EUROPEAN BUSINESS SCHOOL

International University Schloss Reichartshausen

Thesis

To obtain the academic degree

Bachelor of Science

Communication Management in Hospitals ­ A Critical

Analysis of Possible Methods and Their

Actual Implementation

Submitted to:

Department for Market-oriented Management

Submission Date: 25/02/2009

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Table of Contents

List of Abbreviations I

List of Figures and Tables II

1

Introduction 1

1.1

Problem Formulation and Objectives 1

1.2

Course of the Investigation 4

2

Principles of Communication Management 5

2.1

The Concept of Communication 5

2.2

Communication Management and Integrated Communications 7

2.3

Aims of Communication Management 8

2.4

Methods of Communication Management 8

3

Hospitals in the German Health Care Market 10

3.1

Structure of the Hospital Environment in Germany 10

3.2

Trends and Developments in the Hospital Environment 12

4

Communication Management and the Hospital Sector 14

4.1

Aspects and Limitations of Communication Management in German Hospitals

14

4.2

The Communication Management Process in Hospitals 15

4.2.1

Problem Analysis and Target Definition 16

4.2.2

Target Groups 17

4.2.2.1

Criteria for Target Group Definition 17

4.2.2.2

Analysis of Hospital Target Groups 17

4.2.3

Strategy Formulation and Communication Instruments 20

4.2.4

Budgeting and Monitoring 21

4.3

Forms of Communication Management and Their Application in Hospitals . 22

4.3.1

Corporate Identity 22

4.3.1.1

Relevance of Corporate Identity for Hospitals 22

4.3.1.2

The Corporate Identity Mix for Hospitals 23

4.3.1.3

Corporate Identity Strategy in Hospitals 25

4.3.2

Internal Communication Management 26

4.3.2.1

Employee Communication 26

4.3.2.2

Personnel Management and Development 28

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4.3.3

External Communication Management 29

4.3.3.1

Aims of External Hospital Communication 29

4.3.3.2

Hospital Advertising 30

4.3.3.3

Direct Communication 31

4.3.3.4

Multimedia Communication 31

4.3.3.5

Communication with Referring Physicians 32

4.3.3.6

Communication with Health Insurance companies 33

4.3.3.7

Public Relations 34

5

Conclusion and Outlook 36

Reference List 38

List of Appendixes 49

Appendix 50

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Communication Management in Hospitals i

List of Abbreviations

ATL

...

Above-the-line

BTL

...

Below-the-line

CBT

...

Computer-Based-Training

CI

...

Corporate Identity

DKG

...

Deutsche Krankenhausgesellschaft1

DRGs

...

Diagnosis Related Groups

DRK

...

Deutsches Rotes Kreuz2

DTC

...

Direct-to-Consumer

DTP

...

Direct-to-Patient

e.V.

...

Eingetragener Verein3

EPR

...

Electronic Patient Record

GmbH

...

Gesellschaft mit beschränkter Haftung4

HWG

...

Heilmittelwerbegesetz5

IT

...

Information Technology

JCI

...

Joint Commission International

MBO-Ä ...

Musterberufsordnung für die deutschen Ärztinnen und Ärzte6

OECD

...

Organisation for Economic Co-Operation and Development

OTC

...

Over-the-Counter

PDL

...

Pflegedienstleiter7

PR

...

Public Relations

SE

...

Societas Europaea8

SGB

...

Sozialgesetzbuch9

SWOT

...

Strengths, Weaknesses, Opportunities, Threats

UWG

...

Gesetz gegen unlauteren Wettbewerb10

1 Translation: German Hospital Federation

2 Translation: German Red Cross

3 Translation: German Registered Association

4 Translation: German Limited Company

5 Translation: German Law on Advertising in the Health Care Sector

6 Translation: German Medical Association′s professional code of conduct

7 Translation: Head of Nursing Services

8 Translation: European Company Statute of a European Company

9 Translation: German Social Welfare Code

10 Translation: German Act Against Unfair Practices

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Communication Management in Hospitals ii

WHO

...

