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The role of internal communication in service delivery: an

assessment of the Metropolitan Health Group

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The role of internal communication in service
delivery: an assessment of the Metropolitan Health
Group

M. Landman & G. Angelopulo

ABSTRACT
Internal communication can, as part of an internal marketing approach,
contribute to the establishment of a service orientation in an organisa-
tion. This is necessary for survival in an era where a total service offering
is imperative to remain competitive. This study presents the results of a
survey of the extent to which internal communication supports a service
orientation among employees at Metropolitan Health Group (MHG) Head
Office and, eventually, the quality of service delivered. It concludes that
this is not entirely the case at MHG and recommends that an internal
communication programme be developed around the desired outcomes
of strategic alignment, knowledge management/information dissemi-
nation and staff motivation within the framework provided by the Gap
Analysis Model of Parasuraman, Berry & Zeithaml (1985) to remedy the
situation.

INTRODUCTION
The contribution of internal communication to the quality of service delivery to both
internal and external customers is explored in this work. The theoretical approach to
internal communication in this study is from the service perspective, and is drawn
from marketing theory. A measurement instrument that evaluates the degree to which
internal communication contributes to service quality is discussed and its practical
implementation described. The instrument is applied to the Metropolitan Health
Group (MHG), where internal communication has been identified as an area
requiring attention since the formation of the company in 2000. Earlier assessments
that identified internal communication problems proved to be of limited value
because they highlighted aspects of communication that did not appear to be linked
to the success of MHG as a business. The measurement instrument was specifically

Ms Landman is Internal Communication Manager, Metropolitan Health Group. Prof. Angelopulo is an Associate
Professor in the Department of Communication Science, University of South Africa. E mail: angelgc@unisa.ac.za

67
The role of internal communication in service delivery ...

utilised to assess the degree to which internal communication detracted from or

contributed to the attainment of the specific business performance criteria related to
service delivery.
This article reviews the service perspective and its relationship with commu-
nication, proceeds with an overview of MHG and its internal communication,
describes the methodology used in the work and concludes with a discussion of the
findings.

THE SERVICE PERSPECTIVE AND ITS RELATIONSHIP WITH

COMMUNICATION

Changing organisational environment

In recent years, the organisational environment has changed significantly, both
externally and internally. These changes have resulted in a re-evaluation of traditional
approaches to areas such as marketing, organisational communication and employee
relations.
GroÈnroos (2001) suggests that all organisations find themselves in a situation of
service competition in which the core solution, although a prerequisite for success,
must be managed with a number of related solutions to offer a total service offering
that in combination determines the organisation's success. Failure to understand this
leads to customer dissatisfaction, even if the products or services that comprise the
core solution are inherently of a high quality (GroÈnroos 2001). Even if customers are
satisfied with the product and service received from a particular supplier, loyalty
towards that supplier is not guaranteed (Durvasula, Lysonski, Mehta & Tang 2004).
Customers do not look for products or services per se, but for solutions that serve
their own value-generating processes. The latter takes place when the customer
perceives value being created when using a product or service (Johnson & Schultz
2004). Before this perception exists, no value has been generated.
The challenge for organisations is to use information and knowledge throughout
all organisational processes to develop more customer-oriented value-enhancing
services out of physical products or services (GroÈnroos 1998). An organisation's
competitive advantage is contingent on accepting that it is in service competition and
understanding its customers' value-generating processes. Failure to shift from a
traditional manufacturing/supply approach to a service approach results in failure to
remain globally competitive (Kapner 2004). Employees are essential in achieving a
service approach within an organisation. Goldsmith (1999) sees employees as an
extension of the marketing approach, and Schneider (2004) suggests that their role
must be accepted as strategically important for the success of an organisation. Marlow
68
 M. Landman & G. Angelopulo

& Wilson (1997: 37) use the term ``emerging corporate landscape'' to describe the
radical change experienced inside organisations and they identify two major causes
for this, namely:
. Upsizing (competition through acquisition) and downsizing (growth through
reduction) of organisations
. The new employee contract.

The first (upsizing and downsizing) have negative effects on morale, the
management of expertise and complexity, and the effectiveness of communication in
organisations. The second, the new employee contract, is emerging as a result of the
dramatically changed relationship between employer and employee. This new
contract represents a shift from the traditional `psychological contract', where loyalty,
job security and trust characterise an almost patriarchal relationship, to an
arrangement where employer and employee work as partners on an equal basis.
This association is characterised by aspects such as more frequent, deliberate career
movements and a premium placed on competencies that revolve around synthesising
ideas into practical implementation and the ability to integrate patterns of awareness
into a common vision and to align individual contributions to overall organisational
goals (Marlow & Wilson 1997).

Emergence of the service perspective as a strategic approach

In response to these changes in the organisational environment, the service
perspective has emerged as a strategic approach (GroÈnroos 2001; Langerak 2003;
Schneider 2004). Although it provides a perspective on marketing in a changing
environment, it is essentially different from the traditional marketing approach with
its origins in the manufacturing sector (Goldsmith 1999). The marketing of services
involves interactivity between organisations and their markets (GroÈnroos 1998) as
opposed to the predominantly one-way approach to a mass, broadly defined market
that largely characterises the traditional marketing approach (Nowak, Cameron &
Delorme 1996).
GroÈnroos (1998: 325) conceptualises the marketing process within a service
perspective as shown in Figure 1. The figure shows the key parties in the service
marketing process, namely the firm, resources (as opposed to a product) comprising
personnel, technology, knowledge and the customer's time, and of course, the
customer. Along the sides of the triangle are the three key functions of service
marketing: giving promises, enabling promises and keeping promises.
The focus of this study falls on one of the resources of an organisation that
enables the keeping of promises, namely personnel (referred to as employees from
here onwards). It is the employees of an organisation that mostly create value for
customers in a service setting through, for example, call centres, deliveries, main-
69
The role of internal communication in service delivery ...

