8 Jun 2019



Prepared by: (YOUR NAME HERE)

1.0       EXECUTIVE SUMMARY                                                                                    3

2.0       INTRODUCTION                                                                                                  3

3.0       COMPANY PROFILE                                                                                           5

4.0       THE CORPORATE COMMUNICATIONS FUNCTIONS                                             7
            4.1       Roles and responsibilities                                                                             7
            4.2       Internal and External Sources of Communication                                       8
            4.3       The Corporate Communications Function                                                   10

5.0       IMPROVING COMMUNICATIONS IN KPJ                                                      11
            5.1       Core Principles                                                                                             11
            5.2       Priority 1: Brand development and reputation management                                   12
            5.2       Priority 2: Providing, developing and embracing digital
                        communications platforms                                                                            13
            5.3       Priority 3: Building on our success and doing the basics well                     14

PUTERI                                                                                                                   16

6.0       CONCLUSIONS                                                                                                    20

            REFERENCES                                                                                                        21

1.0              EXECUTIVE SUMMARY
The 2016 KPJ Ampang Puteri Annual Reports under the company communication strategy says:
“The KPJ Ampang Puteri Plan sets out a ten-year vision … in which patients always come first and front-line staff are given more responsibility for delivering the care they need. Such a huge cultural shift may be difficult to achieve … communications is vital to driving this process of change. This is not primarily about dealing with the media. It is about how the KPJ communicates with patients, the public, its own staff and other organizations."
In developing an internal communications strategy, the KPJ Ampang Puteri recognizes that our staff are our stakeholders, our representatives and our most powerful advocates and that communication by staff, and with staff, at all levels is essential to bring about involvement and engagement, and contribute to job satisfaction.
This strategy has therefore been developed to support an organizational culture in which all staff feel involved with and valued by the Trust and the people they work with, and in which all staff understand the responsibilities they have in communicating with colleagues and patients, and in giving a positive impression of the hospital within the local community.
In order to achieve these aims, the communication strategy outlines a vision for communication, identifying and recognizing the various communication needs of staff depending on their individual circumstances, analyze the communication methods currently available, and plan improvements and methods of evaluation.
It also develops key strategic objectives for communications, and identifies early priorities to achieve improved communication at all levels within the hospital.

2.0              INTRODUCTION
Communication has become a strategic element capable of positively influencing the medical services provided to patients. Hospitals undertake different communication actions: online communication, marketing, and events. However, the types of medical services provided to patients and the high number of workers employed by these organizations, who have direct contact with patients, transform internal corporate communication into the most important communication initiative for a hospital. Internal communication has different objectives, is divided into different types, uses multiple tools, reflects different strategies, and is based on a respect for ethics. The increasing importance of internal communication combined with the limited communication traditionally demonstrated by hospitals justifies the analysis of organizational performance and its impact.
The main players in communication in a hospital consist of medical staff, nursing staff, patients, the families of patients, health executives, and employees who perform various administrative or maintenance duties (Medina, 2011). From a communicative standpoint, the medical staff assumes significant responsibilities because they must use interpersonal communication to understand the pathology, needs, and expectations of patients and assist patients with reducing stress, improving adherence to treatment, and exercising self-control (Edgar, Satterfield and Whaley, 2005). Nursing staff are critical to hospital communication because the patient frequently expresses a greater trust in nurses than in other medical staff (Berry, 2007). As the recipient of the majority of communicative acts, the patient is the main player in hospital communication (Buckley, 2008). Because a patient’s family can influence their decisions about treatment, excellent communication between families of patients and the medical and nursing staff is crucial. Health executives assume transverse responsibilities in areas such as coordination, employee motivation, and distribution of information within the organization. Administrative and maintenance employees also influence hospital communication (Medina, 2011), especially employees who are involved in the final contact with the patient, which is common in this type of organization.
The development of a corporate communication culture should be based on the strategic use of internal and interpersonal communication (Parsons, 2001). This action requires that the hospital have a communications department that is primarily responsible for defining the brand architecture of the hospital, i.e., identity, values, mission, vision, culture, and image (Medina, 2011). Corporate identity is related to the image and vision of a company (Van Riel, Fombrun, 2007) and is defined as the principles that differentiate an institution from its competition, i.e., the raison d'être of an organization. Identity influences every aspect of a company and serves to connect these aspects. To define identity, we must investigate the external image of an organization (Costa, 2001) and identify attributes that society uses to describe the organization (Van Riel, Fombrun, 2007). An organization should outsource its identity to generate cohesion between the employees and the organization and must measure three variables: organizational performance, communication actions, and symbols (Van Riel and Fombrun, 2007). In addition to identity, the hospital defines its corporate values; according to Aiken & Sloane (2002), corporate values are shared by the employees of an organization and are used to build trust and foster communities. Organizations should create, disseminate, and maintain these values to unite their corporate communicative actions (Long, Iedema, Bonne Lee, 2007).
Thus, this report is prepared to identified, analyzed and improving communication in KPJ Ampang Puteri. his report also aims to provide the opportunity how communication, knowledge and information can be developed and used to improve communication within the hospital and with other organization.  This reports also covers how IT system can be used as a management tool for collecting, storing and dissemination and providing access to knowledge and information. Finally, a detail recommendation will be discussed in improving the IT infrastructure in KPJ Ampang Puteri for strategic and effective communication in the hospital.

