The document discusses communication breakdown within organizations. It identifies some common reasons for communication breakdown including organizational structure, perceptions of people, and lack of transparency. Rumors, misinformation, misinterpretation, and inadequate information are also listed as common elements that can contribute to communication problems. The document then provides examples of issues that arose at a city hospital due to lack of transparency, inclusion of staff in meetings, reliance on informal communication networks, and not providing adequate information to all employees. It concludes by emphasizing the importance of transparency, formal communication, and including employees in decision making to improve organizational communication.