FIRM
Full-time marketers and sales people

Enabling promises Giving promises

Continuous development; External marketing; Sales
Internal marketing

PERSONNEL CUSTOMERS
TECHNOLOGY Keeping promises
KNOWLEDGE
CUSTOMER'S TIME

Source: Gro
Ènroos 1998: 325

Figure 1: The service-oriented perspective: process consumption and marketing

tenance and design of information systems. As such, most employees are involved
with the customer as marketers ± most as `part-time marketers' if they are not
employed in marketing and sales departments. Part-time marketers often outnumber
full-time marketing and sales staff (GroÈnroos 1998). In order to be successful at part-
time marketing functions, it is important that all departments, irrespective of the
degree of their direct contact with the customer, understand that they affect the
keeping of promises to customers and the quality of service delivered (Ashcraft &
Stacher 2004; Auty & Long 1998; Bronn, Roberts & Breunig 2004; Chaston 1993,
1995; GroÈnroos 2001).
To enable employees to fulfil their responsibilities as part-time marketers, the
organisation requires a service orientation in its business conduct and in the way in
which it manages its employees (Schneider 2004). To this end, GroÈnroos (2001: 317±
324) proposes a model for analysing and planning the service process and as a
framework for establishing a service orientation among employees:
In brief, the model combines various service quality-generating sources in a
systematic way. The large central block in Figure 2 illustrates the service-producing
organisation from the customer's perspective. From the service producer's point of
view, a number of different departments or functions may be involved in the process,
but for the customer it is a single integrated process. The customer is located inside
the block, because of the integrated role the customer plays in the whole service
production process. The line of visibility divides the organisation into two parts: one
part that is visible to the customer and one that is not. The customer's expectations
are influenced by the factors in the block at the top right. To the left is the business
mission with its corresponding service concepts, which guide the planning and
70
 M. Landman & G. Angelopulo

management of the service production system. At the bottom is the corporate culture,
which should be service-oriented if the organisation is to succeed in service
competition.

Business mission . Personal needs and values

. Previous experiences
! . company/local images
. Marketing communication
Service concepts . word of mouth
. Absence of communication
!
Support part Interactive part
Expectations
Tota ty nv s b e part

technology and systems how how Systems and operational

L ne of v s b ty

Customers
Systems support resources

Managers and supervisors contact persons

!
!

Management support

support functions and support Physical resources and

persons Physical support equipment

Corporate culture

Source: Gro
Ènroos (2001: 319)

Figure 2: The service system model

The model indicates three kinds of support that need to be built into service
production, namely management support, physical support and systems support.
According to GroÈnroos (2001), the most important of these is management support,
because managers and supervisors should provide leadership, contribute to a service
orientation and ultimately to a service culture in order to succeed. Managers are key
to employees' maintenance of service-oriented attitudes and behaviour, because they
set the example, provide coaching and guidance, and motivate employees to perform.
In an analysis of the support part of a service system, it would therefore be important
to assess the impact of leadership, and for the purpose of this study particularly, the
impact of communication, on the service quality delivered by employees.
GroÈnroos's model (2001) indicates that the support and invisible part of the
organisation (from the customer's viewpoint) have an impact on what can be
accomplished in the interactive part, and eventually on the quality of service
delivered. From here stems the notion that the entire system is integrated into a
holistic service production system in which the different components affect one
another (Lovelock 1995). It is therefore important that support employees consider
the departments that they support (in all functions up to customer contact) as their
internal customers. Internal service has to be as good as the service to the external
customer, as it directly impacts on the quality of external service delivery.
71
The role of internal communication in service delivery ...

The internal customer concept

The importance of the role of all employees in service production and quality
generation processes permeates the service marketing and management literature.
Although organisations have always concentrated on their internal processes to
improve their performance in the market, the concept of the internal customer
emerged in the service marketing and service management literature only during the
1970s (Gilmore & Carson 1995).
The heightened importance attached to the internal market is driven by the
realisation that an organisation must not only be managed to give and fulfil promises,
but also to enable the fulfilment of promises (GroÈnroos 1996). Success in service
competition is dependent on the skills and attitudes of an organisation's employees
(Chaston 1995). Suitable skills and attitudes require emphasis on the internal
dynamics of an organisation, encompassing all internal relationships and the
realisation that meeting the requirements of the internal customer is as important as
meeting those of the external customer (Chaston 1993).
It is important to realise that the focus should not be limited to customer contact
employees only, but should be on all the functional areas of GroÈnroos's service system
model. It is equally important that internal service delivery along the chain should be
focused on the external customer's requirements (Johnson & Schultz 2004; Langerak
2003). GroÈnroos (2001) refers to this as a service orientation that sets the framework
for intra-organisational activities that are geared to delivering service to the customer
according to his/her requirements.
Another viewpoint on this issue is that the prevailing climate in an organisation
could significantly contribute to the quality of service delivered to the client. Because
organisational climate can influence employees' behaviour, it would be reasonable to
assume that within a service setting, the climate should be such that employees view
client satisfaction and service quality as a top priority (Clark 2002). Within the
context of creating a service orientation, a main objective of internal marketing and
consequently internal communication should therefore be to contribute to such a
service-oriented climate.

