Crisis Management A presentation by Bruce Hugman Consultant to the Uppsala Monitoring Centre...
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Transcript of Crisis Management A presentation by Bruce Hugman Consultant to the Uppsala Monitoring Centre...
CrisisCrisis ManagementManagement
A presentation byA presentation by
Bruce HugmanBruce HugmanConsultant to Consultant to the the Uppsala Monitoring CentreUppsala Monitoring Centre
Pretoria, September 2004Pretoria, September 2004
What is a crisis?What is a crisis?
In general?In general? For an For an
organisation?organisation? For government or For government or
bureaucracy?bureaucracy? For a private For a private
company?company? In healthcare?In healthcare? In drug safetyIn drug safety??
TopicsTopics
The nature of crisisThe nature of crisisCrisis management modelCrisis management model
PlanningPlanningRisk assessmentRisk assessmentRisk managementRisk management
Crisis communicationsCrisis communicationsRisk CommunicationsRisk Communications
Key features of a CrisisKey features of a Crisis
Low probabilityLow probabilityHigh impactHigh impactUncertain/ambiguous causes and Uncertain/ambiguous causes and
effectseffectsDifferential perceptionDifferential perceptionss
High level threats:High level threats:
SafetySafetyHealthHealthEnvironmentEnvironmentNational securityNational security
Specific threats to Specific threats to organisation:organisation:
Operational viabilityOperational viabilityReputationReputationCredibilityCredibilityFinancial stabilityFinancial stabilityLegalLegal action action
Consequential effects:Consequential effects:
Uncertainty/ambiguityUncertainty/ambiguityUrgency of responseUrgency of responseStrategic effects of decisionsStrategic effects of decisions
Common features of a Common features of a crisis:crisis:
The situation materialises unexpectedlyThe situation materialises unexpectedly Decisions are required urgentlyDecisions are required urgently Time is shortTime is short Specific threats are identifiedSpecific threats are identified Urgent demands for information are receivedUrgent demands for information are received There is sense of loss of controlThere is sense of loss of control Pressures build over timePressures build over time Routine business become increasingly difficultRoutine business become increasingly difficult Demands are made to identify someone to blameDemands are made to identify someone to blame Outsiders take an unaccustomed interestOutsiders take an unaccustomed interest Reputation suffersReputation suffers Communications are increasingly difficult to Communications are increasingly difficult to
managemanage
Purpose of crisis Purpose of crisis management:management:
PreventionPrevention SurvivalSurvival Successful Successful
outcomesoutcomes
Successful outcomes:Successful outcomes:
Positive balance of success/failurePositive balance of success/failure
- Perpetrator was never identified- Future attempts cannot therefore be precluded
- Swift reactions reinforced Company reputation for integrity- Stakeholders reported high degree of trust- Product did not suffer in long term
TYLENOL TAMPERING
- Long term costs were transferred to public- Delays in implementing clean-up leading to loss of wildlife.- Image management failed to fully recover the Company’s reputation in wider community
- Financial losses were bearable - Costs relating to clean-up were less than pre-emptive costs- Image management recovered the Company’s reputation in business community
EXXON VALDEZ
Failure outcomesSuccess outcomesIncident
Three criteria of success:Three criteria of success:
Has organisational capacity been Has organisational capacity been restored?restored?
Have losses been minimised?Have losses been minimised?Have lessons been learned?Have lessons been learned?
Crisis Management ModelCrisis Management ModelAntecedent conditions
Intrinsic crisisPerceived
crisis
Immature crisis
response
Mature crisis management
Review and Feedback
Existing conditions:Existing conditions:
Open bow doors / Open bow doors /
poor safety culturepoor safety culture
Smoker / poor Smoker / poor cleaning standardscleaning standards
Culture or Culture or
environmentenvironment
Existing conditions:Existing conditions:
Crisis-prepared Crisis-prepared
or crisis-prone?or crisis-prone?
