South Florida Hospital News
Thursday October 1, 2020
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September 2016 - Volume 13 - Issue 3
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Ten Steps for Handling Healthcare Crisis Communications – Part 1

Healthcare Organizations Provide Fertile Ground for a Crisis

Healthcare organizations are inherently complex. Consider the milieu in which healthcare transactions typically occur. Medicine itself is an inexact science, and hospitals are often multi-million dollar institutions with thousands of employees and non-employee agents (physicians, volunteers, vendors, to name few); a diverse and often international workforce and patient population, bringing innate language and cultural barriers; new electronic information systems subject to staff and physician learning curves (and, unfortunately, sophisticated hackers); and, all too often, arcane processes still fraught with waste and the possibility of human error. The sheer volume of interactions between staff, patients, and families in a typical community hospital probably runs into the hundreds of thousands, if not millions, of encounters. The myriad of steps taken in a typical patient encounter - registration and acquisition of sensitive patient demographic and insurance data, a medical history and physical, documentation of drug allergies, diagnosis of the illness with may itself involve multiple laboratory tests, imaging scans, invasive or non-invasive procedures, and the sharing of the most personal of details - almost guarantee the possibility, if not the likelihood, of a medical mishap sometime in the organization’s history.
 
Aside from medical mishaps, there are innumerable other critical situations which may flare up to become crises: untoward regulatory findings, patient privacy breaches, unanticipated financial takebacks or penalties, negative employee or agent interactions, clinical or regulatory compliance violations, labor disputes, governance or management issues, and many, many more. The crisis itself can take many forms. It might be precipitous or it might develop slowly with a gradual crescendo until it erupts into a full-blown media event or until appropriate crisis communications brings it to a conclusion.
Obviously the best intervention in a crisis is preventing the incident from ever happening in the first place. Most healthcare institutions have carefully developed over time a set of institutional procedures, human resources policies, and clinical protocols, care paths and guidelines, which, if religiously followed, can minimize the likelihood of an adverse event occurring. However, even the best-managed, most-automated, most sophisticated institution can experience a crisis. The fact remains that the delivery of healthcare is essentially a series of actions by human beings which, at its core, introduces the possibility of an untoward incident which could develop into a crisis.
 
So, even if the likelihood of a crisis can be minimized, it is improbable or impossible that it will be entirely eliminated. Fortunately, however, the outbound communication around the crisis can and should be managed. The effective healthcare CEO will surround himself or herself with a talented coterie of executives who will need to act as a cohesive team to identify and address the issues leading to the crisis, to develop and communicate the response to the crisis situation, and to rally and inspire the workforce in the face of unwanted publicity, difficulty, and stress. The team, led by the CEO, must be prepared for action and must remain nimble, flexible and focused in its remediation and crisis communication efforts.
 
What are the steps, then, in handling the communication surrounding a crisis? What follows are some basic guidelines for the CEO to consider and to adapt to his or her particular situation.
 
The First 5 Steps in Crisis Communications
1. First of all, become fully informed about what happened and commit to being forthright and transparent with all involved parties.
 
2. Patient safety is paramount. Once you’ve identified the precipitating issue, take all necessary steps to “stop the bleeding.” This may involve conducting a complete root cause analysis as to how the event occurred and should include a plan on how to remedy the situation and how to prevent the adverse event from re-occurring. Although most events are triggered by human intervention, refrain from taking rash personnel actions. Obviously, actions caused by criminal intent, malfeasance, or gross neglect must be immediately addressed. Consider, however, that many events are caused by inadequate training, faulty systems, or poor communications among well-meaning parties, not necessarily by bad people or poor performance. In any event, take swift, but well-considered, action if necessary to remediate the situation and restore patient safety and confidence.
 
3. Apologize personally and privately to the patient, family, or affected party. A public apology may also be necessary, but start with a private one. The chance of forgiveness by the aggrieved party may be optimized, or, at least, the possibility of the event not mushrooming into a full-fledged media event will be greatly reduced, if the aggrieved person or party believes that the organization and its representatives have been honest, forthright, compassionate, and remorseful. The apology should be delivered by the person committing the error and in the presence of the institutional representative with whom the aggrieved party has the closest relationship. For an event involving multiple aggrieved parties, the likely person to deliver to apology will be the CEO.
 
4. Develop the message points to be communicated to internal and external publics. These are the points you want to convey to your constituents - staff, physicians, media, investors, regulatory agencies, etc. There should be no more than 3-5 key points, particularly to the media. Members of the administrative and public relations teams must fully comprehend these points and must be consistent in the delivery of these messages. These message points usually acknowledge the incident itself, specify that remedial action has been taken, and express compassion, regret, and remorse to the affected individuals.
 
5. Insure that the organization commits enough resources to address the crisis. This means dedicating enough operational personnel to functionally address the event and its aftershocks and enough public affairs personnel to develop messages, to identify and coach spokespersons, and to reach out to constituents. In a true crisis, inquiries can come from anywhere - the media, regulatory authorities, Board members, community agencies, worried family members, and even from your own employees. Now is not the time to skimp on resources. Inform your senior staff that “all hands on deck” will be needed. Call in outside assistance if necessary; your public relations counsel or advertising agency can likely provide resources or point you in the right direction. Ensure, however, that communications and messaging do not become clouded or frayed by too many well-meaning advisors weighing in on the development of the message points. The CEO will need to display confident leadership and should set up clear lines of approval of public messages, press releases, and other organizational statements.

Calvin Glidewell is widely recognized as a highly accomplished healthcare executive with more than 30 years of advancing positions of effective leadership. Most recently, Glidewell served as the CEO of Broward Health Medical Center & Chris Evert Children's 716-bed Hospital, the largest hospital of Broward Health's $1.1 billion fully integrated system.

 
“Handling Healthcare Crisis Communications” will be continued in our October issue.
 
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