Vertical and horizontal listening on internal social media during a time of crisis: a case study of a Danish hospital

Abstract

Purpose

The study explores internal listening on internal social media (ISM) during a crisis at a large Danish hospital.

Design/methodology/approach

The study employs a netnographic qualitative design to analyze 142 posts shared by employees on the hospital's ISM platform “The Word is Free” and how these posts are listened to by employees, support functions and management.

Findings

The study finds seven different types of internal listening. Categories of vertical listening included respectful listening, delegated listening, formal listening and no listening, while horizontal listening included confirmatory listening, responsive listening, challenging listening and no listening.

Research limitations/implications

The study focuses on listening on ISM between January 2019 and March 2022. Interviews with employees and managers are needed to further investigate how internal listening at the hospital influences organizational life both in general and during a crisis.

Practical implications

Especially in crisis situations, organizations are encouraged to approach ISM with a holistic understanding of listening and apply three principles: (1) embrace ISM as an employee communication arena where confirmatory, responsive and challenging listening among employees helps them to cope with strenuous situations; (2) monitor the ISM communication arena and (3) conduct respectful listening.

Originality/value

This study focuses on internal listening on ISM during a crisis and suggests a holistic understanding of internal listening that combines vertical and horizontal listening.

Citation

Madsen, V.T., Gode, H.E. and Andersen, M.A. (2023), "Vertical and horizontal listening on internal social media during a time of crisis: a case study of a Danish hospital", Journal of Communication Management, Vol. 27 No. 4, pp. 563-581. https://doi.org/10.1108/JCOM-03-2023-0037

Introduction

When an organization finds itself in a challenging and critical situation, internal listening may be a way for management and employees to maintain trust and improve engagement, as well as overcome worries and resistance (Lewis, 2020; Sahay, 2023). Furthermore, internal listening could represent a learning opportunity for managers (Lewis, 2020). The Covid-19 pandemic meant that organizations had to launch changes overnight to adapt to the new circumstances. While communication often plays a more important role in implementing these changes, listening to employees is rarely prioritized (Neill and Bowen, 2021b). Lewis (2020) also highlights that managers sometimes offer channels for stakeholders to express their views, but in the process they fail to really listen to the perspectives, concerns and questions offered. Researchers refer to this phenomenon as fake listening (Macnamara, 2016) or pseudo listening (Adler and Rodman, 2011).

Listening has been associated with a broad array of beneficial organizational outcomes such as effective teamwork, a supportive organizational climate and stronger employee commitment and identification with the organization. Poor listening, on the other hand, has been associated with negative outcomes, such as counterproductive conflict and organizational mishaps like medical errors, misunderstood work orders, feedback confusion and reduced workplace safety (Barbour, 2017; Lewis, 2020).

To achieve successful organizational listening, Macnamara (2016) suggests an “architecture of listening” consisting of, among other things, technologies to aid listening. In this light, internal social media (ISM) can be a useful communication arena (Heide and Simonsson, 2011) where managers can listen to other members of the organization (Madsen and Johansen, 2019). In the field of organizational communication studies, ISM is defined as an interactive and dynamic communication arena in which organizational members can interact, discuss, negotiate and make sense of their work and organizational lives (Madsen, 2017).

Scholars argue that organizational listening is in its infancy and that it is still undertheorized (Macnamara, 2018; Sahay, 2023). Therefore, researchers should undertake more empirical research on how organizations may build and maintain a strategic listening focus in different contexts (Neill and Bowen, 2021a, b). Research on organizational listening has primarily focused on how organizations listen to stakeholders on public social media (e.g. Reinikainen et al., 2020; Maben and Gearhart, 2018; Pina et al., 2019) or how management should listen to employees (Lewis, 2020; Neill and Bowen, 2021b). Little research attention has been dedicated to studying how internal listening unfolds between managers and employees in ISM during a crisis.

Therefore, the aim of this study is to add to the organizational listening literature by exploring how managers, support functions and employees practiced internal listening on a Danish hospital's ISM platform during the Covid-19 pandemic and a Danish nurses' strike in 2021. This article will document the study's observations of practices of internal listening and how different types of listening among employees contribute to dealing with organizational life and daily working conditions in a crisis situation. Based on the study, we also contribute to the theoretical literature by proposing a holistic understanding of internal listening.

Theoretical framework

Internal listening

The global Covid-19 crisis has been characterized as a “creeping” crisis with no beginning and no end that “crept up on countries, cities, and hospitals. It arrived in full view, yet still surprised politicians, hospital administrators, pundits, business owners, and citizens” (Boin et al., 2020, p. 117). As the pandemic caused work-related changes in many organizations, listening to employees has never been more important (Neill and Bowen, 2021b). Macnamara (2018) defines organizational listening through seven canons, which he argues are essential for effective listening to both external and internal audiences. These include “giving recognition to others, acknowledgment of others' views and expressions of voice, paying attention to others, interpreting what others say as fairly and receptively as possible, achieve an understanding of others' view, giving consideration to what others say and responding in an appropriate way” (p. 6–7).

