2. Hospital communication

As organizations that intend to communicate with their audiences, hospitals have a series of distinctive features, derived from their main function of healing and caring in response to a basic need that in general terms cannot be avoided or postponed. This is a service that, at least in Spain, is warranted by the State as it is deemed a universal right (Costa, 2012a: 176).

On one side, hospitals are organizations where most of the staff is in direct contact with patients and their relatives. On the other, hospital care implies a high degree of proximity with the audience, with the patient being present throughout the whole process of health service provision. That is to say, health care may only be provided in an encounter with “the other”, with the patient, “insomuch as communication and dialogue arise from interaction” (Quintana, Castillo, Carreton, 2018:86). Therefore, dialogue with health care service providers is a unique and differential feature of the human being, and it implies an ability to communicate, to understand, to want and to choose (Quintana, Castillo, Carreton, 2018).

Furthermore, and despite all pre-emptive efforts, sickness is unpredictable, and it is for this reason that the health care profession is considered an activity subject to uncertainty. And this sometimes provokes “peaks” in the needs for health care provision, which are hardly predictable, such as in the case of tragic events or epidemics (Costa, 2012b).

Either way, and regardless of the specific circumstances, the audience of a hospital organization, as with any business, may be classified in three categories based on their relationship with the institution: internal audiences, external audiences and intermediate or ambivalent audiences. Internal audiences are part of the organization and maintain a direct and permanent relationship with it. External audiences, however, have a sporadic relationship with the organization. And intermediate audiences are those that, without belonging to the organization or having a permanent relationship with it, have a somewhat direct influence on it or are affected by it. Also, as pointed out by Viñaras and Cabezuelo, this classification, derived from the strategic planning of public relations, is also valid to identify the CSR targets of an organization (Viñaras and Cabezuelo, 2012:58).

Citizens are an external audience of the hospital. However, if a citizen requires hospital service he or she becomes a user, a patient, thus acquiring the status of an intermediate audience, as also happens to his/her caretakers and relatives. And it is necessary to stop and reflect on the reasons why that citizen has become an intermediate audience. It is because he/she is in a fragile, stressful state, where the interpersonal communication skills of health care professionals have an impact on the patient’s motivation and could condition his/her decisions, such as to follow a treatment or to attend follow-up appointments (Medina, 2017: 357). Patient centred care turns out to be the most efficient approach to interpersonal communication for medical treatment, although “it has barely been explored by national physicians” (Salcedo, 2012: 42).