The role of internal communication in creating a service orientation

Internal communication, often referred to as employee communication, has also
changed in recent years. From describing narrow functions such as the production of
company newsletters, it has evolved into a broader function with outcomes directly
related to the achievement of overall corporate objectives (Tourish & Hargie 1998).
This enhanced approach to internal communication is reflected in the practice of
internal communication in a number of areas of organisational communication, such
as corporate communication, public relations and human resources communication.
Internal communication has obtained a more strategic role, as one of its primary
72
 M. Landman & G. Angelopulo

objectives is to enable the internal market to deliver to the external market. GroÈnroos
(2001) suggests that communication management is a critical part of internal
marketing. Internal communication is discussed here as it relates to the service-
oriented perspective (Figure 1) and the service system model (Figure 2).

Internal marketing: maximising relationships with the internal customer

Beckett-Camarata, Camarata & Barker (1998: 76) identify five key facets of the service
marketing concept that are central to organisational success in service competition:
. Service marketing is an overall management perspective that drives all decisions
throughout the organisation.
. It is customer or market driven.
. It is a holistic perspective.
. It is integrally linked to quality management.
. It identifies the development of employees and reinforcement of their commitment
to organisational goals and strategies as strategic prerequisites for organisational
effectiveness and long-term survival.
In internal marketing, the focus falls on the last point ± the employees of an
organisation, who form the internal market. It has long been recognised that there is a
strong correlation between the satisfaction levels of employees and the quality of
service delivered to customers (Drucker 1972; GroÈnroos 2001; Homburg & Stock
2004; Luthans 1992; Steinmetz 2004; Thompson & Strickland 1984).
However, in the internal marketing concept, the focus is wider than traditional
motivational and behavioural issues. It is distinguished by its emphasis on an active,
market-oriented approach that has shifted from a one-dimensional internal focus to
the relationship between the internal and external market (Varey & Lewis 1998).
Internal marketing has its foundation in the concepts that employees are a first,
internal market for the organisation and that their positive predisposition is a
prerequisite for successful marketing (GroÈnroos 2001). Internal marketing has to be
integrated with the total marketing function, as successful external marketing starts
within the organisation (GroÈnroos 1997). Internal marketing is not defined by its
activities ± all internal activities contribute to internal marketing ± but by its purpose
of gearing all internal employee-oriented processes towards internal and external
customer satisfaction (GroÈnroos 2001).
The internal marketing concept embraces the view that an organisation must
maintain successful relationships with its internal audience that extend beyond
performance management and motivation (Duncan & Moriarty 1998). By directing
all internal activities according to the needs of the external customer, internal
marketing enables non-marketing staff to perform their tasks in a market-oriented
manner with the ultimate aim of enhancing customer relationships (Barnes & Morris
73
The role of internal communication in service delivery ...

2000). This corresponds with the concept of the internal customer to whom internal
services have to be provided in the same customer-oriented manner as to external
customers (GroÈnroos 2001).
These concepts correspond strongly with one of the fundamental principles of
integrated marketing communication (IMC), namely the importance of creating a
customer consciousness, or as the term is used in the service marketing literature,
`service orientation', among employees. If one looks at the role of communication in
the emerging relationship marketing field, it is clear that communication becomes the
vehicle for building relationships and integrating marketing activities both within the
marketing and human resources (HR) functions and across the business as a whole.
The development of integrated marketing and integrated communication has
happened in parallel, and the two previously separate functions show intersections at
various intervals. Indeed, communication becomes the primary integrative element in
managing relationships. In contrast to earlier convictions, relationships (especially
those between an organisation and its stakeholders, of whom employees form an
important part) will be founded on communication and not persuasion (Duncan &
Moriarty 1998: 1).
There are a number of definitions of `integrated communication' found in the
literature. McGoon (1998: 15) defines integrated communication as ``a strategic
business process used to plan, develop, execute and evaluate coordinated and
measurable persuasive brand communication programmes over time with consumers,
customers, prospects and other targeted, relevant external and internal audiences''.
Barker & Du Plessis (2001: 2) define integrated communication as ``the application of
analysis, communication and evaluation techniques to create and manage integrated,
multi-faceted communication interventions combining information, collaboration,
business process design, feedback and incentive systems to improve human
performance and productivity in the workplace in order to achieve organisational
communication goals and objectives''.
Most definitions of IMC, for example McGoon (1998: 15), GroÈnroos (2001: 266)
and Barker & Du Plessis (2001: 2), include the internal audience of an organisation
(namely, its employees), who are the roleplayers in internal communication. As such,
within the context of the purpose of integrated communication, as stated by Barker &
Du Plessis (2001: 2), internal communication will then play a key role in ensuring
that human performance and productivity in the workplace are improved. According
to GroÈnroos (2001: 268), the challenge for organisations, and for MHG, is to manage
all sources of messages about a firm and its resources and all communication media
and their effects in an integrated way. If it is not successful in doing so, its customers
will receive different, possibly contradictory, messages from various sources of
communication.
The relevance of IMC for this study from a service perspective is that in order for
an organisation to survive service competition, it needs to form and maintain
74
 M. Landman & G. Angelopulo

meaningful relationships with its various stakeholders, including employees.

According to GroÈnroos (2001: 281), these meaningful relationships can only exist if
all communication, outcomes and processes are integrated and result in dialogue, an
issue touched on earlier in this discussion.
IMC bears further relevance to this study if viewed in terms of the Gap Analysis
Model, which is discussed more fully in a later section. For example, the model
indicates that a gap could exist between what is promised to the customer through
marketing communication and what is actually delivered to the customer (Gap 5) by
employees. To minimise the gap between the customer's expectations (based in part
on external communication activities) and the actual service, there needs to be
synergy between external and internal communication messages, a function of IMC.
Within this context, it is therefore essential that internal communication in
organisations is practised in an integrated manner with other modes of
communication, such as marketing communication, processes and outcomes.