The traditional understanding of crisis communication has mainly focused on how management should carefully plan and communicate fast information and instructions to employees in the acute phase of a crisis to prevent rumors and confusion. This approach mirrors a traditional view of management that is characterized by command and control and sender-oriented communication, which goes hand in hand with a view on employees as passive receivers (Heide and Simonsson, 2019; Frandsen and Johansen, 2017). However, recent research accentuates that employees play an important role as active senders and communicators that use their social networks to understand and make sense of what is going on at different stages of a crisis (Heide and Simonsson, 2019; Frandsen and Johansen, 2011). In their role as communicators, the employees may also behave as ambassadors and speak in favor or against the organization to their colleagues and the outside world. Therefore, management should constantly build and maintain strong relationships with employees because it may influence their cognitive reactions, feelings of insecurity and behavior before, during and after a crisis (Frandsen and Johansen, 2017). Consequently, crisis communication researchers have started to focus on the managerial benefits from listening to employees. As an example, Mazzei and Ravazzani (2011) emphasize that internal listening plays a key role in creating a trusting relationship between managers and employees. According to these researchers, neglected listening during a crisis may lead to a sense of abandonment and exclusion among employees. Developing trusting relationships with employees may therefore act as a crisis vaccine against mistrust, accusations and negative ambassadorship during a crisis (Heide and Simonsson, 2019, p. 128).

Other scholars have paid special attention to the listening competences of communication professionals and management (Elshoff and Hendrawan, 2022; Lewis, 2020; Neill and Bowen, 2021b; Vercic and Zerfass, 2016). For instance, Neill and Bowen (2021b) address the internal listening of communication professionals in times of crisis. They argue that communication managers need to practice “ethical listening”, which means that their listening to employees should be authentic, open-minded and empathetic. Vercic and Zerfass (2016) investigate the key factors that distinguish excellent communication departments from ordinary communication departments and highlight that the former base their decisions on processes of listening and research. Falkheimer et al. (2022) stress the importance of communication professionals in crisis times and argue that collaborative, participative listening is essential to build relationships with employees, increase engagement and learning and lessen the effects of the crisis.

Lewis (2020) emphasizes that organizations should focus on sincere listening leadership. Consequently, she defines strategic organizational listening as “constituted in a set of methodologies and structures designed and utilized to ensure that an organization's attention is directed toward vital information and input to enable learning, questioning of key assumptions, interrogating decisions, and ensuring self-critical analysis” (p. xvi). As employees actively make sense of change, Lewis (2019) recommends that management solicit input from employees during change to lower resistance, reduce uncertainty and increase feelings of control and satisfaction. A side effect of listening can also be the creation of the impression that the organization is open to feedback (Lewis, 2020).

As mentioned in the introduction above, Macnamara (2016, 2020) proposed the concept of an “architecture of listening”, which consists of eight elements that are necessary for an organization to benefit from the voices of employees, customers and other stakeholders. These are as follows: (1) A culture that is open to listening; (2) Attention to the politics of listening; (3) Policies that specify and require listening in an organization; (4) Systems that are open and interactive, such as websites; (5) Technologies that can aid large-scale listening; (6) Resources, including staff, to operate listening systems; (7) Skills for large-scale organizational listening; (8) Articulation to senior management of what is said to the organization (Macnamara, 2020, p. 380). Still, as pointed out by Ruck (2021), there may be barriers within organizations that can make listening to employees more difficult than listening to other stakeholders. These barriers can be related to employees' perceptions of the culture and the way leaders practice leadership. Leaders might, for example, be more focused on “the need to provide answers” rather than listening to employees (p. 95). Other challenges to internal listening include the possibility that “those charged with these tasks may submerge or discount much of what is heard” (Lewis, 2020, p. 51). Additionally, variations in an organization's situation, including sudden changes such as those caused by the recent pandemic, could complicate listening and even result in listening failure (Barbour, 2017; Lewis, 2020).

Internal social media: an arena for internal listening

Organizations increasingly use ISM as part of their internal communication strategies (Cardon and Marshall, 2015; Sievert and Preisinger, 2021). ISM offers a communication arena inside the organization where organizational members can share knowledge and viewpoints and connect with each other across hierarchies, departments and geographical distances. All employees have the opportunity to voice their opinions (Ellmer and Reichel, 2020), and ISM can pave the way to creating a multivocal organization (Werling, 2020) that involves and engages employees in a different way than other internal communication channels (Men et al., 2020; Ruck, 2021). Organizational members can listen to employees' concerns, feelings and questions on ISM (Heide and Simonsson, 2011; Madsen and Johansen, 2019; Ruck, 2021), making it useful to consider ISM part of the organizational “architecture of listening” (Macnamara, 2016).

ISM can be used for both vertical and horizontal listening (Madsen and Johansen, 2019). Vertical listening happens when employee voices on ISM cut across organizational hierarchies, making the voices of frontline employees available and visible to senior managers. Even if the senior managers are not the target of the communication, their presence as an imaginary audience in a communication arena that is visible to everyone in the organization is psychologically important (Madsen and Verhoeven, 2016). They sanction the channel and that sanction represents a guarantee that voicing an opinion is allowed, which forces specialists and middle managers to respond (Madsen and Johansen, 2019). Horizontal listening happens when employees listen to each other's concerns and share knowledge. A study by Madsen (2021) found that employees enact communicative leadership on ISM when they solve problems, help others make sense of the organization and support and appreciate other employees. Furthermore, communication on ISM can help create “ambient awareness” (Leonardi and Neeley, 2017), a social science term for the awareness of communication and behavior that one is not directly involved in. Communication on ISM can therefore give both managers and employees an insight into what is happening in the organization.

However, using ISM for internal listening is not just a matter of introducing or having ISM. Several studies have found that the organizational culture and management responsiveness (e.g. Ellmer and Reichel, 2020; Gode et al., 2019; Madsen and Johansen, 2019) as well as how other employees communicate and react to communication on ISM (Gode, 2019; Madsen and Verhoeven, 2016; Werling and Maier, 2022) influence interactions and communication on ISM. Employees have to feel appreciated and listened to (Men et al., 2020), which happens when managers and specialists answer on a regular basis, give detailed answers and outline how suggestions and ideas are actioned (Ellmer and Reichel, 2020).