3.0              COMPANY PROFILE
Located just five minutes from downtown Kuala Lumpur, KPJ Ampang Puteri Specialist Hospital (APSH) is one of Malaysia’s leading specialist hospitals, with a long list of national and regional awards for safety and quality of medical care. Ampang Puteri is part of the KPJ Healthcare Group, one of the leading private healthcare providers in the region with more than 26 years’ experience in the healthcare industry.
In 2009 alone, KPJ Healthcare Group facilities treated nearly 207,000 inpatients and 2 million outpatients. APSH, which opened in 1995 and has 230 beds, is one of five KPJ hospitals in Malaysia serving international health travelers.
The hospital has several centers of excellence including those dedicated to cardiology and cardiothoracic surgery, comprehensive health screenings, neurosurgery, orthopedics, and reconstructive surgery. In 2008, APSH opened a pain management center, treating back and neck pain, trigger-point pain, myalgia, fibrositis, fibromyalgia, cancer pain, and complex regional pain syndrome. The hospital has performed more than 15,000 reconstructive surgeries of which one-third were for patients from other countries.
APSH is a state-of-the-art private medical center with extensive diagnostic and therapeutic resources, including endoscopic suites, hemodialysis centers, cardiac catheterization, and magnetic resonance imaging facilities. Medical specialists are highly qualified professionals with extensive international qualifications and are supported by well-trained paramedical staff.
The facilities reflect the comprehensive range of APSH’s specialties including cardiac care, renal dialysis, gallstones, neurosurgery, and reconstructive surgery. The hospital recently expanded its capacities for lithotripsy, hemodialysis, and pain management. Holistic care-based home nursing services also are available for patients recently discharged and who are staying within a 10-kilometer (six mile) radius of the hospital. The accident, emergency, and outpatient services operate 24/7 and are manned by a medical officer and teams of experienced nurses and aides.

Figure 1: KPJ Ampang Puteri Specialist Hospital in Ampang.


            4.1       Roles and responsibilities
All members of staff throughout the organization have a part to play in supporting the delivery of effective communication, ensuring this takes place internally with each other, by engaging with partners and the public and by helping us share good news about our services. Communication is everyone’s business and is not the responsibility of the Communications Team alone.
However, there are specific tasks and responsibilities that are performed and managed by the team. The Communications Team provides leadership, technical expertise, advice, guidance and support on all communications issues. Our responsibilities currently include but are not limited to:
·         brand and reputation management
·         media relations
·         internal communications
·         campaign management
·         web/intranet content development
·         graphic design
·         project support for key corporate developments and service change
·         support for emergency planning/major incidents

Figure 2: Structure of the Corporate Communications function

            4.2       Internal and External Sources of Communication
Internally – With in excess of 2,000 members of staff across more than one acute hospital site, communicating internally can be a challenge. At a corporate level we currently have the following internal communications tools at our disposal:
·         the intranet
·         Outline magazine (monthly)
·         Involve - monthly staff briefing leaflet circulated via global email and monthly open verbal briefing by the Chief Executive held on both sites
·         global email
·         screensavers
·         posters, leaflets, other printed materials
·         100 Leaders events
·         At an operational level the responsibility to communicate with staff is passed
·         by cascade from senior management to their teams.