Intrinsic crisis:Intrinsic crisis: Total situation as seen by neutral observer Total situation as seen by neutral observer
with all the factswith all the facts
As seen by all individuals from particular As seen by all individuals from particular viewpointsviewpoints
Perceived crisis:Perceived crisis:
Crisis Management ModelCrisis Management ModelAntecedent conditions
Intrinsic crisisPerceived
crisis
Immature crisis
response
Mature crisis management
Review and Feedback
Immature crisis Immature crisis response:response:
Instant and irrational Instant and irrational (denial/shock/panic)(denial/shock/panic)
Mature crisis management:Mature crisis management:
Grasp of intrinsic crisisGrasp of intrinsic crisis Implementation of plans and Implementation of plans and
proceduresprocedures
Mature crisis management:Mature crisis management:
Technical intelligenceTechnical intelligenceEmotional intelligenceEmotional intelligence
Review and feedback:Review and feedback:
Assessing success and failureAssessing success and failureFeeding learning into future planningFeeding learning into future planning
Crisis Management ModelCrisis Management ModelAntecedent conditions
Intrinsic crisisPerceived
crisis
Immature crisis
response
Mature crisis management
Review and Feedback
Management objective:Management objective:
Ad hoc emergency reaction?Ad hoc emergency reaction?
OROR
Building management capacity to Building management capacity to handle unforeseen events?handle unforeseen events?
End of Part 1End of Part 1
Part 2:Part 2: Planning for Crisis Planning for Crisis ManagementManagement
Integrationof learning
CrisisManagementImplementation
AuthorisationProcedures
TechnicalIntelligence
Crisis ManagementPlanning
Crisis Management ModelCrisis Management ModelAntecedent conditions
Intrinsic crisisPerceived
crisis
Immature crisis
response
Mature crisis management
Review and Feedback
Crisis-preparedculture
EmotionalIntelligence
Gathering intelligence:Gathering intelligence:
Who?Who?What?What?When?When?How?How?
Who for Government?Who for Government?
MinistersMinisters OfficialsOfficials Political partiesPolitical parties SponsorsSponsors VotersVoters International alliesInternational allies
The public in The public in generalgeneral
Tax-payersTax-payers Consumer and Consumer and
lobby groupslobby groups LawyersLawyers The mediaThe media ??
Who for medicine and drug Who for medicine and drug safety?safety?
ManufacturersManufacturers RegulatorsRegulators PoliticiansPoliticians EmployeesEmployees Health Health
professionalsprofessionals PharmacistsPharmacists AcademicsAcademics
The publicThe public PatientsPatients Consumer and Consumer and
lobby groupslobby groups LawyersLawyers The mediaThe media ??
The first goal of crisis The first goal of crisis management is management is
preventionprevention
Intelligence:Intelligence:
Continuous Continuous scanning scanning (networks/media/p(networks/media/ppublic opinion, etc)public opinion, etc)
Outward focusOutward focus CollaborationCollaboration Positive Positive
relationshipsrelationships
Assess risks
Risk assessment is:Risk assessment is:
IdentificationIdentificationdefine and describedefine and describe
EstimationEstimationlikelihood and consequenceslikelihood and consequences
EvaluationEvaluationacceptability of riskacceptability of risk
AcceptableHigh chance that public and media criticism will arise
Recall of a defective batch of medication may lower consumer confidence and take-up rate
Unacceptable
Medium chance leading to severe health problems or death
Medication in question could be mistaken for sweets by young children
EvaluationEstimationIdentification
Priority actions to sensitively withdraw product whilst reassuring honestly and openly
AcceptableHigh chance that public and media criticism will arise
Recall of a defective batch of medication may lower consumer confidence and take-up rate
Product needs to be re-designed to prevent the possibility
Unacceptable
Medium chance leading to severe health problems or death
Medication in question could be mistaken for sweets by young children
PlanningEvaluationEstimationIdentification
Risk management is:Risk management is:
PlanningPlanningResourcingResourcingMonitoringMonitoringControllingControlling
Crisis Planning:Crisis Planning:
Assess risksAssess risks Produce plansProduce plans Define roles and responsibilitiesDefine roles and responsibilities Appoint crisis management teamAppoint crisis management team Draw up communication planDraw up communication plan Produce contact and organisation chartProduce contact and organisation chart Promote crisis-ready culturePromote crisis-ready culture Publish plans and conduct trainingPublish plans and conduct training Test, review and practiseTest, review and practise
End of Part 2End of Part 2
Part 3:Part 3: Crisis Crisis CommunicationsCommunications
Communication plan:Communication plan:
Core elements are:Core elements are: Identifying audiences (Who?)Identifying audiences (Who?) How communication is to take place (How?)How communication is to take place (How?) What messages are to be communicated (What?)What messages are to be communicated (What?)
The core process is:The core process is: Active, two-way communicationActive, two-way communication
WhoWho matters and how will they matters and how will they be contacted?be contacted?
