Hospital crisis communication: A crisis knows no rules
Hospital crisis communication: A crisis knows no rules
Crises come in many shapes and sizes. Whether it’s poor hygiene, thefts or treatment errors – once the crisis has arrived, things need to move quickly. For hospitals in particular, the right crisis communication is key. Yet many medical facilities still neglect the fact that crisis communication starts before the actual crisis takes place.
The Schleswig-Holstein University Hospital (UKSH) in Kiel, Germany, was just at the center of attention in January of this year. The reason for this was the multidrug-resistant Acinetobacter baumannii, which infected 31 patients in critical care over several weeks. The media honed in on the UKSH due to its non-transparent communication.
A 74-year-old man contracted the germ during his trip to Turkey and brought it to the UKSH on December 11, 2014. The UKSH however did not issue a press release until January 23, 2015, in which it stated that the germ was detected in 12 patients and that no more patients would be admitted until further notice. At the same time, it disclosed that three patients had already been infected prior to January, though the first phase of transmission had subsided, yet the germ had now caused outbreaks again.
Since an admission freeze by an intensive care unit is typically a rare occurrence, the press release raised more questions than it actually answered. What caused further uncertainty was the fact that the hospital only revealed after press inquiries that five of the infected patients had died and that it could not definitely preclude the germ being the cause of this. The evidence appeared very non-transparent. The UKSH increasingly became the focus of public attention.
The German Coalition for Patient Safety (German: Deutsche Stiftung Patientenschutz), DSP, accused the UKSH Kiel of being overwhelmed in managing multidrug-resistant germs and the infected patients. “Patient Zero” was said to have been admitted without having undergone any extended screening. What’s more, the public health authority wasn’t informed until December 24. The initial measures had subsequently not been sufficient. DSP President Eugen Brysch, also spoke about relativization and trivialization of the situation due to the hospital’s differentiation between the original disease and the germ in the Stern.
In the German newspaper Berliner Morgenpost, Professor Klaus-Dieter Zastrow, Board Member of the German Society for Hospital Hygiene (German: Deutsche Gesellschaft für Krankenhaushygiene), criticized that the germ had to have been transmitted through physicians or nursing staff and hygiene regulations therefore had to have been neglected. The Welt reported that recommendations by the Robert Koch Institute Commission for Hospital Hygiene and Infectious Disease Prevention in Berlin were also said to have been ignored by the facility.
The public only gets “piecemeal“ information
Even though the UKSH Kiel press release stated that, it intends to be “proactive“ in approaching the public, the implementation was far from ideal.
Every two days a press conference was held on the current situation and the isolation of those patients, who are germ carriers. These were broadcasted via live stream at NDR.de. In addition, the persisting uncertainty was meant to be eased by a so-called "FAQ" section on the UKSH Kiel website. On January 29, there was also a Q&A session in the University Hospital’s lecture auditorium for family members, which apparently was only scantily frequented. This measure was intended to provide additional information to patients and family members, but it didn’t reach them.
Despite these efforts, the uncertainty rose to where neighboring rehabilitation facilities and other hospitals were no longer willing to admit patients of the UKSH Kiel and emergency patients didn’t want to be admitted to the University Hospital. Buzzwords like lack of hygiene, space shortage in the intensive care unit as well as lack of nursing and cleaning staff started circulating.
“Crisis communication begins before a crisis happens“
Crisis communication in hospitals and clinical facilities is no different from that of other institutions. The focus for all of them is primarily on maintaining credibility and building trust. A proactive approach forms the foundation for dealing with the public. The type of elements that only marginally applied to the communication by the UKSH Kiel.
According to Joachim Lück, communication strategy consultant and coach at the IKU_DIE DIALOGGESTALTER (Germany), best practices in crisis prevention for hospitals and medical facilities look like this:”Immediately after the crisis occurs, appear open and speak with one voice! There needs to be one representative, whether that’s the press officer, the chief of staff or head of department or chief physician of the respective medical department.“
Before a hospital goes public, it is important to establish a network of trustworthy journalists, explains Lück. This is typically a neglected step. “The press release is a message I need to deliver to the journalists. For them to trust me, I need to build trust, which can only be established in the medium or long-term and no longer at the moment the crisis becomes apparent.“ Any available and easy to obtain information should be proactively conveyed. Otherwise, the message conveyed is “we are hiding something.“ This is quite similar to a betrayal of trust.
This incident also turned into a “medium-scale disaster“, because it kept showing up in the media. “This might have been because the press release did not communicate all existing facts of the case. That’s when the media keeps asking and what highlights the facility in the media every day.“
The live broadcast of the press conference as well as the FAQ section might also have been the wrong means of communication. “This adds a dramatic effect to the facts, which sends all the wrong signals. It prompts patients and family members to form their own opinions via live stream. But people generally don’t do that. The FAQ section in turn is not designed for the average patient or family member. Of course, the correct wording is also an integral part of crisis communication.“
After the crisis is the time to get ready for the next crisis
Openness, information and the correct use of media channels in a prompt and proactive manner – that is the formula for success in crisis communication. “The press needs to report ‘the correct facts‘ and I need to make sure that they do,” Lück continues. Of course, you should let sleeping dogs lie. External communication always depends on the degree of crisis. This consideration should have already taken place ahead of time, meaning before the crisis took place to ensure transparent and open communication in an emergency.
An old proverb puts it in a nutshell: you learn from your mistakes. For Lück, this means that the UKSH Kiel should set up an internal task force to analyze the crisis. It helps to consult external experts to determine what went wrong. “Based on these factors, you then need to set up a ‘crisis‘ task force for the next crisis situation,“ says Lück. This recommendation applies to all hospitals and medical facilities, since there are plenty of reasons for crises.