Researchers have been encouraged to direct their attention to more empirical research on how organizations may build and maintain a strategic listening focus in different contexts (Neill and Bowen, 2021a), and to the best of our knowledge, no studies have explored the use of ISM for internal listening during turbulent times. Therefore, this study seeks to answer the following research question.

RQ.

How do managers, support functions and employees practice internal listening on a hospital's ISM platform?

Methodology

This study explored internal listening on ISM at a hospital before, during and after the Covid-19 pandemic, a time period which also includes a nurses' strike in 2021. In the section below, the case organization, empirical material and data analysis are described.

Selection and description of the case organization

This research is based on a qualitative single case study at a Danish university hospital. The hospital was deliberately selected as an extreme case (Eisenhardt, 1989; Neergaard, 2007). Since 2007, all employees in the hospital have had the opportunity to open discussions, ask questions, suggest ideas, raise problems and concerns, critique, applaud and comment on the case hospital's ISM platform, The Word is Free. According to the communication manager at the hospital, The Word is Free constitutes a feedback mechanism where management can learn from and get insights into what is on employees' minds. Moreover, it signals that the hospital is an organization where employees can voice their opinions, and where results are created through horizontal collaboration and communication, rather than solely through vertical interactions (Interview with the communication manager, June 13, 2022). Thanks to the platform, all 11,000 employees across the 60 clinical and administrative departments and service and maintenance units can interact with one another. Thus, this platform provides exceptional opportunities for analyzing how managers, support functions and employees practice internal listening on an ISM platform in turbulent periods.

The Word is Free is one of many internal and external communication channels in the hospital where employees can voice their concerns and questions. They can also, for example, comment on news articles on the organization's intranet as well as post, comment and like on the hospital's Facebook and Instagram pages, making these additional channels through which management can listen to the organization. Furthermore, the hospital uses MED, a sanctioned trade union system, where employee representatives discuss and negotiate with management and, according to the communication manager, have face-to-face The Word is Free sessions in an auditorium where top managers answer questions from employees. While this initiative was paused during the pandemic, it was to be resumed. These other communication channels are not accounted for in our study.

Collecting and analyzing empirical material

The researchers were granted access to the communication on The Word is Free. Posts and comments from the period from January 2019 until March 2022 were downloaded as PDF files. The posts comprised three posts from 2019, 67 posts from 2020, 68 posts from 2021 and four posts from 2022. Furthermore, four news articles posted on the intranet within the same period that generated discussion were included in the analyzed material.

A netnographic analysis (Kozinets et al., 2014) of the 142 posts and their comments on The Word is Free was conducted. Our coding process was reflexive, and through reflexive research (Alvesson and Sköldberg, 2018) we strived to make our interpretations transparent. As researchers, we recognize that we have an active role in the coding process and that our interpretations have been formed by our theoretical framework, the ISM posts and comments as well as our preconceptions. In the coding process, we constantly switched back and forth between theory and empirical material. This iterative process is based on abduction in which we gained new understanding from repeatedly interpreting and reinterpreting theory and the empirical material (Alvesson and Sköldberg, 2018).

First, an overview of all the posts was made by listing them in an Excel spreadsheet and noting who initiated a post and who commented. It was noted that 16 posts received no reactions. 36 posts received one comment, 19 posts had two comments and 71 posts had more than two comments. A handful of those had as many as 16–18 comments, and one post even had 30. Second, we carefully read and re-read all the posts and comments multiple times, and a thematic analysis (King et al., 2018) was conducted. The posts were coded in reference to the themes discussed and observations and notes were made about situations where listening or no listening occurred. Listening was deemed to have occurred when a reaction to a post or to a comment appeared in the form of an answer, support, or a suggestion. No listening, in contrast, was deemed to have occurred when there were no reactions to a post or a comment which appeared to be intended to be listened to by management or colleagues. Third, observations of situations in which listening or no listening occurred were then grouped into vertical and horizontal listening. Vertical listening was said to have occurred when reactions from three different groups appeared: managers, support functions and the communication department. Fourth, vertical listening was coded and grouped into four types of how the listening manifested: Respectful listening, delegated listening, formal listening and no listening.

Horizontal listening was said to have occurred when reactions from fellow employees such as nurses, doctors, medical secretaries and service assistants appeared on The Word is Free. Fifth, horizontal listening was coded and grouped into three types of informal organizational settings in which listening took place: community listening, across-occupation listening and peer-to-peer listening. Sixth, horizontal listening was then coded and grouped into four types of how listening between employees occurred: Confirmatory listening, responsive listening, challenging listening and no listening.

Finally, to extend the analysis of the observations made from the netnographic research, and to better understand the role of the communication department in relation to ISM, a semi-structured telephone interview with the communication manager was conducted. The interview lasted 38 min and was recorded and transcribed, cf. written style (Brinkmann and Kvale, 2015).

Findings

The netnographic analysis of ISM in the hospital revealed who listened and how they listened and that both vertical and horizontal listening occurred across the organization. For analytical reasons, it makes sense to distinguish between vertical and horizontal listening, but they tend to merge and overlap on ISM. Table 1 provides an overview of the identified vertical and horizontal types of listening. Respectful, confirmatory, responsive and challenging listening tended to be attentive listening, while formal and no listening were associated with inattentive listening. Delegated listening oscillated between attentive and inattentive listening.

Vertical listening

Significant differences were seen across instances of vertical listening in terms of how managers, support functions, and the communication department answered questions and found solutions to concerns raised and discussed by employees on ISM. Posts made by employees often received comments from other employees with similar views or experiences or adding more information to give a fuller picture of a situation or an issue raised. In this respect, other employees were often the first listeners. Direct answers to concerns, questions and worries, on the other hand, mainly came from three sources. The first included a variety of staff functions and departments such as the technical department, the IT department and the laundry. The second was staff from the communication department who had investigated an issue returned with an answer. Finally, in some cases, management entered the scene and answered when employees had specifically addressed hospital management.

