Sooner or later, some type of crisis will hit you and your organization. It’s an inevitable part of your job, so risk managers should plan for that day by preparing contingency plans and putting together a “bible” of crucial information ahead of time, suggest two risk managers who have weathered storms.
The advice comes from June Leigh, CPHRM, RN, BSN, MS, FASHRM, ARM, risk control director with CNA HealthPro in Chicago, and Nancy Lagorio, RN, MS, CCLA, risk control consultant with the company. They presented their strategies for crisis management at the recent meeting of the American Society of Healthcare Risk Management (ASHRM) in Orlando, FL.
A risk manager’s crisis can take many forms, Leigh says, from a tornado hitting your hospital to a medical error that causes the death of a patient. “In health care, a crisis is something that suddenly or unexpectedly has actual or potential adverse effects on the organization or its patient, staff, or community,” she says. “That can cover a lot of scenarios.”
Leigh notes that not all crises lead to a disaster in which the organization experiences total failure. But some crises that start out relatively small can build to that point if handled poorly, she warns. “Some organizations may manage to avoid a crisis turning into a disaster through plain old, dumb luck, but more reliably, it’s better to prepare and plan,” Leigh says. “Like the old saying goes, ‘It wasn’t raining when Noah built the ark.’”
All industries have to contend with crises, but she notes that health care providers have an added burden because their crises tend to hit the front page of the newspaper, with the biggest headlines, and stay on the front page longer. They also receive both regional and national attention, a result of the public’s overall level of distrust regarding health care. “The longer the bad news stays on the TV news or on the front page, the more damage it is likely to do,” Leigh says, “and the more difficult it is to overcome.”
Always tell the truth
Risk managers should always keep in mind how the media will portray any action, or inaction, by the health care organization, she says. Leigh and Lagorio offer these key strategies for responding to any crisis:
- Tell the truth, tell it well, and tell it often. This is the No. 1 rule for any crisis. Refer to it when in doubt about what to say to anyone.
- Do the right thing.
- Don’t delay. A crisis always requires prompt action. Doing nothing is always the worst response.
- Don’t expect a crisis to go according to plan. Actual crises rarely are identical to what you prepared for. The best you can hope for is that you prepared for the general type of crisis you’re facing and that your plans are flexible enough to allow you to adapt to the realities unfolding.
Include reps from all major departments
Lagorio says your crisis management plans should start with an identification of potential problems that you could face. These will differ from one organization to the next, depending partly on your geographical location, the size and type of your facility, and the services you offer. The types of crises range from natural disasters, such as tornadoes, to external emergencies, such as a chemical exposure in the community. There also can be internal crises, such as large-scale infections. And don’t forget the internal, nonmedical crises such as an employee strike.
When brainstorming about potential crises and the response plans, be sure to include a representative from every part of the organization, says Lagorio. For each potential crisis, she advises considering each of these points:
- geographic scope and duration;
- impact on operations;
- employee involvement;
- regulatory, accreditation, and law enforcement involvement;
- public concern;
- likely media coverage.
For each scenario you anticipate, carefully establish a formal crisis management and communications team with clearly defined roles and responsibilities. Be sure to consider communications facilities and the heavy demands on space, telephones, web sites, and other resources.
Develop a bible to use in a crisis
Part of your planning should include the development of a bible that can guide you through the tough times, Leigh says. Distribute this handbook of crucial information to leaders throughout the organization so that it is ready to use in a crisis. Leigh and Lagorio recommend including this information in the bible:
- Contact information for core team members, backups, and chain of command.
- Contact information for those others who need to be informed, such as sales representatives, switchboard operators, site security, and contact people at other company sites.
- Information for contacting key people outside the organization, such as experts to whom you can turn for information and external spokespersons.
- A list of local and national media contacts.
- Common questions and answers that may apply in this crisis. For a crisis involving a particular procedure, for instance, the questions might address when the procedure was approved, how many people have the disease, how many procedures are performed nationwide and at your facility each year.
Update the questions and answers frequently, but save the old ones in a separate section in case a reporter asked about information you presented previously. Reporters frequently review archived media stories and may inquire about old statistics or answers, so you need to know where that information came from.
- Any past press releases relating to the issue. Again, you need to know what you have told the press in the past, even if that information no longer is current.
- Procedures that address document management, including e-mail.
- A communication plan that addresses all major constituencies such as patients and families, internal staff, medical staff, board members, and public officials. Be sure to include your policy on who is authorized to communicate with the media or other parties.
- Procedures for media relations, including access to patients, photography, press conferences, message logs, and media inquiry forms.
- Rules for security and confidentiality, including the release of information.
- Policies on training personnel and conducting drills.
Use media to communicate your message
Rely on the bible you prepared before the crisis, but be sure to update it with relevant information during the crisis situation. Add information such as statements issued, supportive statements from third parties, media coverage, and backup information such as published studies and sources for the statistics you will quote.
A major part of your crisis management plan should involve how you communicate internally and to the public. She advises following these key steps for crisis communication:
1. Gather the facts.
2. Determine the size of the crisis.
3. Assemble those involved.
4. Delegate assignments.
5. Relate the facts promptly.
6. Communicate from a high level.
7. Accept responsibility but not blame.
8. Express compassion.
9. Use your positive reputation to your advantage.
10. Follow up with more communications after the crisis to rebuild the image of your organization and restore public trust.
Sooner or later, some type of crisis will hit you and your organization. It's an inevitable part of your job, so risk managers should plan for that day by preparing contingency plans and putting together a "bible" of crucial information ahead of time, suggest two risk managers who have weathered storms.
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