Internal communication from an internal marketing perspective: definition

and functions
The obvious definition of internal communication is in terms of its internal
organisational audience, the employees of an organisation. Van der Walt (2002)
defines internal communication as the key component that links an organisation
together. It is fundamental for the creation and maintenance of the organisation's
internal environment. It is embedded in the ongoing patterns of interaction among
people in an organisation and is therefore an all-encompassing instrument that
connects people and structures within an organisation. Internal communication is not
limited to formal structures and modes of communication, but includes all forms,
whether they are interpersonal, small group, management or mass internal
communication (Mersham & Skinner 2001).
Internal communication has three primary functions. The first is strategic
alignment, the second combines organisational learning, knowledge management
and information dissemination, and the third is motivation.

Strategic alignment
One of the functions of internal communication is to align communication and
actions with an organisation's vision, goals, values and priorities, thereby enhancing
performance and reputation in a measurable way (Moorcroft 2003). This corresponds
with GroÈnroos's service system model (2001), which suggests that the company's
mission, vision and accompanying service concepts form the basis for the activities of
the organisation. It would therefore make sense to ensure that employees are
informed about these issues and that they are motivated and skilled to act in such a
manner that the company's mission is fulfilled. Puth (2002) terms this ``commu-
75
The role of internal communication in service delivery ...

nicating for strategic alignment'', implying firstly that there is a strategic line (a clear
overall strategic direction, intent and a set of desired outcomes to which all
departments and individuals can align their actions), and secondly that everyone is
aware of this strategic line and that it is sufficiently visible for alignment to take place.
Puth (2002) further points out that the key to strategic alignment is
communication of the big picture. This corresponds with findings about employees'
internal communication needs, which highlight, among other things, that the
majority of employees are concerned about a lack of information about their
employing organisations, including where the company is headed and the reasoning
behind decisions (Mersham & Skinner 2001). Therefore, to successfully execute a
service strategy, employees need to know what the strategy entails and what they are
supposed to do to execute it. Relating business and communication strategies helps
employees understand and support the direction of an organisation.

Organisational learning, knowledge management and information dissemination

A major function of internal communication is to facilitate the related processes of
organisational learning and knowledge management (Bronn et al. 2004; Du Plooy-
Cilliers 2002; Stevens 2001; Van der Walt 2002). These processes are closely related.
Organisational learning is similar to individual learning in that individuals gain
new knowledge and insights, but it occurs through shared insights, knowledge and
mental models (Stata 1989). Progress is hampered unless employees learn together,
come to share beliefs and goals and are committed to taking actions to fulfil
organisational goals and bring about change (Senge 1990).
Knowledge management is an integrated, systematic approach to identifying,
managing and sharing all of an organisation's information assets (including
databases, documents, policies and procedures) and includes the unarticulated
expertise and experience of an organisation that is available to the individual who is
responsible for using and replenishing it (Sivan 2000).
Knowledge management is the means by which knowledge as an intangible asset
(Bronn et al. 2004) is managed and applied to the advantage of the organisation.
Organisational learning is the process by which information is transformed into
knowledge and applied to bring about change (Hustad 1999).
Information dissemination is a key concept in both organisational learning and
knowledge management, as learning only takes place and knowledge only gets
generated if information is made available to the organisation (Gore & Gore 1999;
Malhotra 1996). Internal communication plays a crucial role by ensuring that
information is made available to employees effectively, thereby facilitating the
learning and knowledge management processes (Yeomans 2004). An organisation's
ability to learn is directly related to the way in which information and communication
76
 M. Landman & G. Angelopulo

are managed. An organisation needs to create appropriate communication channels

and a climate that facilitates learning, and to convince individuals to share and apply
such knowledge to the advantage of the organisation (Du Plooy-Cilliers 2002).
Communication is a common thread that runs through most definitions of
knowledge management (Van der Walt 2002). Successful companies have the ability
to consistently create new knowledge, disseminate it quickly and incorporate it into
their products and services through communication. Communication becomes the
mechanism for the knowledge production process and is therefore key to creating
value (Bronn et al. 2004).
From the viewpoint of establishing a service orientation, these processes would be
geared towards learning and knowledge about the needs and requirements of the
customer, whether internal or external. Berry & Parasuraman (1997) bring the
concepts of information dissemination, knowledge management and organisational
learning into the context of service management. They state that for organisations to
be successful in service competition, they need systems to capture information about
their customers, competitors and employees, and to effectively use that information to
support decision-making. Service organisations need easy access to accurate,
consistent and up-to-date information to serve clients, and internal communication
should serve this purpose (Jordan 2003).

Motivation
The relationship between employee motivation and satisfaction, the quality of
internal and external service delivery, the creation of a service orientation and the
integral role of communication in the process of motivation are widely noted in the
literature (Schumann 2004; Tourish & Hargie 1998; Watson Wyatt Worldwide 1999).
GroÈnroos (2001: 336) identifies motivation as a primary objective of internal
marketing, stating that it should ``create an internal environment and implement
internal action programs so that employees feel motivated to carry out part-time
marketing behaviour''. He identifies communication management as one of the most
important tools in achieving this.
The concept of employee motivation has enjoyed considerable attention in the
human resource management literature, placing emphasis on the different
approaches to motivation. Luthans (1992) describes the process of motivation as an
interaction between three interdependent elements, namely needs, drives and
incentives. If a need exists, drives or motives are set up to alleviate the need. The cycle
is complete when the need is actually alleviated, which then forms the incentive of
restoring a balance. Robbins (1998) captures this process in his definition of staff
motivation as the willingness to exert high levels of effort towards organisational
goals, conditioned by the degree to which the effort leads to the satisfaction of some
individual need.
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The role of internal communication in service delivery ...