Externally – our Communications Specialists have established excellent relationships with local media and manage the news agenda on a daily basis. Between August 1, 2015 and July 31, 2016, the Communications Team received 592 media enquiries. Although the type and/or quality of coverage is not currently measured we know by recording the nature of all enquiries that the main issues for our local media can be broadly categorized as below:

·         finance and performance: perceived mismanagement of finances, CQC and Monitor interventions, fines, missed targets, investment, capital development
·         patient experience/quality of services: poor/excellent experience, new initiatives, SUIs, new treatments, innovation
·         staff: jobs at risk, Unison action, staff survey, staff awards
·         corporate: sustainability, new contracts, reconfiguration, MP/high profile visits

Our methods of communicating with our external audiences are predominantly traditional, via:
·         press releases
·         news events - campaign launches, interviews, photocalls
·         our website
·         production of corporate materials - posters, documents, newsletters

Positive news coverage is generated on a weekly basis through features and news stories with local press and radio stations. All coverage is shared on a daily basis with the Chair and Chief Executive and is uploaded to the intranet. The outcome or impact of our coverage is not formally recorded or evaluated.

4.3       The Corporate Communications Function
The Communications Team is a corporate function and plans, tailors and delivers key corporate messages throughout the organization. Tasks are currently prioritized in accordance with their direct relevance to the delivery of the corporate objectives. Organized workload of this kind operates concurrently with the management of the press office function, with media enquiries handled daily regardless of scheduled work. As a consequence, the team can find it hard to make time for forward-planning. The extent to which the Communications Team is able to provide robust responses to media enquiries is often limited by the availability/willingness of key spokespeople to provide media interviews.
Along with other departments within the organization, the team works alongside HR and Patient Experience to support the delivery of individual projects, such as the Staff Survey and Awards, and promotion of Inpatient/ Outpatient Surveys. The support provided to these two key departments is not formalised or defined.
Sourcing information for proactive communications can be a challenge for the team and is heavily reliant on established channels via project groups, meeting minutes or management cascade. Innovations, individual awards/ recognitions may not be communicated via these methods and opportunities for promoting key messages may be lost in these instances.
While visitors to our hospitals can post news, comments, images and videos to any number of online forums, the Communication Team’s ability to respond quickly and easily to events is currently limited to what can be provided via a PC at a desk. While our website’s Content Management System (CMS) can be accessed remotely, there are no smartphones within the team to do this. As a consequence, opportunities to update our audiences at a pace at which they are currently able to engage are missed.
Crucially, the team’s ability to assess performance and monitor the impact of campaigns is limited to what we know about the effectiveness of communications at an organizational level. The annual Staff Survey provides valuable insight into overall effectiveness of staff communications and engagement. Patient experience data enables us to understand any reputational issues which may need addressing.
When considering the model for effective communicating organizations thorough and analytical evaluation of our communications activities are largely absent from our corporate function. In addition, the communications perspective is not fully embedded within the organization with no senior communications presence at Board or Executive level. Communications requirements are not routinely considered at the point of strategy development, leading to last minute requests for support and an unpredictable workload for the team.

            5.1       Core Principles
A set of principles will help guide the work of the Communications Team and others working to deliver effective communications within the organization:
ü  strategic: we will justify everything we do by showing how it contributes to the objectives of the organization
ü  transparent: our communications are attributed, open and honest
ü  mainstream: communications is core business for the hospital and everyone has a contribution to make
ü  audience: all communications will be specifically targeted, crafted with a particular stakeholder group in mind. Our stakeholders are defined in the Stakeholder Engagement Strategy
ü  improvement: we will learn from the best and explore opportunities to be better
ü  partnerships: we will work with relevant partners in other organizations to minimize duplication and ensure consistency
ü  practitioners: we are the communications experts and will take the lead on advising and supporting others to deliver good communication
ü  evidence based: we will evaluate what we do, learn from mistakes, build on success and improve as a result.