The exploration of who and how they reacted to posts and comments revealed that internal listening can be divided into four different types of vertical listening: respectful listening, delegated listening, formal listening and no listening. Respectful listening emerged when support functions took the concerns in a post seriously and provided an answer that acknowledged employee concerns as well as indicated that the person was listening. The answers were thus explanatory, clarifying and understanding, despite some very sarcastic, ironic, or emotional outbursts from employees. For instance, in a post an employee expressed frustrations due to the bad smell of a new delivery of hand sanitizer, receiving support from five other employees, before a person from procurement answered, “We from procurement have made a complaint to our supplier concerning the delivered hand sanitizer that smells” (Hand sanitizer smells really horrible, 30.07.2020, comment 6).

Sometimes the responses also led to concrete solutions or initiatives, indicating that the employees were really being listened to. An employee pointed out the inconsistency in the signage in elevators, which read “maximum three people” in one elevator but “keep a distance of minimum 1 meter” in two others. Five days later, the following answer appeared: “In agreement with the hospital management, the technical department will, during summer, change the signs in the elevators and meeting rooms so that distancing should be minimum 1 meter” (How many are you allowed to be in the elevators?, 22.07.2022, comment 1).

A few times, when they were directly addressed, senior managers answered a post. For example, an employee asked the hospital management about the long response times on Covid-19 tests and a leading doctor explained:

Dear [name of employee], … We were the first regional lab who were ready with a SARS-CoV-2 analysis and all along we have had the shortest response times. And response times are exactly what you are asking about. However, there are many challenges both in terms of analyzing as many as the government, the Danish Health Authority and others want us to do and to keep a short response time on tests from patients, where a fast answer is important. Here I will provide you with a small insight into the complexity and response times.

[…]

This is at present the best answer, we can give you.

Kind regards, hospital management and leading doctor [name of manager]

(Response time and covid swab, 01.05. 2020, comment 2)

Delegated listening was instances when the communication department provided answers on behalf of other departments or specialists. This approach had the potential to result in respectful and useful answers, such as when an employee, in a rather sarcastic post, praised the view from their ward but regretted not being able to see it due to dirty windows. This prompted the following response:

Dear [name of employee]. I have asked [name of department]. They report that the windows in area [X] and [Y] are washed twice a year. Next time will be in spring, so hopefully you will soon have a better view from your window ☺. (The view, 21.01.2022, comment 1)

At other times, the answers from the communication department somehow missed the point, reflecting that the listening was somewhat superficial. For example, an employee asked whether there were any official announcements about how many people were allowed in a lunchroom. The person had seen notes stating a limit of ten people, but that would be a challenge since many more people needed to have their lunch. An employee from the communication department answered: “The authorities have decided that no more than ten people are allowed to gather. Therefore, that is also the case in the lunchrooms. Kind regards, [name of employee], the communication department” (Max ten people in the lunchroom?, 18.03.2020, comment 1). The same employee then challenged the answer, referring to official guidelines in which hospitals were noted as exceptions and that their lunch room easily could host 20 people while still allowing them to remain at least 1 meter from each other. This comment was then answered by a person from the planning department, who agreed with the employee and explained how the regulations worked in the hospital. Thus, the delegated listening provided a fast answer, but this seemed to be at the expense of providing attentive listening.

Formal listening occurred when concerns and questions by employees were answered in a routine manner that indicated pseudo listening rather than attentive listening. In answers to one out of five posts, employees were referred to Main Manager, a system to report shortcomings, errors and tasks that needed to be done. The employees' reactions when they were referred to Main Manager indicated that they experienced this as pseudo listening, as illustrated in the following response from an employee:

Create an assignment in Main Manager that salting is needed. You could surely expect that when the weather forecast promises minus degrees then you have to salt. But ok – then would it be okay if I create an assignment now and for the next week or do I have to create a new one every day? (Icy Parking, 28.01.2021, comment 4)

Imprecise or formal answers often provoked a spiral of criticism. Interestingly, employees continued to raise issues on The Word is Free that they were told to report to Main Manager. They seemed to use the visibility of the communication arena to draw attention to issues that should have been dealt with through other channels.

Finally, the fourth category of no listening describe instances in which concerns or questions were raised but no response appeared on the ISM. Examples include posts in which employees proposed that they should be able to buy face masks at the hospital, asked where they needed to wear face masks, or asked clarifying questions about restrictions they considered pointless. Several of these posts and comments were sarcastic and ironic in pointing out paradoxes or incongruities. Some of the posts did not seem to intend to elicit an answer because they were a way to let off steam in a stressful situation. However, other posts seemed to require an answer because the employees asked direct questions.

In one post, an employee was puzzled about why some employees in a specific department were not allowed to share jam and butter, while the canteen was offering a Christmas buffet open to both patients and staff. Another employee commented: “I have thought the same, and I am a little bit curious to see if anyone will answer” (Flowers, presents and take-away are back, 01.12.2020, comment 1). This indicated that employees noticed when concerns or questions were not answered. Apart from posts not receiving an answer, no listening was especially common when a question or concern was raised in a comment to a thread. Such comments might have been overlooked or not considered relevant enough for an answer as many employees would not see them.

