Ashley McCown
Ashley McCown

There’s no other setting quite like a hospital. The heightened vulnerability and emotional state of those who are admitted — sick or injured — can be a volatile mix. That’s just one reason these environments demand the highest level of professionalism and ethical behavior from administrators, medical professionals and staff. When those standards aren’t upheld, the institution’s reputation and ability to fulfill its mission can easily be compromised. From medical errors to data breaches, disease outbreaks and workplace violence, healthcare organizations are among those at greatest risk for a public relations crisis.

Earlier this year, security staff from the University of Maryland Medical Center in Baltimore left a patient, wearing only a hospital gown and socks, at a bus stop in the freezing cold after she’d visited the emergency room. After video of the woman in distress, taken by a doctor who happened to be walking by, was shared widely on social media, UMMC was heavily criticized for failing to provide compassionate care by engaging in a practice widely known as “patient dumping.” The investigation by the Centers for Medicare & Medicaid Services cited the hospital for several failures.

O'Dwyer's Jan. '19 PR Buyer's Guide & Crisis Communications MagazineThis article is featured in O'Dwyer's Jan. '19 PR Buyer's Guide & Crisis Communications Magazine

In June, El Camino Hospital in California came under fire when a video of patient mistreatment went viral. This one showed an ER doctor mocking a patient having an anxiety attack. In a written statement, the hospital’s chief executive called the doctor’s demeanor “unprofessional” and “not the standard we require of all who provide care.” The doctor was removed from the work schedule pending further investigation, and apologies were offered to the patient.

Even in healthcare, most crises can be anticipated and planned for so that small situations are managed effectively and do not spiral out of control. Here are our recommendations to ensure a hospital is crisis-ready:

Assess vulnerabilities. News programs including “60 Minutes” have investigated “patient dumping,” and yet UMMC was seemingly still engaging in this inexcusable and inhumane practice. The hospital should’ve had clear procedures for discharging patients with no known address. Communications staff should work with HR and legal to ensure everyone delivering care understands that patient dumping is completely unacceptable and, in that vein, to take an objective look at all areas where the institution may be vulnerable and at risk including workplace violence, data breaches, sexual harassment/misconduct, regulatory investigations and strikes/union activity. Hospitals need to dedicate senior level attention and resources to sound crisis planning and should make it a priority across the institution.

Proper training. Often, we think crises originate from outside our organizations. It would be easy to blame social media for the two crises discussed earlier. However, both of those incidents were triggered by staff conducting themselves in a way that was inconsistent with the hospitals’ mission and standards of care. While the general public, media and regulators are critical stakeholders, patients and employees are the most important audiences. It’s not just about having the right protocols in place; clear expectations must be communicated to staff.

Define the crisis team. Identify key roles and assign responsibilities. Make sure each person on the team truly understands their own responsibilities and where those fit within the framework of communications procedures. Ensure every role has a backup in case that person is unavailable when a crisis strikes.

Closely and carefully monitor social media. Hospitals should also have experienced communicators on the team who really know how to listen to and monitor social media and who know what steps to take if accusations start flying. Media often pick up and run with controversial videos before they contact the organization for comment. Both these situations started and blew up on social media. Early detection of damaging videos or social posts means a hospital can more effectively respond before they are shared for hours and hours and picked up by the media without the hospital commenting.

Develop a crisis communications plan. A communications plan should be a living document that can be regularly updated and adjusted as personnel and other factors change. Develop clear communications procedures for crises the organization is most likely to face and map out how to respond — across audiences and platforms including social media.

Draft holding statements in advance. Identifying the range of vulnerabilities a hospital wants to prepare for also means it can have some language at-the-ready to address those situations. As part of the crisis plans we develop, we regularly draft holding statements for a wide variety of scenarios. These statements are reviewed and approved in advance by legal counsel, so there’s a bank of easily adaptable language ready to use. Once a crisis strikes and the clock is ticking, it is very hard to determine the right thing to say to the media, patients, Boards of Trustees and regulators, get it approved by multiple reviewers and distributed. This forward-thinking approach can make the difference between responding to media inquiries within an hour or two as opposed to a day, and after several news cycles have come and gone.

Drill, drill, drill. Recent polls suggest that while 75 percent of organizations have some sort of crisis plan, the same percentage has low confidence in that plan’s effectiveness. Having a plan is just the first step. Being able to effectively execute against that framework is paramount. Remember, plans don’t work if they are gathering dust on a shelf or have not been exercised. I recall a time when I was participating on a panel about crisis planning and one of my fellow panelists shared that his organization had a crisis plan and defined Crisis Response Team. However, the first time the team ever met and relied on their plan was when a major data breach had occurred. Regular training and table-top exercises ensure your plan is current and crisis ready and so is your response team. Crisis plans should be updated annually and phone trees for the Crisis Respond Team quarterly.

Share best practices. I share the above examples not to point fingers, but to learn from them. Sound crisis planning isn’t a one and done exercise. It’s a long-term commitment and discipline. Learning from each other and sharing best practices will ensure hospitals are in the best possible position to protect their institutions.

For hospitals and those working in healthcare, it’s not a question of “if” but “when.” How leadership plans for/responds to a crisis will determine how quickly that organization bounces back and whether it sustains any long-term damage to its hard-earned reputation.


Ashley McCown is President of Solomon McCown & Company.