Some of the most frequently articulated needs in organisations are those for
information, creating meaning and the general need for interaction (Tourish &
Hargie 1998; Wilson 2004). Effective communication structures, initiatives, climate
and channels contribute positively to employee motivation, and in turn to a service
orientation.
Tourish & Hargie (1998) have illustrated the relationship between internal
communication and the satisfaction of needs. They cite the work of Arnott, who
translated Maslow's hierarchy of needs into six employee questions related to the type
of information required to maintain satisfactory levels of motivation:
. What's my job?
. How am I doing?
. Does it matter to anybody?
. How are we (as an organisation/department) doing?
. How do we fit into the whole?
. How can I help?

In the Watson Wyatt Worldwide study (1999) on communication and the

alignment of the workforce with corporate strategies, a correlation is found between
the effectiveness of internal communication programmes, the degree of motivation
and employees' alignment to overall strategic goals. The study recommends that
internal communication should place strong emphasis on helping employees
understand the business and provide information and feedback to motivate and
improve job performance.
It seems that the needs for information, meaning and feedback extend beyond
organisational boundaries. Schumann (2004: 28) states that employees ``want plain
talk that makes it easy to evaluate issues of deep importance to them. For many
employees, the company is their only source of information on many personal topics,
including career, retirement and health care.''
In summary, although not the only determinant of motivation levels,
communication plays a central role in the motivation of employees by satisfying
their needs for information, meaning, context, feedback and general dialogue. It
motivates them by clarifying the organisation's service objectives, by indicating how
they contribute to their attainment, by providing feedback on progress, and by
making available channels for dialogue. These essentially encapsulate a number of
basic human needs for communication, which, if satisfied, could lead to increased
motivation to work towards common goals in the organisational context.

Internal communication and the Gap Analysis Model

Internal communication has hitherto been discussed in the context of internal
marketing and service delivery. On its own, this conceptualisation does not offer an
operational framework that is comprehensive enough to assess internal commu-
78
 M. Landman & G. Angelopulo

nication's contribution to service delivery. To achieve this, the Gap Analysis Model, as
proposed by Parasuraman, Berry & Zeithaml (1985, in Auty & Long 1998) and
GroÈnroos (2001), is utilised. Table 1 specifies the role of internal communication at
the interfaces corresponding to the point of each gap. It incorporates factors that lead
to quality problems at the five interfaces along the service chain and the relationship
of internal communication to each of these.

THE DISCIPLINARY ALIGNMENT OF THE STUDY

Although this study has been undertaken with a conscious effort to avoid alignment
with any of the specific disciplines of communication, its location within the broader
field requires some clarification. The study falls within the intersecting areas of
interest that are concurrently addressed in three broad areas of communication:
marketing communication, and specifically integrated marketing communication
(with the focus on an organisation's total communication as it relates to the
marketing discipline); the related disciplines of public relations and corporate
communication (with the focus on an organisation's communication as it relates to the
general governance of the corporate entity); and communication science (the direct
extension from `speech communication', with its focus on an organisation's
communication as it relates most closely to the nature of communication per se).
While attention has been given to aspects of internal communication that are
embraced by each of these fields, this study is most closely aligned to a marketing
approach to communication, and most particularly to a service marketing approach.

METROPOLITAN HEALTH GROUP AND ITS INTERNAL

COMMUNICATION
The Metropolitan Health Group (MHG) provides medical scheme administration
and managed healthcare services to the corporate and retail markets. MHG is a
subsidiary of Metropolitan Holdings Limited, a company listed on the JSE with
assets of R45 billion under management.
MHG as it stands today is the result of a merger between the former Bankmed
Administration Division and Metropolitan Health. Since the merger in 2000, various
audits have highlighted internal communication as a problem area. These audits have
not revealed the specific internal communication requirements of employees and the
relationship of these needs to the success of the business. They have indicated that
employees generally perceive a lack of communication in the business as a factor
contributing to low motivation levels and as an operational obstacle.
In response to the audit results, the decision was taken to establish a dedicated
internal communications function housed within the Human Resources Department.
The Internal Communications Department is tasked with facilitating internal
79
The role of internal communication in service delivery ...

Table 1: The role of internal communication at the interfaces of the Gap Analysis Model
Gap Potential role of internal Relevant function of
communication internal communication
Gap 1: The . Bad or non-existent upward information . Knowledge management
management from the customer interface to manage-
perception gap: ment
Management . Too many layers that stop or change . Knowledge management
perceives information flowing from customer con-
customers' quality tact points
expectations . Management commitment to service qual- . Motivation/strategic align-
incorrectly ity not visible ment

Gap 2: The quality . Lack of clear goal-setting or lack of under- . Strategic alignment
specification gap: standing of goals by members of the
Service quality organisation
specifications are . Management perceptions are not commu- . Knowledge management/
inconsistent with nicated or ineffectively communicated to strategic alignment
management the business
perceptions of . Lack of visible management support for . Motivation/strategic align-
customers' quality service quality planning and procedures ment
expectations

Gap 3: The service . Employees have an inaccurate perception . Strategic alignment

delivery gap: of quality specifications or customer re-
Quality quirements
specifications are . Employees are unsure about their roles in . Strategic alignment
not met in service the service delivery process (role ambigu-
production and ity)
delivery . Employees do not understand how their . Strategic alignment
jobs contribute to the delivery of service
to the external customer
. Employees are not committed to deliver . Motivation
on the required service level, whether
internal or external
. Technological support, particularly to ac- . Knowledge management
cess information, is insufficient

Gap 4: The market . Lack of internal communication about . Strategic alignment

communication external marketing activities
gap: Promises given . Lack of will or ability of the internal . Motivation
by market market to deliver on the promises given
communication are to the external market
not consistent with
service delivered

Gap 5: The Not applicable (the interface falls outside Not applicable (the interface
customer service the scope of internal communication) falls outside the scope of inter-
perception gap: nal communication)
Correlation between
customers' service
expectations and
perceptions of
service delivery

80
 M. Landman & G. Angelopulo

communication at corporate and departmental levels. It also forms an integral part of

various corporate initiatives aimed at the internal market, or employees, with the
objectives of informing staff of corporate objectives and other relevant information, as
well as motivating them to deliver on corporate objectives.

