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CPR: How to Crisis-Proof Your HCO Wisconsin HPRMS Conference Sept. 13, 1007 Kathleen L. Lewton Principal, Lewton,Seekins&Trester.

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Presentation on theme: "CPR: How to Crisis-Proof Your HCO Wisconsin HPRMS Conference Sept. 13, 1007 Kathleen L. Lewton Principal, Lewton,Seekins&Trester."— Presentation transcript:

1 CPR: How to Crisis-Proof Your HCO Wisconsin HPRMS Conference Sept. 13, 1007 Kathleen L. Lewton Principal, Lewton,Seekins&Trester

2 Duke 2003 “A Death at Duke “In the future, we can expect more publicity after major errors in medical care, especially when communication breaks down and trust is lost.” NEJM 3/20/03 “Ms Santillan’s plight also tarnished to some degree the reputation of one of the nation’s most renowned hospitals.” NY Times 2/22/03

3 Mt. Sinai New York 2002-03 “ On top of the fiscal mess came the death of a man who had donated part of his liver in January 2002.....a state investigation found “woefully inadequate care.... Violations occurred in 80 of 195 complaints patients had brought.....The sum of it all has been a crisis of spirit.” “Today, most worrisome are the occupancy numbers.” New York Times

4 Johns Hopkins 2001 “Hopkins officials reacted with outrage to the suspension of research, calling the action unwarranted, unnecessary, paralyzing and preciptious.”* NYTimes *Three days after accepting “full responsibility” for the death of a young woman in a clinical trial

5 Cleveland Clinic 2003 “But the Cleveland Clinic Foundation is struggling these days.... Nearly $500 million of its wealth has vanished. “Dr. Loop did not return several calls seeking comment.” NY Times

6 Crises will happen  Surviving them means having a reputation and relationships that can weather the storm  And then managing the crisis effectively If the goodwill bank is empty, survival is difficult If the crisis is not managed effectively, the bank account is overdrawn

7 First, let’s define “crisis”  A crisis in a healthcare organization is NOT an external disaster that the HCO must respond to That’s by-the-book and you can plan and drill for it – and it’s not “your” crisis  A crisis is something that happens within the hospital that can damage reputation And it’s something that happens unexpectedly, vs. a long-simmering issue that can be managed

8 Such as:

9 MedRel Advanced:CPR  It’s not “if” a crisis happens – it’s when and how soon Medical errors are inevitable Patients/families now understand why and how to take their stories public HCOs still seem to be caught off guard, to respond with arrogance and reinforce pre- existing negative stereotypes

10 And CPR is needed because:  It’s life or death Media coverage is instant Web coverage is instant-er  The outcomes are critical Litigation Damage to reputation Loss of confidence among patients, physicians and EMPLOYEES Loss of productivity Undercut all your marketing efforts

11 When the crisis comes, it is a CRISIS  Crisis PR may be only 2% of a PR job, but it can often be make or break Reputation can be irrevocably damaged – not by the medical or institutional mistake, but by how the institution reacts and responds The public WILL forgive mistakes – but NOT dishonest, disingenousness, arrogance

12 Some make CPR sound simple  But it’s not No cookie cutter approach that works in every case A plan is only a piece of paper without institutional buy-in Situations can be anticipated, but real life can be different It‘s about people – unpredictable people – and in health care, it’s about life/death

13 It begins with a mindset  Strategic communications process in place  Full buy-in of senior management  CPRO part of senior management team  Detailed operational plan  Pre-existing conditions: strong credibility and good relationships with media

14 And also requires:  Effective internal and stakeholder communications channels already in place and fully road tested  Spokespersons already trained and tested One MUST be an MD, ideally not the CEO  And a full account in the goodwill bank

15 The Basics: The Team  Established in advance – crisis is no time for saying “Should we call XXX” or answering “But what about ME?” CEO HR Legal Operations Risk management IT possibly Security PR Others PRN  Establish chain of command and tie-breaker

16 The Basics: The Plan  Must be in sync with HCO values, mission  Detailed P&P to insure that potential crises are reported! And make sure employees are oriented and trained  Detailed info on who does what when For example, when senior manager hears about a crisis situation – who gets called FIRST? CEO? PR? Lawyer? Figure it out now.  Implementation instructions  Resource and contact info – updated weekly

17 The Basics: The Essential Info  Master list of all key audiences Contact database  Allies database  Systems – phones, pagers, Blackberries With fall-back plans when systems crash  Media logistics  Fact sheets already printed  “Dark” section on website, ready to go

18 The Basics: Pre-Screened Spokespersons  SpokespersonS must be: Credible Mediagenic Coachable, trainable Constantly available Calm, calm, calm – unemotional, ego-free Stamina  Weigh the merits of CEO, COO, MD, PR  TRAIN, train, train, and train

