HEALTHCARE is among some of the most crisis-prone industries in the United States, according to the Institute for Crisis Management (ICM). In 2005, it was ranked No. 8 in the list, which named pharmaceuticals, software makers and airlines in the top three. Healthcare-related incidents quickly make headlines; who hasn’t heard about the incident at Duke University Health System hospitals where surgical tools were washed in hydraulic fluid, or the time when Kaiser Permanente’s Northern California kidney transplant program fell under attack? In 2005, the family members of three individuals killed in a house fire sued a dialysis machine manufacturer, alleging the machine started the fire. These are all examples of crises that can develop instantly and require adept communications, media relations and reputation management by healthcare professionals.
Statistics confirm healthcare has its issues; the Institute of Medicine’s infamous 1998 report, “To Err is Human,” pronounced that as many as 98,000 people die from medical errors and adverse events in healthcare facilities annually, while a number of healthcare quality improvement agencies, along with the Centers for Disease Control and Prevention (CDC), confirm that as many as 2 million Americans develop infections while being treated in hospitals. Most clinicians consider these healthcare-acquired infections (HAIs) to be one of the most alarming crises the industry is facing to date, as rates of associated morbidity and mortality escalate rapidly. Healthcare professionals working in dialysis clinics should be aware that Staphylococcus aureus infections are a major cause of complications, morbidity and hospitalization in dialysis patients. In addition, outbreaks stemming from highly contagious bloodborne pathogens such as HIV and hepatitis B can pose a danger to patients, healthcare workers and members of the community at large.
Not only can a crisis threaten the lives of patients, it has the potential to present a moral, ethical and legal nightmare to the facility whose professional reputation and future operational viability hangs in the balance. A crisis is an occurrence that has the potential to disrupt an organization’s income sources, operating expenses, stock price, competitive position and ongoing business; in healthcare, you might add to that list anything that endangers patients and healthcare workers, including bioterrorism events, infectious outbreaks and other adverse events such as medical errors and “near-misses” that become public. Proper crisis communications matters because you—as an administrator or healthcare practitioner—are your facility’s front line against infectious threats and adverse events. You are the individual charged with helping to protect the safety and wellbeing of patients and healthcare workers.
The most effective crisis management occurs when potential crises are detected and dealt with quickly before they can impact the organization’s business. However, in healthcare, an outbreak or a catastrophe gives no warning, and a clinic or hospital may be caught off guard. In a 24/7 media-driven society, chances are the news media will discover this adverse event, and you face a complex agenda that encompasses information dissemination and damage control.
Healthcare organizations and clinics with an established strategy for responding to a crisis will be in a better position to minimize the impact of the event. It is critical for facilities to have an established crisis communications infrastructure already in place, including a crisis communication team whose members are tasked with specific, concrete actions to be taken in the midst of a crisis or infectious outbreak. This team should be comprised of individuals who are key to the situation, including the CEO, the chief of public relations, a senior manager or administrator, the risk manager, the organization’s legal counsel and anyone else who is pertinent to the organization.
Dealing with the Media
The main tenets of crisis communication are: Tell it all, tell it fast and tell the truth. This is especially important to remember when members of the media show up on your clinic’s doorstep demanding details. Responding quickly and efficiently to the media is critical to reputation management in the midst of any crisis; as soon as possible a prepared statement should be provided. This statement may be as simple as, “Facts are still being gathered but there will be a press conference, give me your name and number and I will call you back to let you know when.”
One of the first responsibilities of the crisis communication team should be to determine the appropriate positioning or message to address the emergency. In the case of an infectious outbreak or an adverse event at the clinic, the first priority is to gather information and present it to fellow workers and to the community. There should be a designated spokesperson, one individual who is knowledgeable about the nature of the crisis and who will help the organization present information and answer media questions throughout the crisis.
The media are hard-wired to find out about crises, and infections and outbreaks are on their radar more than ever in an age of public reporting. It’s essential that you know how to help your clinic deal with the media. While your clinic’s public relations person will bear the brunt of it, you can be an invaluable resource to him/her, or if you are in a small clinic without official communications staff, much of the work may fall to you.
Controlling the media interview process is key to managing the crisis. Do your homework and prepare for the tough questions that journalists will inevitably ask. Know the rules when interacting with the media. Engage in the “be-attitudes,” including: Be knowledgeable, be prepared, be honest and be accessible. Reporters may ask to speak to clinic staff that are involved with or have been affected by the crisis. It is best to restrict all interviews to the primary spokesperson, back-up spokesperson or technical expert. Controlling the interview process is key to managing the crisis; however, remember that reporters have the right to interview anyone they want to and if they don’t get the answers they want from you, they will get them somewhere. It is important to rehearse prepared statements and answers to potentially tough questions from reporters. While it is essential to be truthful in dealings with the media, don’t volunteer any information unless it is a point the clinic wants to make and the question hasn’t been asked. A few don’ts to keep in mind: don’t talk off the record, don’t speculate and don’t overreach your ability to provide information. As the crisis progresses, new facts will become available, and you will have a chance to update the media then. It also is advisable for healthcare professionals to help reporters understand complex healthcare concepts and information related to dialysis, infectious diseases, outbreaks and infection prevention so that accurate information will be disseminated to the public. Clinics should do what they can to eradicate a “fear mentality” that can creep into any healthcare-related crisis when an infectious outbreak is involved, for example.