RESEARCH DESIGN AND IMPLEMENTATION

This study focuses on internal communication at the location of the interface of Gap
3, the Service Delivery Gap, where the quality and nature of internal communication
most directly affect service delivery. The effects of internal communication along the
service delivery chain are most evident here. Its desired outcomes (strategic
alignment, motivation and the related factors of organisational learning, knowledge
management and information dissemination) play a strong role in service delivery
and act as strong indicators of a service orientation.

The items measured at Interface 3 (Service Delivery Gap)

The factors within each construct making up the specifications of Gap 3 (see Table 1)
were drawn from the literature, and these were developed into the individual items of
the measuring instrument. Table 2 indicates the subsets of factors measured per
construct for Interface 3.

Methodology
The methodology for this study was initially used by Chaston (1995) to develop a
typology for the evaluation of branch-level perceptions of internal customer
management processes within UK clearing banks. Both studies have similar
theoretical foundations (the Gap Analysis Model) and both measure employee
perceptions to identify the internal processes that contribute to service delivery. As is
the case with this study, Chaston (1995) also structured his study on the principles of
the gap analysis models proposed by GroÈnroos (2001) and Parasurman et al. (as
discussed in Chaston 1993, 1995; Auty & Long 1998). However, where Chaston
defines specific constructs to measure employees' perceptions of internal customer
management practices, this study focuses on employees' perceptions of internal
communication processes in a service context. The methodology applied here is thus
similar to Chaston's, but the constructs measured are different.
The Gap Analysis Model based on the SERVQUAL system, as developed by
Parasuraman, Zeithaml & Berry, has been the topic of much debate regarding its
reliability and validity (Auty & Long 1998: 11). Yet, this model has made the most
significant contribution to the study of service marketing in recent years (Buttle 1996:
158). The reliability of the gap analysis model as applied here is derived from its wide
application in the field of service marketing, the context within which this study was
undertaken. Validity was addressed by identifying and measuring specific constructs
81
The role of internal communication in service delivery ...

Table 2: List of constructs and their subsets

Construct Subset of factors

Availability of information on external client . Effectiveness of information flow about
needs client needs/service specifications, in-
cluding changes in specifications
. Access, storage and retrieval of informa-
tion
. Quality of information (up-to-date, accu-
rate, relevant)
Availability of information on internal client . Extent to which departments communi-
needs cate with one another about meeting
client requirements
. Effectiveness of inter-departmental com-
munication
. Effect of organisational structure on inter-
departmental communication
Understanding of individual roles in the . Understanding of role in meeting client
service delivery process needs
. Extent and effect of communication be-
tween individual and superior regarding
client needs (vertical communication)
. Feedback on performance (effect, rele-
vance)
Understanding of departmental roles in the . Understanding of where the department
service delivery process fits into the total service delivery process
(role, priorities)
. Feedback on departmental performance
(extent, effect)
Motivation levels: individual, departmental . Motivation levels of departments to deli-
ver to internal clients
. Motivation levels of individuals to deliver
to internal clients
. Motivational effect of management's
commitment to client satisfaction

that are indicative of internal communication. A number of these constructs have

been identified by GroÈnroos (2001) in the Gap Analysis Model, and this set of
constructs was expanded with others defined from the literature review.
A survey was undertaken among employees at MHG head office in Cape Town.
The questionnaire was developed to measure employees' perceptions of the degree to
which internal communication supports a service orientation at Interface 3, the
juncture of service delivery. The questionnaire was designed to obtain quantitative
data on the five constructs of internal communication identified in Table 2, namely:
82
 M. Landman & G. Angelopulo

. Availability of information on external client needs

. Availability of information on internal client needs
. Understanding of individual roles in the service delivery process
. Understanding of departmental roles in the service delivery process
. Motivation levels, both individual and departmental.

The questionnaire comprised 25 statements, each relating to a specific indicator

in the subset of factors that make up each construct. Respondents were asked to
express their degree of agreement with the 25 statements using a scale ranging from 1
(strongly disagree) to 5 (strongly agree). All questions were phrased in the positive to
avoid confusion among respondents whose first language was not English.

Sample
The sampling procedure was guided by three objectives:
. To obtain an overall indication of employees' perceptions of the degree to which
internal communication at MHG supports a service orientation
. To identify possible differences between the perceptions of managerial and non-
managerial staff
. To identify possible differences between the perceptions of client contact sections
(employees in direct contact with clients) and support sections (employees who
render support services and are not in direct contact with the client, including
Human Resources, Finance, Information Technology, Public Relations and
Branding, Document Processing and Office Support).

To achieve the objectives, a stratified random sample was drawn as follows:

. The population comprised permanent employees at the MHG head office in Cape
Town, numbering 573 employees in total.
. The accessible population was identified by eliminating all employees that were
not available as a result of long leave, maternity leave or involvement in special
projects off site, resulting in a total accessible population of 511.
. The accessible population was divided into strata corresponding to the data
evaluation objectives, resulting in four strata, namely Management Client Contact,
Non-management Client Contact, Management Support Services and Non-
management Support Services. A sample of 30% (rounded up) was drawn from
each stratum, applying a technique of random number selection. The sample size
of 30% was selected based on the guidelines of Du Plooy (1995), which provide for
a 95% confidence level and 5% error tolerance.

