What should you do if bad publicity threatens your hospital's reputation?
Advance preparation can defuse a media crisis
If a news crew from your local TV station showed up at your doorstep, would you be ready? If you are correctly prepared, a potentially negative media situation can be turned around to benefit the community and your hospital, says a Wisconsin health system manager who has survived several crisis situations.
Mary Fields, the director of public relations and strategic communications at Milwaukee's Aurora Health Care, knows firsthand that public perception isn't always what you expect. She has lived through several crises, the most recent one involving a child who died - allegedly of meningitis - after presenting at an Aurora facility on a weekend and being sent home.
"The key is to have a behavioral communications plan in place," Fields says, explaining that these plans provide a way to identify your target audiences and direct their behavior. "You pull together a team that will identify all your audiences - your patients and your potential patients - and you identify what information they need to make them behave how you want. In this case, it is to remain a loyal patient."
Then, Fields says, you disseminate that information through someone credible. "That spokesperson may shift depending on your audience," she explains. "What works for existing patients may not work for the wider community. You set a time line, and then that plan becomes your bible."
Everyone needs a crisis plan, says Cydney Koukol, president of Communications Strategies in Bellevue, NE. "Hospitals have been way ahead on this, but now practices are facing some of the same situations."
Frank Corrado, president and managing partner for Communications for Management, a Chicago-based consulting firm, agrees, but he says getting physicians to talk about potential crises can be difficult. "They often balk at it, but even if you just get them to kick around a bunch of what ifs, you are ahead of the game. It can help you when and if a situation does arise." Potential crises don't always revolve around the unexpected death of a patient, he says. "There are all sorts of scenarios. A partner leaves, an employee does something wrong, or there is a fraud investigation. There are limitless possibilities."
It's crucial to think in advance because when a crisis strikes, Corrado says, you can become paralyzed. "In many ways, it mimics what happens when there is a personal trauma - you have denial, anger, and finally acceptance. You have to be prepared."
What should a crisis plan include? Koukol says first and foremost, you need to gauge public opinion among the decision makers and your patients. "In a case where a child dies, it's very emotional, and the public will demand an explanation. But for all you know, your patients will stand by you, and your potential patients will understand."
You can start by having your nursing staff talk to patients, says Corrado. They may be able to tell if there will be a short bump or a long-term problem with your patients.
You may want to hire a public relations firm to conduct a thorough survey of attitudes toward your practice in the wake of a crisis, he adds. "In a big case, that can help you determine how much you can minimize the damage. In some cases, people will be upset in the short-term, but the long-term impact isn't great."
When the young patient treated at Aurora died, one person was assigned to pull together all the facts of the case. The lead physician - not the physician allegedly involved in the case - was chosen to speak for the clinic.
"We broadened the issue to something educational," Fields recalls. "We gave out information on the signs of meningitis parents should watch for. The focus became educational, not blaming. The media were used to disseminate the message to the wider community, and current patients were also contacted by the practice.
In the end, the medical examiner determined the cause of death was not meningitis, and there was no blame to assign. In the course of the crisis, however, Fields and her team had been able to provide a public service and bring something positive out of the tragedy.
But there are situations where someone is at fault, Fields says, although it might not be a criminal case. For instance, you give the wrong medication to a patient, and that patient has a bad reaction and goes to the media. "In that case, if the outcome is known, you should really admit there was a problem and present an action plan that will ensure it won't happen again," she says.
Fields says at no time should you blame a patient, even if the fault lies with him or her - for instance if the problem arose due to noncompliance with a care plan. "The public will feel for the patient. And besides, for confidentiality reasons, you just shouldn't discuss it."
At some point, you may consider bringing in professionals to help you deal with the situation, Corrado says. "You have to understand that the court of public opinion meets before the courts of law, and if you don't act quickly, you are going to damage your business," he says. "You have to get help before you lose control."
Even if you are unsure if you need professional help, Koukol says you should get it lined up earlier rather than later. "It can look bad - or even make you look guilty - if late in the day you hire a PR person or a lawyer," she advises.
If you do need a lawyer, choose carefully. "You don't want a high profile lawyer," Koukol says. By hiring a big-name lawyer, you could be sending a message that your practice is worried about the case. "If the person is associated with criminals - or has ads on television that are the subject of jokes - you don't want to choose that person."
Corrado warns that when picking a lawyer, you should also be aware that they often have very different agendas than PR professionals. "Lawyers will want to limit how much you talk. They want you to hunker down and keep your mouth shut when, sometimes, the best action is to say you are sorry."
And you shouldn't worry that an apology implies guilt, he adds. "Case law has shown that an apology is not an admission of guilt, and often, that's all people want."
Finally, Fields says you should let issues die a natural death. "Sometimes, physicians want to justify their positions and explain their actions, and that keeps issues alive longer than they need to be. You have to help [those involved] walk away. Make your statement and let it become yesterday's news. Don't extend it beyond that."
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