5.2       Priority 1: Brand development and reputation management
The changing policy landscape means reputation management is becoming increasingly important to all KPJ organizations. Reputations are built by developing strong and valuable relationships with key stakeholders and cannot be managed by one team alone. Our reputation consists of the perception that stakeholders develop through their accumulated experience of our hospitals, both in their direct contact with staff and services and via external influences such as the media. It is only as good as the actions of the staff they come into contact with in our organization.
External influences on our reputation will continue to become increasingly important as the development of online communities, and the speed at which they can build or damage reputation, continue to grow. A good reputation amongst staff ensures better levels of morale and an increased ability for the Trust to retain and recruit staff. It also increases an organization’s ability to implement change as staff embrace the organization’s vision and values.
Understanding the issues which arise as a result of Inpatient and Outpatient Surveys will help us assess our reputation with those who have direct experience of our services and staff. In 2016 the Care Quality Commission visited KPJ Ampang Puteri and KPJ Pantai and presented positive reports; the national inpatient survey showed 93% of patients rated their care as good, very good or excellent. We will;
·         work with the patient experience team to explore opportunities to gain insight into the impact of communications activity and the effect on reputation, capture information gathered through informal routes, such as focus groups
·         promote an awareness among staff of the value of relational and reputational capital, working with service lines to develop materials to support communications channels and with Education, Learning and Development to influence communications training
·         monitor and evaluate media activity to assess the impact of our communications output and adjust accordingly to manage and build reputation
·         produce a monthly reputation report, circulated to the Executive Team
·         the hospital's vision and values are the foundation of our brand identity. They define what we stand for and reflect our ambitions as an organization. We will;
·         review the use of our internal/external branding to ensure best approach
·         monitor and maintain consistency of all branding across all traditional and online communications platforms
·         develop a brand center to facilitate consistent use of branding while empowering and educating others
·         identify ways to further embed the values throughout the organization.

5.2       Priority 2: Providing, developing and embracing digital communications platforms
The website: The hospital website and intranet are now supported by a new Content Management System and much of the information on the old sites has now been updated and migrated into the new platform. An organization’s website can no longer act solely as a digital brochure, something that we have recognized during the past 18 months of the Web Redevelopment Project. In order to build and further develop our sites we will:
·         establish a culture of continuous improvement in relation to web development
·         exceed the expectations of our users, using the best of technology to improve patient experience via our websites
·         explore opportunities for the development of a mobile website
·         empower staff to manage their own web content and communicate directly with patients via the CMS

The intranet: Successful intranets are no longer simply information or document stores, they are forums for collaboration and knowledge sharing, useful tools for performing key tasks, and engaging platforms where the organizational values are evident and culture is developed. We will:
·         produce an intranet development strategy aimed at addressing key staff engagement and involvement issues within the hospital
·         facilitate collaboration and initiate a shift in staff culture from passive to active knowledge acquisition

Social media: The way people access and share information has changed dramatically in the past decade. The development of a Social Media policy and associated Code of Practice will define how appropriate and considered use of social media will support the achievement of our objectives and improve stakeholder engagement. By using social media as a communications tool, we will:
·         support the general public’s expectation for enhanced access to online information
·         improve the trust’s ability to effectively get information to its stakeholders, including diverse audiences, through a more balanced approach
·         ensure that the Hospital’s communications spend is used effectively (social media is a free method of reaching a wide audience)
·         gain useful insight into the public’s perception of our services or topics that are of interest to target audiences
·         increase openness and transparency of information and provide more accessible customer service by improving Hospital ability to respond to questions, requests and inaccurate information online in real-time.

5.3      Priority 3: Building on our success and doing the basics well
In recent years, the Communications Team has directly supported the successful completion of key Trust developments including the opening of the Women’s Centre in 2011, the internal communication of the Safety campaign, the creation of the Kindness and Respect Behaviour Standards, the redevelopment of our web and intranet sites and the re-design of our corporate brochures. In addition, the team produces a monthly newsletter, a quarterly FT Members newsletter and a monthly team brief.
It is important for us to build on these successes and to organize our small team so our work is efficient, effective and has maximum impact:

Internal communications and engagement: Our organization is not only judged on its corporate words and actions, but by the myriad of individual transactions that take place on a daily basis between our staff and patients. High quality, effective communications must be carried out at all levels of the organization. To enable our staff to better convey the organizational narrative, we will:
·         align the work of the Communications Team more closely with the work of the service lines, providing a detailed proposal of the support available
·         develop toolkits and supporting materials to empower service lines and divisions to communicate effectively with staff
·         develop an intranet strategy to employ social elements, facilitating staff engagement and meaningful dialogue