The detail of the sample drawn is summarised in Table 3.

83
The role of internal communication in service delivery ...

Table 3: Summary of stratified random sample of available population

Stratum Accessible Sample

population
Management Client Contact 28 9
Non-management Client Contact 309 103
Management Support Services 30 12
Non-management Support Services 144 51
Total 511 175

Response
The questionnaire and covering letter were e-mailed to every individual in the
sample. A total of 111 usable questionnaires were returned. A breakdown of response
percentages per stratum is indicated in Table 4. The total of 111 usable responses
represents 63% of the sample and 22% of the accessible population.

Table 4: Summary of response rate per stratum

Stratum Sample Response Percentage

Management Client Contact 9 7 78
Non-management Client Contact 103 67 65
Management Support Services 12 9 75
Non-management Support Services 51 28 55
Total 175 111 63

FINDINGS

Results
The results obtained from the questionnaire are categorised according to the five
internal communication constructs identified earlier. The values attached to each of
the responses are: Strongly disagree = 1; Disagree = 2; Neither agree nor disagree =
3; Agree = 4; Strongly agree = 5. For the purpose of analysing the results, the mean
scores are interpreted in the following manner:
. A score of 4 and higher would indicate that the majority of respondents agree to
strongly agree with a statement.
84
 M. Landman & G. Angelopulo

. Between 3.5 and 4 would indicate a neutral to more positive response, although
there would be less than general agreement on the issue in question. Such items
should be monitored and measures introduced to prohibit deterioration.
. Between 3 and 3.5 would indicate a neutral to negative response. These items
could be cause for alarm, requiring future action.
. Lower than 3 would indicate that the majority of respondents disagree to strongly
disagree with a statement. It will be considered an internal communication gap
warranting immediate attention.

Internal communication that supports a service orientation is defined in terms of

the five constructs measured. Therefore, the degree to which internal communication
at MHG supports a service orientation can be assessed in terms of the overall mean
ratings measured for each of the five constructs in each of the four identified strata.
These ratings are indicated in Table 5.
With the exception of one construct, the understanding of individual roles in the
service delivery process, all constructs achieved an overall mean rating of below 4, the
minimum score indicating general agreement among respondents. The two
constructs that scored the lowest overall mean ratings relate to the availability of
information on both internal and external clients. These two areas would therefore

Table 5: Summary of overall mean ratings for each construct per stratum

Construct Mean rating on 5-point scale

Overall mean Client Client Contact Support Support

rating Contact Non-manage- Manage- Non-man-
Management ment ment agement

Availability of informa- 3.34 3.89 3.29 3.00 3.41

tion on external client
needs

Availability of informa- 3.53 4.04 3.45 3.42 3.64

tion on internal client
needs

Understanding of indi- 4.05 4.6 3.99 4.09 4.06

vidual role in the ser-
vice delivery process

Understanding of de- 3.88 4.31 3.83 3.62 3.99

partmental role in ser-
vice delivery process

Motivation levels, both 3.91 4.52 3.86 3.91 3.89

individual and depart-
mental

85
The role of internal communication in service delivery ...

require immediate attention to increase the extent to which internal communication

supports a service orientation at MHG. Although the remaining two constructs
(understanding of departmental role in the service delivery process, and individual
and departmental motivation levels) were closer to the 4-point overall mean rating,
there is no majority agreement on these two issues either. It would therefore be useful
to investigate these two aspects further to identify possible causes and relationships
with the other constructs (for example, whether the lack of information or
understanding of roles could be linked to decreased motivation levels).
In terms of differences among the four strata, the most apparent finding is the
significantly higher mean average ratings achieved by the Client Contact Manage-
ment grouping for all five constructs. This grouping indicated general agreement
with four of the five constructs. With regard to the other groupings, there is very little
variance in ratings, and specifically no ratings where one group indicated agreement
in contrast with non-agreement of other groups.
Specific areas that were identified as requiring attention (overall mean rating of
3.5 or lower) are the following:
. Effective communication of client needs to the business
. Effective communication of changes in client needs to the business, particularly to
the Support sections
. Easily accessible storage of information on client needs
. Availability of up-to-date information on client needs for all groupings other than
Client Contact Management
. Accuracy of information on client needs, again for all groupings other than Client
Contact Management
. Effectiveness of inter-departmental communication in ensuring that client needs
are met, particularly as perceived by the Support sections
. Clarity among departments on priorities regarding client service
. Priority attached to meeting client needs by Support Management
. Motivation levels of Support Management to strive for client satisfaction.