MinistersMinisters OfficialsOfficials Political partiesPolitical parties SponsorsSponsors VotersVoters International alliesInternational allies Tax-payersTax-payers ManufacturersManufacturers PoliticiansPoliticians Health professionalsHealth professionals PharmacistsPharmacists AcademicsAcademics
PatientsPatients ShareholdersShareholders Stock-marketStock-market RegulatorsRegulators Senior executivesSenior executives ExpertsExperts EmployeesEmployees The publicThe public CustomersCustomers Consumer and lobby Consumer and lobby
groupsgroups LawyersLawyers The mediaThe media ??
Dear Consumer Group
You will understand that managing
the nation’s drugs is a complex
business.
From time to time there are scares or
crises which cause much concern to
everyone.
We are keen to discuss the handling
of such events, and to plan jointly
with you and others how we might
best communicate with you in such
circumstances. We’d like to establish
one-to-one contact between a
member of your team and ours…
GatherIntelligence
Complete arisk
assessment
Produceplans to
address risks
Promotecrisis- ready
culture
Publish plansand conduct
training
Test, reviewand practice
Message Options Message Options [What?][What?]
1)1) Full apologyFull apology
2)2) Corrective actionCorrective action
3)3) IngratiationIngratiation
4)4) JustificationJustification
5)5) ExcuseExcuse
6)6) DenialDenial
7)7) Attack the attackerAttack the attacker
What does the world want to What does the world want to see?see?
Acceptance of responsibilityAcceptance of responsibilityWillingness to take positive stepsWillingness to take positive steps
Message Options:Message Options:
1)1) Full apologyFull apology
2)2) Corrective actionCorrective action
3)3) IngratiationIngratiation
4)4) JustificationJustification
5)5) ExcuseExcuse
6)6) DenialDenial
7)7) Attack the attackerAttack the attacker
Critical activities:Critical activities:
Initial responseInitial responseLines to takeLines to take
Initial response:Initial response:
Tell the truth as it is knownTell the truth as it is knownFacts beyond questionFacts beyond questionActions being takenActions being takenAcknowledgement of Acknowledgement of
emotions/psychological needsemotions/psychological needs
Lines to take:Lines to take:
Essential responses plannedEssential responses plannedEach new authorised response is Each new authorised response is
loggedloggedDatabaseDatabaseBookBookWallchartWallchartMessage boardMessage board
Question Is there a specific risk to aged patients from the medicine in question ?
Is the medicine known by any other trade names?
Source / Date
Regional Health Authority secretaryby phone 1/2/02
Feature editor Daily News by phone 2/2/02
Line to take Patients over 65 and of frail health are considered to be high risk
Action to trace other trade marks is urgently proceeding
Source / Date
Professor Changletter dated 2/2/02
Crisis team leaderdocument dated 1/2/02
Media demands Media demands [How?][How?]
Accuracy and simplicityAccuracy and simplicityStatistics which are explainedStatistics which are explainedContext of informationContext of informationComments from highest authorityComments from highest authoritySome controversial elementsSome controversial elementsBoth sides of the issueBoth sides of the issueSpeed, speed and speedSpeed, speed and speed
The ideal spokesperson:The ideal spokesperson:
Polite and patientPolite and patientWell-informed and authoritativeWell-informed and authoritativeAccurate and reliableAccurate and reliableArticulateArticulateAvailableAvailableTrustworthyTrustworthyEvidently committed to the processEvidently committed to the process
Continuing public information Continuing public information and educationand education
‘‘No drug is 100% safe’No drug is 100% safe’Many drugs have potential side-Many drugs have potential side-
effects and adverse effectseffects and adverse effectsComplexity of benefit-harm / Complexity of benefit-harm /
effectiveness-riskeffectiveness-riskRational use of drugsRational use of drugs
Elements increasing media Elements increasing media interest:interest:
Dramatic emotional impact e.g. thalidomide and Dramatic emotional impact e.g. thalidomide and childrenchildren
Large numbers affectedLarge numbers affected Unexpected links e.g. MMR vaccine and autismUnexpected links e.g. MMR vaccine and autism Polarised opinionsPolarised opinions Conflict e.g. health professionals vs. Conflict e.g. health professionals vs.