Horizontal listening

Horizontal listening occurred in a bold and straightforward tone of voice, and particularly interesting observations were made regarding where and how listening occurred among employees. Horizontal listening emerged in three distinct social contexts: community listening, cross-occupation listening and peer-to-peer listening. Community listening was seen in response to issues relevant to many or all employees, who responded by sharing their experiences, asking questions, suggesting ideas and raising problems and concerns. Listening across occupational groups revealed tensions between different professions at the hospital, while peer-to-peer listening occurred between employees addressing one another directly by name. In these social contexts, employees were listened to in four different ways: confirmatory listening, responsive listening, challenging listening and no listening.

Confirmatory listening among employees appeared frequently within horizontal listening. It occurred when employees reacted with support to a post or a comment containing critique, concerns, or ideas. The employees conducting confirmatory listening expressed their support by agreeing, coming up with similar concerns, contributing more examples, or expressing frustration or bewilderment about the same topics. Consequently, the employees reacting in a confirmatory way not only agreed with their colleagues' expression of voice, but were often also inspired to voice their own viewpoints. Examples include the reactions to a post that critiqued the traffic conditions at a specific parking exit (Entrance/exit from P[x], 01.12.2021). Employees were waiting too long in car queues to exit the parking because a Covid-19 test center had been placed close to the parking lot. Many employees in the community listened to this post and reacted supportively by confirming the concerns and frustrations of the original post: “I completely agree with the above” (comment 3), “How nice that finally someone writes about this huge problem” (comment 15). The employees also added more supportive comments to the critique, such as “Yesterday, I stayed in the queue for more than half an hour” (comment 4), and “Unfortunately, it is not only at P[x] that there are problems. One can stay for a long time (very long time) at the traffic lights at […] and at the parking structure at […]” (comment 16). Confirmatory listening also emerged across different professions, where it often appeared as a fight for status, respect and resources. For example, medical secretaries discussed struggling to find time to write patient notes after staff reductions, and service assistants described feeling a lack of respect from their colleagues in other occupational groups. In one post, a service assistant aired her frustrations with colleagues leaving dirty uniforms in stairwells, toilets and storage rooms and expressed her feeling that her profession was not being respected. Most of the reactions to this post incorporated confirmatory listening: “I want to support [name of the service assistant]” (Dirty uniforms, 13.05.2020), comment 1), “You are completely right […]” (comment 2) and “I have also often asked myself whether the colleagues in the other professions make such a mess at home […]” (comment 3). Confirmatory listening also appeared when an employee wanted to support a specific colleague, such as “Hi [name of the colleague], Strong letter! I completely agree […]. I want to support your concern – if more people address the same problem, it might make the right institutions aware of the problem” (Traffic problems in the afternoon, 04.03.2021, comment 17). In this example of peer-to-peer listening, the employee not only supported their colleague by addressing her directly by name, but also tried to mobilize other colleagues to confirm that they had also experienced the same specific traffic problems.

Responsive listening among employees often emerged as a reaction to a question or a call to action on The Word is Free and involved listening to statements on a range of issues, from a search for missing scooters to Covid-19 issues. Responsive listening was characterized by its short and precise, fact-oriented, or clarifying responses. Accordingly, the employees who listened in a responsive way showed that they had carefully considered what their colleagues had asked about and responded in a pertinent manner. An example of this style of listening involving the community at large was seen when a nurse asked if anybody knew whether they were allowed to sign up for a vaccine, or if they were automatically invited when the AstraZeneca vaccine came back onto the market. The responsive listening emerged as a short and precise response from one colleague informing that “so far, there is a pause on employee vaccines” (Waiting for a vaccine – or …, 29.03.2021, comment 1), and as a clarifying response from another colleague, “I have the impression that you cannot just mix the AstraZeneca vaccine with other vaccines, so we cannot get the second injection with another vaccine just like that” (comment 2). In another post, an employee wondered why some departments offered free employee coffee while other departments did not, and asked his colleagues whether or not they paid for their coffee. The responsive listening occurred when one colleague responded and clarified that “In the X-Ray and Scanning department the coffee has unfortunately been removed to save money” (Do you get free employee coffee?, 25.09.2020, comment 2).

Challenging listening appeared when employees reacted to a post or comment with disagreement and expressed another viewpoint, sometimes with an attempt to correct others' behavior. Challenging listening added nuance to the online debate not only through careful consideration of colleagues' expression of voice, but also through a feeling of being provoked. This happened in the reactions to a post in the community listening category that raised the challenge of uniform trousers no longer having strings around the waist. The challenging listening was demonstrated in responses such as, “If the uniforms are defective, then remember to mark them with a piece of red tape that indicates they are defective … otherwise they will not be repaired” (Strings in the surgery trousers, 22.05.2021, comment 2) and “Couldn't people just stop cutting the strings” (comment 4). Challenging listening also appeared in a long dialogue about a demand for electric vehicle charging facilities in the hospital's parking lot. Most of this listening emerged as confirmatory, but one employee demonstrated challenging listening when commenting “I think it is a spoiled attitude that the workplace must ensure charging stations for electric cars. If you chose to buy an electric car, you must make sure you charge it at home” (Electric car and plug in charging, 18.11.2021, comment 12). Cross-occupation challenging listening not only emerged as a fight for status, respect and resources, but was also about collaborating and helping one another across professions to promote respect for other occupational groups. In this context, challenging listening also occurred when reacting to the post in which the service assistant expressed her frustrations about the mess with the dirty uniforms:

One must assume that employees here at the hospital are adult, responsible persons who can clean up their own mess, and who are able to consider who else should do it? Show some respect towards your colleagues, no matter who they are (Dirty uniforms, 13.05.202, comment 1).