GP communications: In the current climate of KPJ reform, building partnerships with our future GP commissioners will be essential if we are to shape future service provision that best meets the needs of local people. GPs are a trusted source of healthcare advice and have a strong influence over a patient’s choice of provider. To facilitate better communications, we will:
·         explore opportunities to further develop and promote the GP section of the website
·         develop a new e-newsletter with targeted content

Media and public relations: Having the resources, knowledge, expertise and flexibility to deal with reactive and crisis communications will always be an essential prerequisite for any communications team. Time should also be made available to organize proactive public relations campaigns, redress the balance when the hospital is under fire and consider approaches for positive but more time-consuming media opportunities. We will:
·         use relationships with service lines to identify and forward plan positive PR opportunities
·         identify and train informed, key spokespeople throughout the organization to speak publicly on a range of high profile issues
·         reorganize workload within team to provide protected planning and evaluation time.
6.1       Knowledge
In healthcare, we have the presence of both explicit and tacit forms of knowledge. Explicit knowledge is available in medical journals, research reports, and industry publications. Explicit knowledge can be classified under: internal and external. Internal are those that are relevant to the practice of medicine, such as medical journals and research reports. External are legal, governmental, and other publications that do not directly affect patient treatment methodology but govern general medical practices. Three dimensions in health information outlined by Sorthon, Braithewaite and Lorenzi (1997) include management information, professional information, and patient information. Overlap and commonalties are identified, but fundamental differences exist in the types of information required for each dimension, the way the information is used, and the way standards are maintained. The achievement of a comprehensive and integrated data structure that can serve the multiple needs of each of these three dimensions is the ultimate goal in most healthcare information system development. Tacit knowledge is found in the minds of highly specialized practitioners, such as neurosurgeons or cardiac arrest specialists. Much of tacit knowledge resides in the minds of individuals. Seldom does efficient knowledge sharing take place. One exception to this is where practitioners exchange know-how at industry or academic conferences. This, however, happens on an all-too-infrequent basis.
Staged look at knowledge management
Figure 3: Staged look at knowledge management

            6.2       Knowledge Capture and Storage
Once gathered, knowledge needs to be captured and stored to allow for dissemination and transfer. Two strategies are common for capture and storage: codification and personalization. The codification strategy is based on the idea that knowledge can be codified, stored and reused. This means that the knowledge is extracted from the person who developed it, is made independent of that person and reused for various purposes. This approach allows many people to search for and retrieve knowledge without having to contact the person who originally developed it. Organizations that apply the personalization strategy focus on dialogue between individuals, not knowledge objects in a database. To make the personalization strategies work, organizations invest heavily in building networks or communities of people. Knowledge is shared not only face-to-face, but also by e-mail, over the phone and via videoconferences. In the medical domain, the codification strategy is often emphasized, because clinical knowledge is fundamentally the same from doctor to doctor. For instance, the treatment of an ankle sprain is the same in London as in New York or Tokyo. Hence it is easy for clinical knowledge to be captured via codification and to be reused throughout the organization.
Knowledge capture has been one of the most cumbersome tasks for hospitals. Until rather recently much of the patient knowledge was stored in the form of paper reports and charts. Moreover, the knowledge was dispersed throughout the hospital without any order or structure. Knowledge was also recorded in different formats, which made summarization and storage difficult.
Recently we have seen advancements in the technology of Electronic Medical Records (EMRs). EMRs are an attempt to translate information from paper records into a computerized format. Research is also underway for EMRs to include online imagery and video feeds. At the present time they contain patients’ histories, family histories, risk factors, vital signs, test results, etc.. EMRs offer several advantages over paper-based records, such as ease of capture and storage. Once in electronic format, the documents seldom need to be put through additional transformations prior to their storage.
Tacit knowledge also needs to be captured and stored at this stage. This takes place in multiple stages. First, individuals must share their tacit know-how with members of a group. During this period, discussions and dialogue take place in which members of a group validate raw tacit knowledge and new perspectives are sought. Once validated, tacit knowledge is then made explicit through capture in electronic documents such as reports, meeting minutes, etc., and is then stored in the knowledge repositories. Use of data warehouses is common for knowledge storage. Most data warehouses do have web-enabled front-ends to allow for optimal access.