When granting an interview with a reporter, try to obtain advanced knowledge of what you will be asked, if possible, and ensure you are prepared in detail. Begin the interview by making your most important point as the take-away message for the reporter, and try to maintain control of the interview. Set a time limit in advance and don’t allow the reporter to wear you down; he or she may repeat themselves in different ways to gain details you may not want to provide. After the interview, you can ask to check technical points, but do not ask to see advance copy of the story.
A clinic’s first reaction to a crisis may be to try to avoid the media, but the best course of action is to be forthcoming because the media will produce their stories with or without your assistance. So it is always in a healthcare organization’s best interest to participate in a story so that your position is represented correctly. Being non-responsive to the media is a losing proposition; remember that openness during a crisis enhances your respect and credibility with the media.
Enhance your Reputation
Your healthcare facility doesn’t have to be involved in a crisis for it to interact with members of the media. It is possible to foster good working relationships with your local and regional media in situations that don’t include an adverse event. The key to solid media relations is cultivating sources at news outlets, whether they are newspapers, radio stations or television stations, as well as building relationships in order to secure the kind of positive and fair coverage you want. There is a sizeable appetite for healthrelated news and information among the general public, and most editors and reporters realize this. They are looking for interesting stories that will engage, enlighten, educate and even entertain their readers and listeners, and your clinic may be in a perfect position to supply this kind of material.
For example, if your clinic is holding some kind of open house event in conjunction with National Kidney Month, it’s important that you promote this event to the local newspapers and television stations. Not only will it provide a colorful news bite, it can serve as a springboard for reporters to discuss topics such as chronic kidney disease, diabetes and the role dialysis plays in health maintenance. While there is no guarantee the media will attend your event, as it is competing against other hard and softer news stories for attention, communicating its worthiness is imperative. Creating a successful media event isn’t a mystery; it comes down to providing interesting people, interesting places and interesting subjects. If one of your patients has an intriguing story to tell, ask for their participation and get them in front of the camera. Or if one of your healthcare professionals is an outstanding member of the community, that deserves some ink.
Timing for a media event is critical to maximizing its potential, and providing the media with advance notice is key. Compile a list of all local and regional media outlets and update this regularly; it will be the backbone of your outreach efforts, whether by telephone, by email or by direct mail. Your main publicity tool will be the press release, which provides the who, what, when, where, why and how of your media event. A press release can not only announce an event, but it can be used as a backgrounder to help educate the media about dialysis-related issues. Your press release is the first interaction you will have with the media, so remember to make it accurate and complete. Touch upon the key elements of the event within the first paragraph, and then explain the purpose of the event in additional paragraphs, which will also include a quote from the spokesperson for your healthcare organization or clinic. Also be sure to include a brief description of your organization or facility. The most important thing to remember is to be succinct in all of your communications with the media; these journalists will appreciate your consideration of their multiple deadlines.
One last component of a good media relations plan is to consider the opportunities that exist to publish a bylined article in regional and national trade journals, such as Renal Business Today, and other professional publications. These titles know an industry inside and out and speak to pertinent issues in the field, they are read by your supervisors and colleagues, and they are used by vendors and manufacturers that have a direct impact on the dialysis industry. Healthcare publishing is a dynamic, ever-evolving industry in constant need of submissions from the professional community to remain viable and relevant to its readers. Your expert perspective is needed by healthcare publications because you are in the trenches and the best source of information about what works and what doesn’t in the real world. You have interesting ideas about how to improve business and clinical operations that can benefit others. And you have a feel for where the industry is heading and what future needs and issues are. Writing and getting published helps your career and makes your boss happy because not only do you demonstrate expertise and that reflects well on your entire department and healthcare facility, but you demonstrate leadership skills and initiative, you help others in their pursuit of education and information, and you help differentiate your clinic or healthcare organization.
To begin the process, send a well thought-out query to a publication’s editor, with a clear idea of the issue you want to write about and what you have to say. You can identify topics by determining what you know best, what concerns you, how you can help solve a problem, or how can you raise awareness of an issue and encourage further dialogue on this issue for the benefit of the larger healthcare community. But you should do your homework before querying an editor, including discovering what has already been written on this subject in the medical literature, what you can do to make the topic fresh, and determining what aspect of the issue has yet to be addressed. Have these things worked out before you call or email an editor to inquire about writing an article and you will get a much better reception.
When writing your article, use a clean, straightforward narrative style adopted by the newsmagazines such as Time or Newsweek. Write clearly, refraining from unnecessary complexity, jargon and fancy words, and write tightly, refraining from unnecessary verbiage. Do not plagiarize when gathering information; look for data in the public domain, or be sure to paraphrase and provide proper citations and references. Interview experts in your facility, community or national organization for additional information and material. Create an outline of your pertinent points and use it as the skeleton for the article. Start with a summary statement of the purpose or focus of the article, and then introduce facts and assertions in a logical order, using your research to back up your points. When you have finished your draft, put it away; come back to it with a fresh eye to determine if it needs reworking and editing. Have a trusted colleague read your work and offer suggestions. The editor of the publication will provide the safeguard of additional editing before the article is printed, but you will want to impress him/her with the quality of your work. RBT
Kelly M. Pyrek is the group editor of the medical division at Virgo Publishing LLC, and has 25 years of experience in magazine and newspaper publishing.