Through challenging listening, this employee strongly encouraged her colleagues to change their behavior towards the occupational group of service assistants. Peer-to-peer listening also appeared in the challenging form. In one post, an employee expressed her ethical concerns about the hospital's supplier of computer eyewear, which was in the Danish media because of accusations of tax evasion. The first reaction to this post did not agree with the content, and the second comment was a reaction to the first comment “[name of the colleague], I do not know whether or not [name of the supplier] has evaded paying taxes, but your comment about the operational deficit is wrong” (Computer screen glasses, 18.05.2020, comment 2). He continued by explaining to colleagues how companies use operational deficits to evade paying taxes.

No listening occurred in horizontal listening when no employees reacted to a post on the ISM. As an example, one employee wrote that she had been hit by a car on her bike near the hospital, and that she was looking for witnesses to support her in the police report (Cyclist hit on June 5th – looking for witnesses, 14.06.2021). Another employee asked for witnesses because she had been assaulted on the cycling path on her way to the hospital (Searching for witnesses, 18.11.2021). No reactions appeared on The Word is Free, despite the fact these posts included calls to colleagues to act.

Concluding discussion

Vertical listening: the importance of consistent attentive listening

The Word is Free was found to be an important part of the hospital's architecture of listening because managers, support functions, and the communication department used it deliberately to reach out to employees and listen to their concerns, input and suggestions during the crisis. This internal listening was practiced strategically, as the communication department coordinated the responses between themselves and the different support functions across the organization, and it indicates that the hospital's intention was to practice sincere listening leadership (Lewis, 2020). By practicing respectful listening, the hospital gave the impression that it acknowledged, paid attention to, considered and tried to understand and respond to the employees' concerns, perspectives and suggestions. This was also the case when senior managers stepped in and answered posts directly in a respectful manner. In this way, respectful listening has similar characteristics to the seven canons of listening by Macnamara (2018) and the elements of ethical listening by Neill and Bowen (2021a, b). However, the written nature of ISM is different. When analyzing the written ISM posts, it is difficult to know whether the practiced respectful listening is an expression of true attention, open-minded and empathic listening. Regardless of the listeners' intentions, reactions to respectful listening behaviors indicated that this practice seemed to calm the situation and take the edge off the employees' frustrations. In a stressful situation where everyone was overwhelmed by the increased workload and daily uncertainty due to the new rules and procedures adopted in response to the pandemic, respectful listening may have contributed to the creation of a communication climate characterized by trust, thereby minimizing the gap between management and employees. Hence, respectful listening on ISM can play a strategic role as a crisis vaccine that supports a trusting relationship between management and employees during a crisis (Mazzei and Ravazzani, 2011; Heide and Simonsson, 2019).

Employees' reactions to delegated and formal listening reflected a more negative perception of their interactions with the administrative listeners. This could be explained by the inattentive or off-topic answers that were often provided by the listeners. In line with previous research, delegated and formal listening may be perceived as pseudo listening by employees (Adler and Rodman, 2011) because they may feel that their concerns and needs are not really being supported, acknowledged and responded to in an appropriate way (Macnamara, 2018). The situational context plays an important role in crisis communication (Frandsen and Johansen, 2017), and the crisis context may have influenced management and the support functions to practice delegated and formal listening. This type of listening could be an attempt to control a stressful situation by providing fast information and instructions to the employees which is in line with the traditional approach to crisis communication (Heide and Simonsson, 2019). This could also explain why they turn to routine answers, a formal voice and sometimes even fail to listen. Thus, the crisis context could make it difficult for the listeners of ISM posts to constantly practice all seven canons of listening (Macnamara, 2018) or live up to the standards for ethical listening proposed by Neill and Bowen (2021a, b). According to Heide and Simonsson (2021), a crisis like the pandemic calls for collaborative and democratic leadership that focuses more on improvisation, flexibility and listening instead of providing fast and effective internal communication to employees. In the studied hospital, the managers and administrative functions seemed to be aware of the strategic importance of listening to the employees in a prolonged crisis like the pandemic. However, The Word is Free was not used deliberately by managers to solicit input as suggested by Lewis (2019) as the communication manager stressed that ISM was an employee communication arena, where discussions should be initiated by employees. In this respect, it was more an opportunity for managers to listen to the organization than to solicit input.

Still, organizational listeners must know their media and audiences when they use ISM as a listening arena during a crisis. An overly formal tone of voice, routine answers, or no listening can induce the employees' feelings of inattentive listening, which may cause increased frustration and tension.

The study thus demonstrated that vertical listening on ISM was strategic. Respectful listening could de-escalate an issue and improve both the manager and employee's understanding of the crisis situation and the manager-employee relationship (Falkheimer et al., 2022; Sahay, 2023). While answers that were formal, inattentive or not quite to the point, could be perceived as pseudo listening by the employees and escalate a situation, leading to a lack of trust in management, the support functions and the communication department (Adler and Rodman, 2011). In this respect, consistent attentive listening proved to be valuable from a strategic point to improve the relationship between employees and the organization.

Horizontal listening: the importance of employees as strategic listeners

Listening on The Word is Free was not only practiced by the management, support functions and communication department, but also by employees when they listened to each other. Horizontal listening seemed to mobilize employees specifically in the confirmatory and challenging way of listening where many employees reacted to the posts and participated in the online dialogues. The employees listened to and exchanged experiences, frustrations and viewpoints concerning parking, working conditions and Covid-19 issues. This mobilization, with more employees participating in online dialogues and adding more supportive material to critiques, often developed into a spiral of voice, pushing managers and support functions to answer (Madsen and Johansen, 2019). In this way, the employees could be argued to be strategic listeners that could escalate a situation by listening to and confirming each other. These strategic moves could both be in relation to the organization as a whole or in relation to other occupational groups in their fight for status, respect and resources. The visibility of the communication arena was strategically used to draw attention to issues and stressful situations.

