Hospital crisis management plan: communication, theory, and media response

Hospital Crisis Management Planning

The study of crisis management is one of the most written about issues of importance. This is true in part because crises can happen to any or all types of organizations (from businesses to community or governmental initiatives), and they can arise on a broad variety of levels. As such, they can be difficult to predict and to plan for at the same time that digital connectivity makes rapid and prepared responses all the more important.

There is much evidence that suggests that digital community building and the speed with which someone can access a wave of interconnected supporters will be most important in the future as crises arise. And this is particularly true for organizations such as hospitals, which carry out public benefit as well as profit obligations, making the potentials of crises even bigger. A hospital, for example, can have an internal crisis of its own (relating to a disease or professional faltering) or it could find itself a service part of the ongoing catastrophe, which may require it to have a continuing plan of action (see below) even if it gets drawn into the challenges.

Of course, to a certain extent this is what crisis management is all about. Others have defined the concept as the experience an organization has when it deal with "unwanted, unexpected, unprecedented, and almost unmanageable," activities that can cause uncertain impacts. Several researchers have noted that crises tend to be very ambiguous, are thought to have a low probability of occurring, and yet pose a true and deep a threat to an organization. In addition, they usually offer little time to permit a response, often surprise operating staff or other stakeholders, and can present a dilemma as to what needs to happen to correct the problems.

Shrivastava (1993) developed an early perspective on the 4C's of crisis management, which he identified as being the Causes, Consequences, Caution and Coping aspects of the inundation. These key aspects center on the immediate and quickly following conditions that brought the crisis about, the immediate and longer-term results that happen, the entity's measures taken to minimize try to minimize the effects, and any of the other results that are required to address the unexpected consequences.

More recently, however, another element has risen to importance. Though it can be said to be implied in the 4Cs, today it is separately identified as being the "crisis after the crisis." Much evidence suggests that what happens following the initial activities can be worse than the first impacts if care is not taken either in advance of such problems or to convey what happened. This may stem from the willingness of the public to extend some level of forgiveness during the event, or it could be that new media technologies make follow-up transparency more important. Those who have a tie to the organization may not like any kinds of apparent lack of honesty or failure to be forthright once the situation returns to normal.

As a consultant to a hospital I would ensure that I follow the traditional emergency planning steps (including educating and testing the plans) for regular urgent responses, and begin to provide a greater ongoing continuity of operations element that includes many of the steps of what at least one online poster has called Digital Governance, or the integration of social media and connectivity tools into the full environment of an organizations responses. Many traditional crisis action plans centered on going through the 4Cs with an expectation of returning to normal. The "crisis after the crisis" issue assumes a longer operational time and fits best when the issues impact organizations like hospitals that can be required to stay in the crisis as it unfolds. The following examples demonstrate some of the specifics of what my hospital plan and communication strategies would include:

PHARMACEUTICAL & MEDICAL DEVICES: In a recent posting by Hanvik (2011), he offers an Introduction to Digital Governance. The key components of his approach start with having hospitals and other medical services learn to foster a true understanding of digital activities and what they offer the hospital at all levels. This must include educating employees about how they work and their capabilities, linking their relevance to health care and community services, aligning digital connectivity to the full business and service expectations of the hospital, and generally ensuring that digital governance and communication is a healthcare way of life.

NATIONAL H1NI PANDEMIC: The 2009 global flu crisis gave many hospitals the chance to work with a similar new model. In a posting called Continuity of Operations Planning (COOP): Lessons Learned from the H1N1 Pandemic (Grady-Erickson, O and Saruwatari, M., 2009), the authors talk about the experience of hospital in generally learning to use the new COOP directives, which take a traditional Emergency Operational Plans and expand it. The COOP is for longer term challenges and includes ongoing management of healthcare even if the hospital itself becomes part of the crisis (in this case, if the staff got the flu). This approach was ordered into place by the nation's national security officials and got its first testing with the H1N1 pandemic. The document details how it was used and why it is a good model for other hospitals. It also discusses the new national security laws and other government publications that are beginning to mandate how hospitals should react. For example, on page three they demonstrate how the COOP elements have an origin in other emergency initiatives. As they say, "Additional EOP guidance comes from The Comprehensive Planning Guide 101 (CPG 101), which was developed by the U.S. Department of Homeland Security (DHS) and Federal Emergency Management Agency (FEMA)." This suggests how others will likely also begin using these methods.