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11 Nov

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Crisis Communications and Ebola

November 11, 2014 | By |

There is a saying that the first casualty of war is the truth. It is similar in a crisis, where the first risk is misinformation. Many organizations respond to the fear of saying the wrong thing by saying nothing. This unfortunately leads to the news media reporting on information from “unofficial” (read: often wrong) sources. However, when an organization releases a statement, then rescinds, then corrects, and then corrects again, this can lead to even more confusion and creates an impression of chaos.

Such was the unfortunate case at Texas Health Presbyterian Hospital in Dallas when they found themselves at the center of national panic over Ebola when treating Eric Duncan, a patient who had recently been in Liberia. We don’t have to review the basics of the case of how the patient was sent home from the emergency department with some antibiotics, only to return several days later with full-blown symptoms and, sadly, contagion. Then later, nurses treating the patient came down with the virus.

The Texas hospital was not the first in the United States to treat a patient with Ebola. That honor fell to Emory University Hospital in Atlanta. The difference was that Emory University had advanced warning that a patient, a health care worker, was being flown by private charter from East Africa. The public relations team had time to strategize about messages and get ahead of the communications. Although they came under harsh criticism—courtesy of some hysterical media outlets that fomented the fear—they were able to get ahead of the story by focusing on the unique facilities and expertise of their hospital to care for patients with Ebola.

Texas Health was caught by surprise not only to have a patient but by the impression that it botched the care of the patient. The PR team did the right thing by being open about the case and explaining their understanding of events. Unfortunately, they had to backtrack on numerous occasions. First, they blamed miscommunication among the emergency department staff. Then they blamed the workflow built into the electronic medical record.

It is a tricky balancing act, trying to be forthcoming and transparent, yet making sure the information is correct. In the commotion that occurs in a crisis, it can feel like playing “chicken” by stopping to ask a fundamental question, “What is the strategic message we want to convey?” rather than just the litany of facts.

It’s easy to critique the performance of the hospital’s communications team from the comfort of my office. Having worked through several major national news stories at academic medical centers, I can empathize with the team. We, in fact, don’t know what was really happening behind the scenes, and the facts as we know them were damning indeed. The PR team was dealing with apparent breaches of protocol, which is difficult to manage under the best of circumstances.

That said, there is one primary guiding principle that should be the litmus test for all crisis communications, courtesy of the philosopher Aristotle—logos, pathos, ethos. Before you make a statement, as these questions:

Logos—is it factually true? Be an internal investigative journalist and double check your sources. Don’t just take the word of the attending physician, or the charge nurse. Ask others. In other words, “Trust, but verify.”
Pathos—humans are emotional, institutions are not. In this case, putting a physician out in front of the cameras humanized the story. Anonymous “statements,” clearly parlayed by the lawyers, does nothing to connect humans to a very human story.

Ethos—is it credible? Platitudes about “patient and employee safety is our utmost priority” may or may not be true, but when the evidence at the time contradicts it, it’s time to re-evaluate the statement.

Again, we don’t want to pick on the Texas hospital. There are plenty of examples of poor communications around Ebola, from the CDC to New York’s mayor and governor. Perhaps all spokespersons in health care can learn, and sympathize, with the very difficult situation their colleagues in Texas continue to face. While the case in Texas forced the CDC to revise its protocols and moved hospitals around the country to revisit its own preparedness, so too must health care communicators revisit their own policies and procedures for communicating in a crisis so they are prepared.