Communication on The Word is Free offered insight into the issues that occupied the minds of employees in a period when the hospital was under a lot of pressure due to Covid-19, a lack of staff and the nurses' strike. However, it is remarkable how topics such as a lack of nurses and resources were not directly addressed on The Word is Free. These concerns were perhaps taken care of through MED, the sanctioned communication channel between managers and employees, or the employees knew through experience that they would not receive answers to such questions. It could be argued that the topics discussed, which can be characterized as mainly daily sources of irritation or frustration, could be seen as reflecting employees feeling unappreciated at a time when they displayed extra effort and flexibility. When the employees listened to one another about their concerns, proposals and puzzlements, it provided them with a sense of cohesion and of not being alone in their frustrations or observations. This might be important in a stressful and complex situation like a creeping crisis (Boin et al., 2020) that cannot be changed from one day to the other and in which employees somehow have to live with the situation.

Our observations of horizontal listening highlight the value of employees being recognized, acknowledged, understood and listened to by other colleagues. Voice has no value without listening (Macnamara, 2020), and the findings indicate that voice has value not only as upward communication when listened to, but also in contexts of horizontal listening where employees listen to employees. There is a growing awareness in strategic communication that employees are both necessary and responsible communicators (Andersson, 2022; Madsen and Verhoeven, 2019). It could be argued that the employees in this case study acted as strategic listeners, since the horizontal listening often fulfilled the needs of the employees and in several cases replaced the need for vertical listening. Other times one occupational group used it strategically to listen to each other and at the same time made other occupational groups aware of their perception of lack of respect or resources. When employees in this way enter the arena and act as responsible communicators and attentive and strategic listeners, it may provide essential support for their wellbeing, especially when the organization is in a crisis situation and has to tackle sudden and unexpected changes.

Towards a holistic understanding of internal listening

The vertical respectful listening and horizontal confirmatory, responsive and challenging listening observed on The Word is Free embrace the seven canons of listening (Macnamara, 2018) in the sense that these four types of listening recognize the employees' right to a voice; acknowledge the employees' viewpoints and seek to interpret and achieve an understanding of these viewpoints; pay attention to the employees in showing that their voices matter; and respond in an appropriate manner. Respectful, confirmatory and responsive listening should not be understood as always agreeing with employees or colleagues' concerns, but rather as validating the importance of their voices (Gode, 2019) and their right to express those concerns. In this respect, the study indicates that internal listening is not just a matter of managers listening to employees but just as much a matter of employees listening to employees; horizontal listening and vertical listening support and reinforce each other, together becoming an enactment of internal listening on ISM.

Both horizontal listening and vertical listening are important in organizational contexts. They each serve a strategic purpose. Vertical listening connects managers with the experiences of frontline employees, and respectful listening can help lower resistance and reduce uncertainty (Sahay, 2023; Lewis, 2020). Meanwhile, horizontal listening increases “ambient awareness” (Leonardi and Neeley, 2017) and the feeling of not being alone with frustrations in a stressful situation. Both types of listening contribute to organizational transparency and can thus help build trust and engagement (Barbour, 2017; Lewis, 2020), which is especially important in a crisis situation (Falkheimer et al., 2022).

Horizontal listening has so far been neglected in research on listening. Based on this study, a holistic understanding of internal listening is proposed that combines vertical and horizontal listening on ISM and frames both horizontal and vertical listening as an integral part of the architecture of listening in an organization that is influenced by the organizational and situational contexts (see Figure 1). ISM makes both vertical and horizontal listening visible to the organization, but internal listening also happens in other fora such as officially sanctioned communication channels and informal talks around the coffee machine.

Crisis communication researchers emphasize the managerial benefits from listening to employees in times of a crisis to develop and maintain mutual positive relationships (e.g. Frandsen and Johansen, 2017; Mazzei and Ravazzani, 2011). The results of this study provide an important nuance to earlier crisis communication research by highlighting the importance of a holistic understanding of internal listening that embraces and acknowledges the importance of both the horizontal and vertical listening that occur in an organization. An architecture of listening ought to consider both, because they primarily complement each other but sometimes they are exclusive. On the one hand, they are complementary when an issue is first discussed among employees on ISM and later addressed by managers or support functions. On the other hand, some discussions and knowledge sharing are best discussed and solved among employees without the interference of managers, and some questions should quickly be addressed by managers, supportive functions, or the communication department in order not to create unnecessary unrest in a crisis situation.

The organizational context of this study seemed to be characterized by a climate of open communication, developed through many years of sustained use of ISM, while the situational context was influenced by the crisis situation. Employee voice and listening on ISM are only likely to occur when employees perceive other employees and managers as attentive (Ruck, 2021), and when the process is supported by listening through other channels in the organization and sanctioned by management (Ellmer and Reichel, 2020; Gode et al., 2019; Madsen and Johansen, 2019). Furthermore, it can be argued that stressful situations create a need for employees to be listened to by either other employees, support functions, or management, and vertical listening and horizontal listening on ISM thus enact and create the potential of an open communication climate that supports internal listening. Thus, when a communication department or an organization designs an “architecture of listening” (Macnamara, 2016) and conducts respectful listening on ISM in a crisis situation, this could be an important strategic move that may develop trusting relationships with the employees and as a consequence a listening culture in the organization.

