Seven steps for surviving a public health care crisis

Proven techniques for dealing with disaster

Keeping the public calm, disseminating information, and ensuring public safety are among the most important tasks to be undertaken in a crisis. But one expert says preparations often go undone until the crisis actually occurs. Peter Goelz, senior vice president and director/worldwide crisis communications for Washington, DC-based APCO, says the health care community, including hospitals and home health care agencies, should be ready with a plan in the event the worst happens.

So, in light of Sept. 11, who did well?

According to a straw poll taken during a recent meeting of public affairs and relations professionals from around the country, the White House, and the New York City mayor’s office rose to the occasion; the Postal Service did an excellent job of containing the threat of anthrax but was weak in several arenas; and public trust faltered slightly because of poor communication. The Centers for Disease Control and Prevention in Atlanta also stumbled when it came to getting the word out to people who feared they might be infected with anthrax.

The health care industry, says Goelz, "needs to work at providing more information not less in times of crisis, and the recent anthrax cases are a prime example. No one knew who should be tested and when, how accurate the tests were, or where to go to get tested. They should have had more sources of information and better communicated to people that this is the health profile of someone with a possible infection, if you meet these criteria you need to follow these steps.

"No one in the health field is ready on this level," he says. "The health care system must prepare itself to address future threats and determine how it will communicate plans to the public."

Planning for an unknown crisis may seem daunting, but there are a few basic rules all agencies should have as part of their plans:

• Be prepared. The best plan allows for your company to keep vulnerability away, Goelz says. A hospital should implement security checks of all visitors and even staff, as well as develop plans for direct and indirect threats (i.e. pinpointing possible areas from where infection could spread). "It boils down to due diligence in terms of the systems you implement," he says.

• Educate your people. A hospital should be certain that its staff are familiar with the new safety procedures and feel comfortable acting on them, for example, questioning people without an ID badge or who are on the wrong floor. "It’s also vital that there be 24-hour assistance and a number that employees can call if they need information or have something to share," explains Goelz.

• Define ways to get accurate information to people. This means both your staff and the public at large, Goelz notes. If you’re worried about getting the information out — and noticed — by staff members, take a page from David Chilcote’s plans. Chilcote, an administrative director with Community Home Services Inc. in (Naples, FL), says he uses a variety of methods to spread the word about policy changes and the like. "We encourage participating members to share the word with their co-workers and test pilot the change with a small group and make updates to ease the burden."

Chilcote also makes use of his agency’s communications vehicles including using the voice mail program and the monthly in-house newsletter to mass notify all staff members that there has been a policy change. Additionally, Community Home Services requires that all changes are included in orientations and competency trainings.

Laresa Boyle, RHIA, business office/medical records coordinator, at CRH Home Health Agency in Cushing, OK, also has a suggestion for getting information out to staff. "Our clinical supervisor makes up a coordination of service [COS] memo weekly with any changes, updates, etc., and every employee is given one in their box and a copy is kept in a three-ring notebook as well. All clinical staff meet once a week for COS and the memo is then read out loud."

• Develop scenarios that will help your agency or hospital deal with a given crisis. Be it something as basic as stopping the spread of infection or as unlikely as coping with a terrorist attack, preparation is essential to a smooth running and successful crisis plan.

Seven crisis communication principles

Once you have a plan in place, half the battle is won. With any luck you’ll never face the second half — dealing with a crisis in a public arena. If you suddenly find that your agency or hospital is in the public spotlight, don’t panic. There are proven steps that can help you weather the storm and come out on top.

• Act in the public interest. Now is not the time to worry about your agency’s bottom line, says Goelz. "You have to put the public interest before economic interest. If you don’t, you can be sure that you will be held accountable for it down the road."

• Lead, don’t follow. With a plan in place you can hit the ground running in the event that your agency is struck with a public health crisis, such as being the point of contamination for a highly infectious disease. Step up to the plate, he advises, announce your plan, implement it and keep the public informed as to how it’s going.

• Move quickly. Your agency or hospital should be the one to come out and admit there is a problem, rather than wait for the media to expose one. Rumors move quickly and dispelling them not only can take up energy that should be devoted elsewhere, but can prove to be the downfall of a company.

• Fix the problem. If your agency is determined to be a point of contamination, take every step to see that that outlet is shut down.

• Communicate forthrightly. If your agency is to survive, he cautions, you must be honest about what happened and why. The public has a little patience for misinformation and half-truths, he notes, but a long memory when it comes to deception.

• Show compassion. The public welfare should be a company’s first concern and that care should be communicated through every action a company takes following a crisis.

• Restore credibility. Demonstrate your agency’s viability by continuing with strong safety measures or strict anti-infection policies. Remember actions, at times, do speak louder than words.

[For more information, contact:

• Laresa Boyle, RHIA, Business Office/Medical Records Coordinator, CRH Home Health Agency, Cushing Regional Hospital Home Health, P.O. Box 1409, Cushing, OK 74023. Telephone: (918) 225-2915.

• David Chilcote, ACSW, Administrative Director, Community Home Services Inc., 851 Fifth Ave. N., Suite 203, Naples, FL 34102. Telephone: (941) 263-7113.

• Peter Goelz, Senior Vice President, Director, Worldwide Crisis Communications, APCO, 1615 L St. N.W., Suite 900, Washington, D.C. 20036. Telephone: (202) 778-1000.]