19 Testing 1, 2, 3, 4 -- Checklist

20 The Basics: Anticipate and Rehearse  Issues anticipation The predictable and generic The “that could be US” opportunities  Routinely (at least quarterly) put the team through a crisis drill with a scenario “torn from the headlines”

21 Scenario Drills  “Working” these issues provides ideal time to: Kill the “no comment” mentality Try out spokespersons and decision-makers – role play Confront the “WE DON’T MAKE MISTAKES LIKE THAT” mentality Thrash things out with legal in advance

22 Scenario Drills  Allows for: Assessing probability Identifying potential audiences by scenario Assessing severity and risks Determining – in advance – what the answer to the first question

23 Scenario drills also:  Allows you to show CEO et al examples of good CPR and bad Start with the classics -- Nixon, Exxon vs. Iacoccoa, Tylenol Then use current/recent hospitals  Allows you to road test your team, your plan, spot any inbred issues and deal with them  And provides time to teach your team the RULES

24 CPR: The Cardinal Rules  Never, ever, ever lie – the truth will ALWAYS COME OUT The “You Tube” generation Any employee can dial NY Times  And never speculate Educated guesses that turn out to be wrong – look like lies to the public “I don’t know” can’t come back to bite you like a lie or speculation can  Respond quickly and calmly

25 CPR: When the crisis happens, the first pulse to take is your own  Bring in outside counsel Internal staff simply cannot be objective and callous Outside counsel can confront CEO, MDs, angry Board chairman, et al

26 CPR: The crisis is upon us  ID and prioritize the affected audiences Employees and closest in audiences are always first, usually forgotten –Employees in an info vacuum = rumors –Employees receiving bad or misleading info = critics –Employees receiving frequent updates and info = community info representatives Validate your statements to media ID and counter rumors Able to be productive and do their jobs Then – who else is affected???

27 CPR: The crisis is upon us  Get the facts – divide up the work if needed  Assess the damage potential Overreaction is dangerous – poll if needed But in a 24/7 news environment, with patients/advocates who see the role coverage can play, assume it will go public sooner rather than later  Frame the messages FIRST, before obsessing about channels Do NOT write by committee!

28 CPR: The crisis is upon us  The message must: Focus on the harmed party – NOT “we” Be utterly candid – “I don’t know that now” is OK, no comment is not Begin with statement of compassion –Know how to apologize or at least express regret Accept blame if an error has been made –Assume there WILL be a lawsuit someday –Worry about court of public opinion NOW

29 CPR: The crisis is upon us  The message must also SHOW as well as say Prove it! What steps are you going to take? What steps have already been taken?

30 CPR: The crisis is upon us  Get to your internal audiences BEFORE they see the coverage and stay in touch Employees Board, governance Physicians KEY community opinion leaders Patients, past patients  Stay below radar – e/vmail, CEO phone calls, employee meetings – but assume everything will go public  USE your website!!!!

31 CPR: The crisis is upon us  Monitor media coverage – correct rumors or misinformation  Monitor public opinion, formally and informally  Know when to go back to “normal” mode  Make sure management is still flying the plane!

32 Case in Point: Let’s Practice CPR

33 Case in point: The Duke Disaster  Looking from the outside in – which is precisely the perspective of the institution’s key audiences  CORE PROBLEM was how caregivers managed (not) relationship with patient’s family “ Conflict between caregivers and the patient’s supporters” -- Dr. Davis The story “suddenly” became public – should not have been a surprise

34 Duke  Let situation fester and worsen  Did not bring in professional PR counsel  Initial comments bad – “We do hundreds of these, we don’ t make mistakes, this is a tragedy for US”  Spokespersons not charismatic  WW syndrome “Patient’s supporters” (they are a FAMILY) “These things happen”

35 Duke  Did things by the book, but didn’t seem to comprehend how that plays to public Refused second opinion on brain death  Never seemed to get it together After Jessica died, spokesperson said “he could not confirm” whether 2 nd opinion was requested Doctors and admins “not available for comment” ’60 Minutes’ not bad – until the end, when surgeon said ‘these things happen’ – sounding cold, irresponsible

36 Duke is not an isolated case  HCOs generally tend to believe they are infallible “This could not have happened” “We do not make mistakes like this” “We have procedures in place and followed them”  The public thinks: It did. You did. So what?

37 It’s now a brand new world  The medical error issue will not go away, even without cases like Jessica  “Inappropriate” deaths are inevitable and unavoidable, as are all kinds of other errors  Media smell blood in the water  HCOs that are deficient in good patient relationship skills increase the likelihood of family going public

38 So the next Duke could be you  Have the conversations, the scenario planning, the bitter fights over who will speak, what will be said – NOW  AND strengthen and refine reputation building program so that the goodwill bank will be as full as possible when the crisis hits!

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