The Healthcare Public Relations and Marketing Society of Greater New York hosted a breakfast seminar Thursday, Dec. 1, on the do’s and don’ts of crisis communications.

Brian Conway, vice president, communications, Greater New York Hospital Association, and Marcia Horowitz, senior executive vice president and head of the Crisis Management Group at Rubenstein Associates, discussed:

• What materials healthcare organizations should have prepared and ready for any unexpected event;
• How social media has changed the game;
• The types of talking points that may serve senior management well;
• The potential challenges and value of internal communications during a crisis; and
• Opportunities for post-crisis follow-up.

Following are highlights of the presentations:

MARCIA HOROWITZ

Hospitals and Crisis Communications

There are a variety of crisis situations that can arise for hospitals and doctors, said Horowitz:

• Outside forces: blackout, hurricane, earthquake, fire
• A mistake during an operation or something unexpected happens
• MRSA, legionnaire’s disease, hepatitis, other viruses and infections spread through water or air in the hospital that can affect staff and patients
• Employee issues ranging from a nurse’s strike and health insurance issues to individual allegations of discrimination,  harassment, etc.
• Noted patients and dealing with confidentiality

HIPPA Regulations and the Release of Patient Information

The federally mandated Health Insurance Portability and Accountability Act of 1996 (HIPAA) went into effect in April 2003 at health care institutions across the country, said Horowitz. HIPAA changed patient privacy standards and has limited hospitals’ ability to release information about patients to the media and public. The following information helps clarify what patient information a spokesperson may (or may not) legally release to the media:

•        Under HIPAA, hospitals must ask each patient (or their legal representative) if he or she agrees to disclose information about his or her stay at the hospital. Patients may opt to refuse the release of information (including the fact that they are currently patients) or to limit the information released.

•        A member of the media must have a patient’s name in order to ask for information. A patient’s condition will be provided only if that patient has approved the release of information. No additional or detailed information beyond the condition will be provided about the patient.

•       If the media does not ask for the patient by name, no individual identifiable information about the patient may be legally disclosed by the hospital.

•       For patients who die at the hospital, the hospital may not release any information without the written authorization of next of kin.

Do’s and Don’ts

Do:

•       Remember HIPPA.  It can help or hurt you depending on the situation. You can't defend your actions or even confirm the existence of a patient at your hospital, but you can use it as a shield to deflect discussion about the details of an incident.

•       Form a crisis team. Organize your critical team members, such as the internal and external public relations/press staff, internal and external attorneys, hospital officials.  Designate one or two spokespeople on a particular issue, to keep facts straight and consistent.

•       Know your facts. Regardless of what you ultimately say or do, an internal or external review of the situation is usually warranted.

•       Remind your staff not to speak to reporters. Have all calls referred to one or two central people in the press office.  This should be standard media policy so that when you put out the notice, it is to remind them of the policy, not make it appear to be new due to the situation.

•       Remember your audiences.  Consider all the audiences affected and/or important to you.  In some cases, this can range from phone calls to board members to emails to employees who appreciate knowing about something before they read or hear about it in the media.

•       Return phone calls. Call reporters back even if you have nothing to say.  Find out what the questions are as much as possible so that you can prepare accordingly.

•       Express Cooperation.  Although you won’t know much at first, make this statement broad.  Things can change.

•       Draft message points. Following appropriate review, focus on three or four points and emphasize these during conversations, as part of written statements, and in answering questions. Put together an internal Q&A, especially of the hardest questions. 

•       Update your messages and statements. Statements are often reactive at first, but can be proactive thereafter.  If you conduct an internal investigation and find deficiencies, announce your plan to fix them before you are told you must. If you have conducted an internal investigation and found a lawsuit to be without merit, use this information as part of your statement.

•       Protect yourself by putting it in writing. Ask reporters to email questions and respond by email. This helps prevent knee-jerk reactions and insures accuracy in reporting.

•       Designate who should serve as official spokespersons. This way the messages are consistent and controlled.  Depending on the situation, if you don’t want to look like you are hiding, have a media-trained doctor or a hospital official speak rather than a press person.  Also, balance the need to show you take the situation seriously with the need to shield top doctors and hospital executives.

•       Use the Internet.  As needed, the intranet or website can help to get out your message.  After the dust settles, try to add content online that is positive to help elevate positive news in search engine results.

•       Monitor social media sites.  Monitor Twitter, blogs, comments, etc.

•       Correct inaccuracies. If information in an article is incorrect, consider writing a letter to the editor to set the record straight.  For the online version of an article, ask for a correction.

•       Consider advertising. If it is the only way to get your message across in a positive way, look into newspaper, or radio ads in targeted media, reaching your audience.

Don’t:

•       Don’t lie.  “If you don’t lie, you won’t have to remember what you said.” – Mark Twain

•       Don’t blame someone else. In addition to possibly getting into legal trouble by libeling or defaming someone, you can create detractors in the press by being perceived as deflecting blame and failing to take responsibility.

•       Don’t wing it. If you receive a question you do not know the answer to, say you will get back to the reporter.

•       Don’t go on camera or do a radio interview. You don’t want to say anything in the public eye before you know the answer to every potential question.

•       Don’t say too much. Statements should be short so a reporter can’t condense what gets used.

•       Don’t assume your communications are confidential. Be aware of what you are saying in emails and other correspondence and just consider them “public.” In case of litigation, an attorney should be part of any email chain.

•       Don’t forget to be caring. If someone was injured or died, regardless of culpability, express sympathy for the family.  Portray your hospital as a caring institution.

BRIAN CONWAY

Form a Crisis Team

First, select a spokesperson, said Conway. Ideally, it’s the CEO, but it doesn’t have to be.

Make sure a high-ranking communications person is on the crisis team.

While “war rooms” are cliché, they are also important. The ideal war room is a straightforward expansion of day-to-day procedures, rather than a radical change in normal operating procedures. Events are happening so fast, there’s no substitute for face-to-face communication and instruction.

Know Your Facts

Fact: You won’t know everything. While “no comment” is never OK, “I don’t know, but I promise to try to get the answer and get back to you” is sometimes exactly right, advised Conway.

Also, use the Internet and monitor social media sites.

Lessons Learned

• The critical importance of up-to-date lists (email, phone, cell, even fax). Have multiple hard copies of these lists in case power goes down
• Redundant communications (telephones, cellphones, email, 800MHz radios)
• Have an emergency contact directory, with key information for local, state and federal agencies.
• Use the Health Emergency Response Data System (HERDS), which collects data on beds, staffing and supply needs/availability, as well as event-related data (number of patients seen, waiting to be seen, admissions, unidentified patients, mortalities).

Considerations

Before an emergency:

• Maintain up-to-date media lists. Have copies at your desk, in your travel bag, and at home. Have media contacts in your iPhone and BlackBerry.

During an emergency:

• Set up a communications center with phones, computers, hard-copy media lists.
• Remind all staff of media policies, and direct all calls to the communications center.
• Review key messages and develop written materials.
• Prepare for a phenomenal amount of calls – around the clock.
• Designate tasks: fielding calls, writing press releases and statements, coordinating interviews with the spokesperson, etc.
• Anticipate questions. Reporters always want/need numbers and data. Accept that reporters act differently during emergencies.
• Speed is crucial. Public perception of how you handled an emergency is largely determined by the speed and consistency with which you delivered information.

After an emergency:

• Be a harsh judge of yourself. What worked well? What needed improvement? What resources would have improved your efforts? Was your message the right one?

For more information on the Healthcare Public Relations and Marketing Society of Greater New York, visit their website at hprmsny.org