You've Said It Three Times. They Still Don't Get It. Here's Why.
You've explained the emergency triage process to the reception team.
You've reminded them — twice — how new patient referrals should be handled.
You've clarified who's responsible for what when the phones are ringing and the waiting room is full.
And yet, nothing's changed.
Same mistakes. Same confusion. Same frustration on both sides.
So you say it again. And you start to wonder: are they not listening, or do they just not care?
Here's the hard truth: if people didn't act, the message failed. Not them. The message.
The illusion that communication has taken place
George Bernard Shaw (allegedly) said it best:
"The single biggest problem in communication is the illusion that it has taken place."
Most leaders assume that saying something means it's been understood.
It hasn't.
And the gap between what you said and what they heard is where everything falls apart.
You explained the triage process clearly. You even wrote it down.
But clear to you doesn't mean actionable to them.
Because communication isn't about transmitting information. It's about creating shared understanding — and then confirming that understanding exists.
Most leaders skip that last part.
Why instructions don't stick
When a process or expectation doesn't land, it's usually because one (or more) of these steps is missing:
1. You didn't check for understanding
You explained it. You might even have asked, "Does that make sense?"
They nodded.
But "Does that make sense?" is a terrible question. It invites a passive yes, not active comprehension.
What works better:
"Talk me through what you'll do when an emergency patient calls."
"What's your first step if someone asks for an urgent appointment?"
If they can't repeat it back in their own words, they didn't understand it.
2. You didn't get agreement
Understanding isn't the same as buy-in.
Someone can follow your explanation perfectly and still think, "That won't work here" or "That's not my job."
If you didn't pause and ask, "Are we on the same page with this?" — you don't know if they're on board.
And if they're not on board, they won't follow through.
3. You didn't follow up
This is where most communication dies.
You explained it. They understood it. They agreed.
Then nothing happened — because there was no checkpoint, no feedback loop, no moment where you confirmed it's actually working.
Without follow-up, people assume it wasn't that important.
Or worse — they tried it, it didn't go smoothly, and they quietly reverted to the old way.
Real scenario: Emergency triage
I was recently asked by a client to work with the reception team on emergency triage. Patients were getting booked in incorrectly, wasting clinical time and frustrating the clinicians.
The practice manager had explained the emergency triage process three times.
It was written down. It had been covered in a team meeting. It was on the noticeboard.
And yet, patients were still being booked incorrectly. Clinical time was being eaten up. The team was frustrated.
Here's what actually happened:
Round 1: Manager explained the process in a team meeting. Assumed everyone understood. Didn't check. Didn't confirm.
Round 2: Manager noticed it wasn't working. Sent a reminder email with the steps. Still no check for understanding. Still no agreement.
Round 3: Manager brought it up again, more firmly this time. Team nodded. Said they'd follow it. Manager assumed that was enough.
But there was still no follow-up. No observation. No conversation about what's working and what's not.
So the team reverted to what felt easier — the old way.
Not because they're difficult. Because the new way wasn't reinforced.
What actually works
If you want a message to stick — whether it's a process, an expectation, or a change — follow this sequence:
1. Explain clearly
Keep it simple. No jargon. No assumptions.
Break it into steps:
Step one: Confirm the patient's reason for calling
Step two: Check urgency using the triage guide
Step three: Book, refer, or escalate
Not: "Just use your judgement."
2. Check for understanding
Don't ask, "Does that make sense?"
Ask them to walk you through it:
"What's your first step when an emergency patient calls?"
"What happens if they say it's urgent?"
If they can't explain it back, you haven't communicated it clearly enough yet.
3. Get agreement
Understanding isn't the same as commitment.
Ask directly:
"Are we aligned on this?"
"Can you do this?"
"What support do you need to make this work?"
If there's hesitation, surface it now — not three weeks later when nothing's changed.
4. Follow up
This is non-negotiable.
Schedule a checkpoint:
"I'll sit with you tomorrow morning and watch how the first few calls go."
"Let's review this at Friday's huddle and see what's working."
Without follow-up, people assume it wasn't that important.
With follow-up, they know you're serious — and they'll take it seriously too.
The real issue
Most leaders think repetition means failure.
It doesn't.
Repetition is leadership — if the message is structured properly.
But saying the same thing three times without checking for understanding, getting agreement, or following up?
That's not repetition. That's hope.
And hope isn't a strategy.
What to do this week
Pick one message you've been repeating.
Ask yourself:
Did I check they understood? (Not "does that make sense?" — actual comprehension)
Did I get agreement? (Not just a nod — actual buy-in)
Did I follow up? (Not just assume it's working — actual confirmation)
If the answer to any of those is no, that's why it's not sticking.
Fill the gap. Say it again. But this time, close the loop.
Because communication determines culture.
And if your team isn't following through, it's not because they don't care.
It's because the message isn't landing yet.