pharmaceutical companies, or between pharmaceutical companies, or between professionalsprofessionals
Geography e.g. proximity to own country, hospital Geography e.g. proximity to own country, hospital etcetc
Emotive pigeonholes e.g. ‘miracle drug’, ‘poison’Emotive pigeonholes e.g. ‘miracle drug’, ‘poison’ Links to celebritiesLinks to celebrities
XXXWeb Site
XMobile Offices
XEnquiry Desks
XXEmails
XXConferences
XNews Releases
XXInterviews
XHotlines
XXTelephone
AccessTransmission
Primary PurposeMethods
Crisis Management ModelCrisis Management ModelAntecedent conditions
Intrinsic crisisPerceived
crisis
Immature crisis
response
Mature crisis management
Review and Feedback
Integrationof learning
CrisisManagementImplementation
AuthorisationProcedures
TechnicalIntelligence
Crisis ManagementPlanning
Crisis Management ModelCrisis Management ModelAntecedent conditions
Intrinsic crisisPerceived
crisis
Immature crisis
response
Mature crisis management
Review and Feedback
Crisis-preparedculture
EmotionalIntelligence
GatherIntelligence
Complete arisk
assessment
Produceplans to
address risks
Promotecrisis- ready
culture
Publish plansand conduct
training
Test, reviewand practice
End of Part 3End of Part 3
Part 4:Part 4: Communicating RiskCommunicating Risk
Communication of riskCommunication of risk
Very poor public grasp of risk and Very poor public grasp of risk and risk statisticsrisk statistics
Confusion between Confusion between relative/absolute/reference/ relative/absolute/reference/ attributable riskattributable risk
Variable perception/tolerance of Variable perception/tolerance of different kinds of riskdifferent kinds of risk
Fantasy of a ‘safe drug’Fantasy of a ‘safe drug’
Perception of riskPerception of risk
Factors increasing intolerance:Factors increasing intolerance: InvoluntaryInvoluntary - e.g. exposure to pollution rather - e.g. exposure to pollution rather
than voluntary, such as smoking or playing than voluntary, such as smoking or playing dangerous sportsdangerous sports
Unfairly distributedUnfairly distributed - some benefit whilst other - some benefit whilst other suffersuffer
InescapableInescapable - cannot be avoided by one’s - cannot be avoided by one’s personal actionspersonal actions
UnfamiliarUnfamiliar - arising from a novel source - arising from a novel source Man-madeMan-made - from other than natural sources - from other than natural sources
continued…continued…
Perception of riskPerception of risk
Factors increasing intolerance:Factors increasing intolerance: Hidden/irreversibleHidden/irreversible - e.g. effects damaging but - e.g. effects damaging but
concealed for yearsconcealed for years Affects posterityAffects posterity - threatens children, births or - threatens children, births or
future generationsfuture generations Particularly dreadfulParticularly dreadful - e.g. distressing - e.g. distressing
symptoms or social rejectionsymptoms or social rejection Victims identifiableVictims identifiable - e.g. a particular blood - e.g. a particular blood
type or social grouptype or social group Scientifically obscureScientifically obscure - new or rare - new or rare ContradictedContradicted - argued by responsible sources - argued by responsible sources
Problematic issues in drug Problematic issues in drug safety:safety:
Adverse effectsAdverse effectsRisk as a concept in medicineRisk as a concept in medicineBenefit-harmBenefit-harmEffectiveness-riskEffectiveness-riskPublic health versus profitPublic health versus profitAccess to medicinesAccess to medicines
continued...continued...
Problematic issues in drug Problematic issues in drug safety:safety:
Individual patient variation and Individual patient variation and susceptibilitysusceptibility
PolypharmacyPolypharmacy Relationship of allopathic and traditional Relationship of allopathic and traditional
medicinesmedicines ResistanceResistance Diagnostic errorsDiagnostic errors Prescribing errorsPrescribing errors Compliance issuesCompliance issues
Risk Factors for Government Risk Factors for Government OfficialsOfficials
Political expediencyPolitical expediency Culture of secrecyCulture of secrecy AccountabilityAccountability Bureaucracy and inertiaBureaucracy and inertia HierarchyHierarchy Process versus performanceProcess versus performance ComplexityComplexity WorkloadWorkload CorruptionCorruption
SummarySummary
Topics covered:Topics covered:The nature of crisisThe nature of crisisCrisis management modelCrisis management modelPlanningPlanningRisk assessmentRisk assessmentRisk managementRisk managementCrisis communicationsCrisis communicationsLearning from experienceLearning from experience
and good luck!(though luck has nothing to do with good crisis management!)