            6.3       Knowledge Transfer and Dissemination
Knowledge in the hospital once stored centrally needs to be made available for access by the various organizational members. In this manner knowledge assets are leveraged via diffusion throughout the organization. One of the biggest considerations here is security. Only authorized personnel should be able to view authorized knowledge. Techniques such as the use of multiple levels of passwords and other security mechanisms are common. However, organizational security measures also need to be in place. Once the authorized users get hold of the knowledge, care should be taken while using such knowledge, to avoid unscrupulous practices. Moreover, employees need to be encouraged to follow basic security practices, such as changing passwords on a frequent basis, destroying sensitive information once used, etc. Ensuring security is a multi-step process. First, the individual attempting to access information needs to be authenticated. This can be handled through use of passwords, pins, etc. Once authenticated, proper access controls need to be in place. These ensure that a user views only information for which he or she has permission. Moreover, physical security should also be ensured for computer equipment such as servers and printers to prevent unauthorized access and theft.
Disseminating healthcare information and knowledge to members outside the organization also needs to be handled with care. Primarily physicians, clinics, and hospitals that provide optimal care to the patients use health information. Secondary users include insurance companies, managed care providers, pharmaceutical companies, marketing firms, academic researchers, etc. Currently no universal standard is in place to govern exchange of healthcare knowledge among industry partners. Hence, free flow of healthcare knowledge can be assumed to a large degree. From a security perspective, encryption technologies should be used while exchanging knowledge over digital networks. Various forms are available such as public and private key encryptions, digital certificates, virtual private networks, etc. These ensure that only the desired recipient has access to the knowledge. An important consideration while exchanging knowledge with external entities is to ensure that patient identifying information is removed or disguised. One common mechanism is to scramble sensitive information such as social security numbers, last and first names. Another consideration is to ensure proper use by partners. Knowledge transferred outside the organization (i.e., the hospital) can be considered to be of highest quality as it is validated multiple times prior to transmittal.
Medical data needs to be readily accessible and should be used instantaneously. The importance of knowledge management cannot be stressed enough. One aspect of medical knowledge is that different people need different views of the data. Let us take the case of a nurse, for instance. He or she may not be concerned with the intricacies of the patient’s condition, while the surgeon performing the operation will. A pharmacist may only need to know the history of medicine usage and any allergic reactions, in comparison to a radiologist who cares about which area needs to be x-rayed. Hence, the knowledge management system must be flexible to provide different data views to the various users. The use of intelligent agents can play an important role here through customization of user views. Each specialist can deploy customized intelligent agents to go into the knowledge repository and pull out information that concerns them, thus avoiding the information overload syndrome. This will help the various specialists attend to problems more efficiently instead of being drowned with a lot of unnecessary data. Another dimension of knowledge management is the burden put on specialists. A neurosurgeon is paid twice as much, if not more, than a nurse. Hence, we should utilize their skills carefully to get the most productivity. Expert systems play a crucial role here in codifying expertise/knowledge. When a patient comes for treatment, preliminary test and diagnosis should be handled at the front level. Expert systems help by providing a consultation environment whereby nurses and other support staff can diagnose illness and handle basic care, instead of involving senior-level doctors and specialists. This allows for the patients that need the care of experts to receive it and also improves employee morale through less stress.

This Communications Strategy outlines key areas for development over the next ten years, focusing on three core areas to enable us to become a more strategic and effective communicating organization.
The communications function comprises of a small team with a wide remit to guide and protect corporate reputation, improve communications standards and influence decision-making at a senior level. It is vital that the function has the tools, skills and buy-in of the senior team to support further develop communications within the organization and achieve the goals that have been set.
It is important to note that many of the key areas for development may not be achievable within the current available resources of the department.
If the priority areas for development are endorsed by the Board, we propose the next stage of strategy implementation will be to identify any gaps in organizational structure and resources required and put forward plans to address these.
Effective communication is something to which everyone within the organization can and should contribute. We welcome feedback on this vision for the future of communications within our organization and look forward to working with our colleagues to deliver it.


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