Critical to successful engagement in any organisation is an understanding of the important elements affecting good communication. There are many dimensions to the study of communication in the 21st century, both generally and in health service settings, in the 21st century. This chapter considers the foundational concepts, with references to help students discover more about communication in organisational, social and cultural settings. Many believe that even the definition of communication is worth questioning. As a notion it is so discursive and diverse that any definition other than the simplest becomes so complex as to cease being useful.

The complexities inherent in healthcare organisations highlight the multifaceted nature of their operations. Regardless of role, scale, procedural intricacies or governance structures, these organisations need to deal with the complexities of both internal dynamics and external landscapes. The diversity of stakeholders involved adds layers of challenge to effectively managing clinical and social processes, optimising outcomes, allocating resources equitably, developing and retaining a skilled workforce, making informed decisions and upholding ethical standards.

The advent of the digital age has brought about significant changes in how information is created, disseminated and consumed. Recent developments in the use of big data and artificial intelligence (AI) have brought all things digital into sharp focus. Big data and AI have played pivotal roles in shaping the digital landscape. The term ‘big data’ describes the vast amounts of structured and unstructured data generated every day. Advanced analytics on big data enable businesses and organisations to extract valuable insights, make informed decisions and enhance various processes. AI, on the other hand, has brought about a paradigm shift in how machines learn, reason and perform tasks traditionally associated with human intelligence. Machine-learning algorithms, a subset of AI, process vast datasets to identify patterns and make predictions. This has applications across diverse fields, including health care, finance, marketing and more. The combination of big data and AI has fuelled advancements in areas such as personalised recommendations, predictive analytics and automation in all aspects of our day-to-day lives.

Managers and leaders need to critically analyse their own thinking and decision-making processes so they can objectively evaluate the problems and issues they face every day. To do this they need to understand their personal preferences, prejudices, values and cultural beliefs, and their motivations and desires. It is also important for them to understand how these factors shape the biases managers and leaders take to decision-making. To achieve success, they require the ability to analyse, synthesise and evaluate material, and to assemble their thoughts in a logical argument.

The financial management of healthcare organisations is a key management responsibility for both public and private facilities. While this responsibility has always been important, it is becoming increasingly more so, with the rising costs of healthcare provision due to advances in technology and rising rates of chronic disease and ageing populations. The responsible use and management of scarce healthcare resources requires knowledge and information. The accounting process provides the necessary information to develop and monitor a budget. However, it is the financial management of the budget and associated activity levels that provide the necessary framework to ensure budget integrity and financial governance.

Effective strategic planning, implementation and management drive organisational performance. Healthcare managers have recognised the increasing importance of strategic planning and management as the healthcare industry has become more dynamic and complex. However, development of feasible strategy can be difficult, and implementation of even well-developed strategy is often challenging. This has become increasingly complex as healthcare organisations aim to implement triple bottom-line (TBL) reporting to better ensure sustainability. This chapter provides advice on leading and improving strategic planning and management for sustainability in health-service organisations.