will be able to help prevent a communication breakdown from escalating and affecting your ability to work as a team.

A Perpetuated Misinterpretation
In 1967, Mehrabian and Ferris⁴ researched three components that convey meaning in human communication: what we see at delivery, what we hear in the voice, and words actually spoken.

They found:
55% of impact is determined by body language
38% by voice tone
7% by the content or the words themselves.

Their work is frequently misstated and misused by those who try to impress the value of each component; especially the visual being more important than the words. But not so fast—Mehrabian and Ferris explained their work is based on a sender discussing feelings or attitudes and does not universally apply to all communication. This illustrates the importance of taking special care when emotions run high in interpersonal interactions. Once again, we see there are no simple concepts when it comes to something as complex as communication.

References
1. The Mathematical Theory of Communication. Shannon CE, Weaver W. University of Illinois Press, 1949.
2. The Process of Communication. Berlo DK. Holt, Rinehart, & Winston, 1960.
3. Communicating, 11th ed. Berko RM, Wolvin A, Wolvin D. Pearson Education, 2010, pp 9-12.
4. Inference of attitudes from nonverbal communication in two channels. Mehrabian A, Ferris SR. J Consult Psychol 31:248-252, 1967.
5. Truth and trust, they go together. Robbins S. Harvard Business School Working Knowledge, April 2005.

Charlie Powell is the public information officer for Washington State University College of Veterinary Medicine and public information director for the Washington State Veterinary Medical Association.