Practical implications

Based on this study, organizations are encouraged to develop a holistic perception of internal listening based on three principles. First, organizations should embrace ISM as an employee communication arena that works on employees' terms, in which employees are free to voice their opinions, share their thoughts and challenge each other so that horizontal listening can develop. Second, the communication department should monitor the communication on ISM and provide answers. However, rather than giving fast or imprecise answers, they should allow dialogues to develop to create room for horizontal listening and they should locate a person with the expertise to answer accurately. Third, and following Lewis (2020), if organizations take strategic listening seriously, management, support functions, and the communication department should receive support and training to become excellent listeners. Therefore, they should be trained to develop respectful listening skills, also in unexpected and difficult circumstances such as a crisis. This is specifically important when listening occurs on ISM since they will need to learn to engage with employees on ISM and react to concerns in an explanatory, clarifying and understanding manner. If the listeners are trained to act as strategic respectful listeners on ISM before, during and after a crisis, they may contribute to building and maintaining trusting relationships (Falkheimer et al., 2022), the effect of which may last longer than a crisis vaccine.

Limitations

The study focuses on listening to written posts and comments on ISM in a specific period during a special crisis. Consequently, it is not possible to gain an in-depth understanding of how organizational listening is carried out in the hospital on an ongoing basis. Therefore, further interviews with employees and managers could investigate how internal listening in the hospital influences organizational life both in general and during a crisis. Interviews with employees and managers could also provide insights into their strategic listening intentions and psychological responses.

Figures

Figure 1

Towards a holistic understanding of internal listening

Table 1

Internal vertical and horizontal listening on The Word is Free

Code	Description	Examples of reactions representing the different types of listening
Vertical listening
Respectful listening	When administrative, technical and support functions, the communication department, or managers took the concerns of one or more employees seriously and provided an explanatory, clarifying and understanding answer	Hi everyone, the logistic department is aware that the degree of filling in the boxes are sometimes rather low. […] We are working on improving the degree of filling … (Waste of resources and pollution, 22.10.2020, comment 5) Hi [name of employee]. Yes staff meetings are resumed here in autumn. We expect that the first meeting is conducted on the 8th of September and an agenda will be sent out in the usual manner as well be announced on the intranet. Kind regards [name of a chief secretary]. (Staff meeting, 11.08.22, comment 1)
Delegated listening	When an employee, generally a member of the communication department, answered on behalf of either managers or support functions	Dear [name of employee]. At [name of hospital] it is expected that critical frontline staff is vaccinated first time by the end of week 2. You can see a status on vaccinations on [name of hospital] here: [link] Kind regards [first name, communication department]. (Status of vaccinations on [name of hospital], 10.01.22, comment 1) We unfortunately no longer have the option to offer a vaccine against COVID-19 at [name of hospital]. Instead you can book a time for a flu vaccine. Kind regards [name of employee, communication and management department] (Covid-19 vaccine on [name of hospital], 17.10.22, comment 2)
Formal listening	When concerns and questions from employees were answered in a routine or formal manner that indicated pseudo listening	For the sake of security the hospital has decided that the door will be locked until 7 am. As an employee you can always outside opening hours use your access card. Kind regards [name of technical manager and title] (Locked main entrance, 03.09.22, comment 1) New directions from the authorities. Face masks must be used in the cafes […] (Face masks in the canteens???, 28.09.22, comment 7) […] If you observe that hand sanitizer is missing in the dressing rooms, then you are welcome to create a task in Main Manager. (Theft from the dressing rooms, 14.01.21, comment 4) Hi [name of employee]. The technical department are in charge of signs. You can create a task in Main Manager then they will look at the task. (Covid-19 test, 23.06.20, comment 1)
No listening	When employees raised questions or concerns but did not receive a reply from anyone in authority or from the communication department	[…] CAN WE THROW AWAY OUR FACE MASKS ON MONDAY??? (Covid, 10. June, 2021, first post) → no reaction
Horizontal listening
Confirmatory listening	When employees reacted with support to a post or a comment containing critique, concerns, or ideas	Really desirable that uniforms are stored according to size and not in a mixed pile. This has been going on for two years now (New uniforms, 11.09.19, comment 7) I agree that the parking house in the north should be open to employees. It is completely empty … (Parking prices and waiting times, 22.01.20, comment 4)
Responsive listening	When employees reacted to a post or a comment by giving short, precise and fact-oriented or clarifying responses	They have written about it on the homepage:) [Link to homepage] (The gym, 12.06.20, comment 1) There are waste containers for blue bags and containers for cardboard on level 4. (Unclean waste containers, 11.08.20, comment 4) Try to ask in the kitchen! I have previously got empty canisters there. (Empty canisters, 18.12.20, comment 1)
Challenging listening	When employees reacted to a post or a comment with disagreement, expressing another viewpoint or intending to correct others' behavior	Synoptik is NOT in tax haven. If you acquaint yourself with the matter, then you know that an organization do not pay tax of an operating deficit … This is gross misinformation. (Computer glasses, 18.05.20, comment 1) More than ever we need to be treated in a positive way [wagging forefinger emoji]. Have a nice day. (What happened to the lilacs?, 07.12.20, comment 3) [Name of employee] your post makes no sense, when you do not give your full name or what occupational group you belong to. (Vote no to the collective agreement, 13.04.21, comment 1) [Name of hospital] is a smokefree area, so therefore you cannot buy cigarettes in the two kiosks … (Ashtrays, 09.07.21, comment 4)
No listening	When no employees reacted to a post or a comment	To all departments: When you send your patients to blood sampling, please make sure that you have ordered the samplings […]. Hope for your help and improvement. Thank you (Heart sigh from the blood sampling units, 24.06.21) → no reaction IMPORTANT!! Anyone who has received a delivery from the pharmacy in a grey box with iv-test medicine for the […] studio today? […]. Thank you in advance for your help. Best regards [name of employee], (Missing iv-test medicine for the […] studio, 16.06.21) → no reaction

Source(s): Authors own creation