World Health Organization

WOM

...

Word of Mouth

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Communication Management in Hospitals iii

List of Figures and Tables

Figure 1:

The Technical Model of Communication 6

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Communication Management in Hospitals 1

1

Introduction

1.1 Problem Formulation and Objectives

In recent years, the German health care sector underwent considerable structural

changes. Up until a few years ago hospitals were still being considered as benevolent

facilities providing medical care. Nevertheless, these medical facilities increasingly rec-

ognise that their resources are limited and that they are subject to mechanisms of other

markets, meaning that they need to ensure the own position in the health care market

more than ever (Schreyögg, 2000, p. 185).

Increased competition between hospitals, scarce resources, and amendments of legisla-

tion are forcing every provider of medical services to consider a sustained and efficient

structure of the provision of their services over and above a strong customer orientation.

On the part of the patient, this implies higher transparency of the medical service offers.

On the part of the hospital, however, it means that it has to publicly present and vindi-

cate its medical procedures and bear comparison with its competitors. Prior to this tran-

sition, the status quo of a hospital was independent from changing patient numbers and

remained relatively constant. With several reforms (e.g., the introduction of Diagnosis

Related Groups ­ DRGs) coming from the government, which were supposed to retain

an eminent level of public health care and at the same time putting a halt on the consis-

tently rising health care costs, the hospital was now heavily reliant on the number of

patients treated. Thus, hospitals were faced with the challenge of retaining or gaining

more patients, while concurrently having an unchanged or lower budget, which meant

that the role of the hospital changed from being a mere renderer of medical services to

having the function of an economic actor.

Concretely, this implied for hospitals adopting a strategic concept that is aligned to the

market and to the heterogeneous target groups of this market, such as patients, health

insurance companies or referring physicians. Clinics have to question themselves

whether they consider the patient to be a customer, who is offered the service according

to his needs, whether the general practitioner with a private practice is seen as a com-

petitor, as partner for cooperation (i.e. in a sense of integrated supply of medical ser-

vices), or as a customer in terms of being a referrer, and whether they meet the needs of

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Communication Management in Hospitals 2

health insurance companies. All these matters have to be taken account of when devel-

oping an extensive communication concept.

The increased autonomy, owing to perpetual health care reforms, also entails a reloca-

tion of services to the ambulatory sector and reduced residence times of patients in hos-

pitals. Moreover, patients are nowadays not only driven in their demand by the quality

of the medical treatment, but by a function of several different factors, which include

among others the communication of a positive image through advertising and public

relations. Next to the original medical service offers of the hospital, potential yields can

be created in various other areas, which lead to a realignment of the external communi-

cations. The patients have also become more responsible and cost-conscious, due to

their obligations of financial contribution (e.g., through participation in health services

through practice charges11 or the abatement of over-the-counter [OTC] drugs from the

range of pharmaceutical products offered).

Nevertheless, business-like reasoning of the economist on the one hand and traditional

Aesculapius professional perception of the physician on the other hand seem to be in-

compatible with each other, especially when having to make cost-benefit considerations

for a treatment or in terms of hospital advertising. Frequently, ethical concerns stand in

the way. However, it is inevitable that with the transition from a state-controlled to an

autonomous health-care sector in a free-market economy, these concerns are put aside

in the long-term, the more so as rising privatisations require economic thinking in hospi-

tal management. Oftentimes, the exigency of communication management is not under-

stood and there is resistance amid the employees. An elaborate internal communicative

structure is essential in this respect and has a decisive influence on logistic flows, and

information exchange and transfer, especially when reorganisations or restructuring take

place in large companies. Besides that, a holistic corporate identity approach can help to

represent a comprehensive conception, which integrates and homogenises the entire

communicative activities, internally and externally.

Hospitals are thus confronted with the defiance with the challenge of asserting them-

selves in the competition and acquiring sufficient demand for the medical services of-

11 Translation: Praxisgebühr

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