Just my two cents

Musings on social media and the world as I see it


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Managing a hospital crisis in the new media world

A crisis. Most hospitals have one at some point. If your organization hasn’t faced one yet, it will. Whether a local disaster fills your ED to overflowing or a sentinel event occurs and makes the headlines, your staff and your board will need to know what happened, and the media will probably be camped outside your front door. For the communications team, it’s all hands on deck.

While every situation is unique, when it comes to communication surrounding a crisis, there are general rules that apply to all. I believe that being visible, honest and timely are the most important.

In a crisis, the last thing you should do is assume it will all blow over, or that word will not get out. Definitely not true, particularly in the age of Twitter, Facebook and other forms of social media. Playing possum will not make the situation go away. To use an old advertising tagline, “inquiring minds want to know.”

When something happens in a hospital, you need to quickly assess the situation, develop your course of action and key messages, identify the best spokesperson and address the situation head on.

If you’re not visible and discussing the matter publicly, you’re leaving the facts open to interpretation. So many recent scandals provide the support for this argument. Consider Tiger Woods, who still hasn’t spoken publicly, and South Carolina Gov. Mark Sanford, who disappeared for days and was less than candid about his whereabouts. This isn’t exactly the best approach when responding to a crisis.

Being honest
While there may be details that should not or cannot be made publicly known about the situation at hand, recognizing the situation, taking responsibility for the event and providing the overall facts are absolutely for any crisis response, regardless of your audience.

A crisis can damage a reputation quickly, but not recognizing the crisis or not responding can be even more damaging. An appropriate response can go a long way to maintaining or rebuilding trust.

Of course while some things are more easily forgiven than others, an “I’m sorry” can go a long way toward rebuilding trust with your community (consider the legislation now being proposed to make the “I’m sorry” clause for doctors a law). Public recognition of the situation and the apology must come from a trusted source, and determining the appropriate spokesperson can greatly impact the success of your crisis communication response.

Being timely
The concept of “timely” has changed quite a bit in recent years. Five years ago, your crisis response would be timed to a news cycle, with your internal audiences of staff and the hospital board notified in advance of the general public. But that news cycle no longer exists with the rise of social media. Information flows 24/7 and it is not from typical news sources. The emergency plan landing on New York’s Hudson River and news of Michael Jackson’s death, for example, were both reported first on Twitter.

When a crisis happens in your hospital, there are lots of people examining the situation from many angles – senior leaders, risk management, legal, medial directors, communications/media relations, etc. This will have an impact on just how timely you can be, but it is the communications professional’s responsibility to produce the right communications at the right time.

Given today’s myriad of communication tools, you should make use of all of them to get your response out there. If you provide a statement to the media, post it on your web site. If you have a recorded message from your president, post that on your web site and link to it through Twitter. If you have a Facebook account, post your video there and post your official statement on your Facebook fan page.

Remember — it’s about being visible, honest and timely. And because of the way news is now communicated, you must assume that your audience is not just local anymore. Sending a statement to your local television station or doing an interview with your hometown paper is not an adequate response. In a true crisis, you can expect e-mails and web postings from people internationally who may have never heard your brand name before, but they will now. That is the world we live in today.

So those are the basic rules. Are they always followed in every situation? Unfortunately, no, but they should be!

This post was originally written for and appeared on www.hospitalimpact.org.


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Why is it so hard for hospital staff to follow HIPAA rules in social media?

HIPAA is a common term in hospitals. If your hospital or health system is like ours, you spend a lot of time training, reminding and testing all employees on what is covered by HIPAA laws. For the most part, I believe employees understand the law and what they need to do to protect our patients and their privacy. Hospital employees sign agreements and promise to uphold their end of the deal, realizing there will be consequences if there are violations.

But for some strange reason, when it comes to social networks, employees seem to forget they are bound by those same regulations.

There have been numerous reports of breaches of patient privacy through social media outlets lately. Just this week, the LA Times storyreported that staff members were fired from St. Mary Medical Center in California, and another three were disciplined after posting photos of a dying man on Facebook rather than treating him.

In June, Tri-City Medical Center, also in California, terminated five employees and disciplined another after discovering they used “social media to post their personal discussions concerning hospital patients.” The hospital issued a statement on their website apologizing for the breach and how they were addressing it. (Applause for the transparency!)

As disturbing as they are, stories like these and others are popping up in the national news and it’s unsettling for everyone. There is something to learn from this though, and it is not that we need to ban social media from our hospitals. Social media is a powerful, evolving medium that allows us to communicate vital information and to hear from, and engage with, members of our communities. It should not be ignored. In fact, I strongly believe it should be embraced by hospitals as another way to reach out to their communities.

The stories of these breaches simply underscore the vital need for having strong policies in place that address the use of social media within and outside of the hospital. Employees need to know and understand that they are accountable for upholding the HIPAA laws even when they leave the hospital. That includes when they enter chat rooms, social networking sites or even their own blogs. In addition, human resources departments must be on board in recognizing that HIPAA laws extend to the use of social networks and any breaches of patient confidentiality through these means will result in disciplinary action.

Ed Bennett is the director of Web strategy for the University of Maryland Medical System. He also manages a blog which provides a wealth of information on hospitals and social media. The site provides a nice list of publicly published policies. It’s a great resource for hospitals, and can help in developing a new policy or tweaking an existing one to address social media specifically.

I am still confused as to why hospital staff members would ever think it was okay to reveal privileged patient information through any means, especially one as public as social media. Perhaps these changes in the way we communicate call for not only new and revised policies but also for additional training and signed agreements for staff to further understand the ramifications of violating HIPAA through social networks. What are your thoughts?

This post was originally writtten for and appeared on www.hospitalimpact.org.