Extent to which internal communication supports a service orienta-

tion at MHG
Table 6 indicates the following:
. The five constructs identified earlier
. Employees' perceptions of the effectiveness or ineffectiveness of each construct
. The desired functions of internal communication in supporting a service
orientation (strategic alignment, the linked outcomes of organisational learning,
knowledge management and information dissemination, and motivation).
86
 M. Landman & G. Angelopulo

Table 6: Effectiveness of internal communication functions in relation to constructs

measured

Construct Indication of Internal communication

effectiveness function(s)

1 Availability of information on external client Ineffective Organisational learning/

needs knowledge management/
information dissemina-
tion

2 Availability of information on internal client Ineffective Organisational learning/

needs knowledge management/
information
dissemination

3 Understanding of individual role in the service Effective Strategic alignment

delivery process

4 Understanding of departmental role in the Ineffective Strategic alignment

service delivery process

5 Motivation levels, both individual and depart- Ineffective Motivation

mental

The summary provided in Table 6 indicates that none of the desired outcomes of
internal communication are effective in achieving the objectives of each of the
constructs. Strategic alignment is partially successful, as employees indicated general
agreement that they understand their individual roles in the service delivery process.
However, the same result was not achieved for Construct 4, understanding of
departmental role in the service delivery process, which points to a lack of a common
understanding of `the bigger picture' and what needs to be done to achieve service
objectives throughout the company. Organisational learning/knowledge manage-
ment/information dissemination and motivation are ineffective in the company at
large.
Furthermore, a significant discrepancy exists between the management grouping
of client contact departments on the one hand and the rest of the organisation on the
other. If viewed against the characteristics of a service orientation, it is clear that
internal communication at MHG head office does not support a service orientation,
particularly at Interface 3, which addresses actual service delivery. A service
orientation is characterised as follows:
. Service quality delivery and achieving customer satisfaction are viewed as top
priorities throughout the organisation, from strategic to operational levels.
. There is a realisation that the quality of service delivery to internal customers
directly affects the quality of service delivery to external customers.
. All internal service production activities are integrated to meet the needs and/or
requirements of the external customer.
87
The role of internal communication in service delivery ...

The internal communication functions of strategic alignment and motivation

impact on the first and second characteristics. Because both functions are ineffective,
it can reasonably be argued that internal communication at MHG does not support a
service orientation in this regard. Furthermore, internal communication should
support the notion of the internal customer by facilitating inter-departmental
communication and cooperation within the framework of meeting the needs of
external clients. The survey results indicate that this is not generally the case at
MHG, because interdepartmental communication is not achieving the desired results,
and information on the external client is not effectively disseminated to all areas of
the business. With regard to the third characteristic of a service orientation, the
discrepancy in almost all areas between perceptions of Client Contact Management
and the rest of the business points towards a lack of integration of goals, information,
knowledge and eventually communication.
Against this background, it can be concluded that internal communication at
MHG does not support a service orientation, although there are certain areas of
strength as indicated by the results of the survey.

Internal communication needs at MHG

The ultimate goal of the study is to identify internal communication needs at MHG
based on assessment of the degree to which internal communication supports a
service orientation. Based on the results of this assessment, the following internal
communication needs are identified:

Strategic alignment
An internal communication programme needs to be developed around the objective
of strategic alignment with the service strategy of the organisation. The following
specific areas need attention:
. Clarity and alignment among departments on the priorities regarding client
satisfaction
. General understanding throughout the business on corporate service strategy
. The establishment of internal service delivery and the concept of the internal
customer
. Clarification and consensus about the role of each department in the service
delivery chain.

Organisational learning, knowledge management and information disse-

mination
It would be important for MHG to improve the flow of information from source to
the rest of the business in order to achieve success with the implementation of an
88
 M. Landman & G. Angelopulo

internal service delivery process in particular. The following are specific areas that
were highlighted for attention:
. Effective and timely distribution of external client information from source to the
rest of the organisation
. Improvement of inter-departmental communication to ensure clarity on both
internal and external client requirements
. Accuracy of information.

Motivation
The motivation level of staff to meet organisational objectives is often a function of
the outcomes with respect to strategic alignment and organisational learning,
knowledge management and information dissemination, implying that an improve-
ment in these two could lead to increased motivation levels. However, the effect of
communication by and with management (departmental and overall) is highlighted
by the survey as an area of weakness. An internal communication programme would
therefore have to address the necessity for the affirmative communication of
management support of a service orientation within the framework provided in this
study.

CONCLUSION
This study sets out to provide a meaningful framework for an internal
communication needs assessment that relates in general to the success of a business,
but more specifically to its service orientation. The approach is derived from a service
marketing perspective of internal communication, and it provides a useful instrument
for the assessment of the quality of an organisation's internal communications.
It is suggested that a service orientation among employees is a prerequisite for
successful marketing in an ever-changing organisational environment, and that
internal communication plays a crucial role in the establishment of a service
orientation. Using the service-marketing model proposed by GroÈnroos (2001), a
measurement instrument that evaluates the degree to which internal communication
contributes to service quality was developed and tested at the Metropolitan Health
Group.
The findings point to the fact that internal communication does not entirely
support a service orientation at MHG, although there are areas of strength that
should be extended to the rest of the organisation. In particular, the Client Contact
Management grouping indicates a satisfactory perception of the necessity for internal
communication in establishing a service orientation, but perceptions in the support
89
The role of internal communication in service delivery ...

areas indicate a less than satisfactory situation. Specific areas that require attention
are identified, and these provide the basis for a structured internal communication
programme.
Since the conclusion of this study, MHG has embarked on a number of initiatives
that demonstrate a deliberate move in the direction of a service perspective as a
strategic approach, based on the same broad principles as those conceptualised by
GroÈnroos. As a first phase, MHG has launched a project called Super Service in
conjunction with one of its biggest clients. The objective of Super Service is to run
the business from a member-centric perspective, meaning that interactions with
individual members will be relationship-based. In support of the Super Service
initiative, an extensive internal communications programme, developed according
to the principles of internal marketing (as discussed in the article), has been
launched. In conjunction with training and other change management initiatives, it
has achieved several significant successes ± it has served to help staff in the pilot area
focus on specific outcomes and strategic objectives; it has served as a motivational and
educational driver and a change management vehicle; and (because of its internal
success) it was also used as a tool to promote MHG to prospective clients. Therefore,
the role of internal communication in service delivery, as applied in this study, has
provided MHG with a competitive edge on several levels, both internal and external.

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