Crisis Management

A presentation by
Bruce Hugman
Consultant to the Uppsala Monitoring Centre
Pretoria, September 2004
 What is a crisis?
 In general?
 For an organisation?
 For government or
bureaucracy?
 For a private
company?
 In healthcare?
 In drug safety?
 Topics
 The nature of crisis
Crisis management model
 Planning
Risk assessment
Risk management
 Crisis communications
 Risk Communications
 Key features of a Crisis
 Low probability
 High impact
 Uncertain/ambiguous causes and
effects
 Differential perceptions
 High level threats:
 Safety
 Health
 Environment
 National security
 Specific threats to
organisation:
 Operational viability
 Reputation
 Credibility
 Financial stability
 Legal action
 Consequential effects:
 Uncertainty/ambiguity
 Urgency of response
 Strategic effects of decisions
Common features of a crisis:
 The situation materialises unexpectedly
 Decisions are required urgently
 Time is short
 Specific threats are identified
 Urgent demands for information are received
 There is sense of loss of control
 Pressures build over time
 Routine business become increasingly difficult
 Demands are made to identify someone to blame
 Outsiders take an unaccustomed interest
 Reputation suffers
 Communications are increasingly difficult to
manage
 Purpose of crisis
management:
 Prevention
 Survival
 Successful
outcomes
 Successful outcomes:
 Positive balance of success/failure
Incident Success outcomes
EXXON - Financial losses were
VALDEZ bearable
- Costs relating to clean-up
were less than pre-emptive
costs
- Image management
recovered the Company’s
reputation in business
community
TYLENOL - Swift reactions reinforced
TAMPERING Company reputation for
integrity
- Stakeholders reported high
degree of trust
- Product did not suffer in
long term
Failure outcomes
- 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
- Perpetrator was never
identified
- Future attempts cannot
therefore be precluded
 Three criteria of success:
 Has organisational capacity been
restored?
 Have losses been minimised?
 Have lessons been learned?
Crisis Management Model
Antecedent
conditions

Intrinsic crisis Perceived crisis

Immature crisis
response

Mature crisis
management

Review and Feedback

 Existing conditions:
Culture or
environment

 Open bow doors /

poor safety culture

 Smoker / poor cleaning

standards
Existing conditions:
Crisis-prepared
or crisis-prone?
Perceived crisis:
As seen by all individuals from particular
viewpoints

Intrinsic crisis:
 Total situation as seen by neutral observer
with all the facts
Crisis Management Model
Antecedent
conditions

Intrinsic crisis Perceived crisis

Immature crisis
response

Mature crisis
management

Review and Feedback

Immature crisis
response:
Instant and irrational
(denial/shock/panic)
 Mature crisis management:
 Grasp of intrinsic crisis
 Implementation of plans and
procedures
 Mature crisis management:
 Technical intelligence
 Emotional intelligence
 Review and feedback:
 Assessing success and failure
 Feeding learning into future planning
Crisis Management Model
Antecedent
conditions

Intrinsic crisis Perceived crisis

Immature crisis
response

Mature crisis
management

Review and Feedback

 Management objective:

 Ad hoc emergency reaction?

OR

 Building management capacity to

handle unforeseen events?
End of Part 1
Part 2:
Planning for Crisis
Management
 Crisis Management Model
Crisis Crisis-
Management Antecedent prepared
Planning conditions culture

Technical Emotional
Intelligence Intrinsic crisis Perceived crisis Intelligence

Authorisation Immature crisis

Procedures response

Crisis
Management Mature crisis
Implementation management

Integration Review and Feedback

of learning
 Gathering intelligence:
 Who?
 What?
 When?
 How?
 Who for Government?
 Ministers  The public in
 Officials general
 Political parties  Tax-payers
 Sponsors  Consumer and
 Voters lobby groups
 International allies  Lawyers
 The media
?
 Who for medicine and drug
safety?
 Manufacturers  The public
 Regulators  Patients
 Politicians  Consumer and
 Employees lobby groups
 Health  Lawyers
professionals  The media
 Pharmacists ?
 Academics
The first goal of crisis
management is
prevention
 Intelligence:
 Continuous
scanning
(networks/media/p
public opinion, etc)
 Outward focus
 Collaboration
 Positive
relationships
Assess risks
 Risk assessment is:
 Identification
define and describe
 Estimation
likelihood and consequences
 Evaluation
acceptability of risk
Identification Estimation Evaluation

Medication in question Medium chance leading Unacceptable

could be mistaken for to severe health
sweets by young problems or death
children

Recall of a defective High chance that public Acceptable

batch of medication may and media criticism will
lower consumer arise
confidence and take-up
rate
Identification Estimation Evaluation Planning
Medication in Medium chance Unacceptable Product needs to
question could be leading to severe be re-designed
mistaken for sweets health problems to prevent the
by young children or death possibility

Recall of a defective High chance that Acceptable Priority actions to

batch of medication public and media sensitively
may lower criticism will arise withdraw product
consumer whilst reassuring
confidence and honestly and
take-up rate openly
 Risk management is:
 Planning
 Resourcing
 Monitoring
 Controlling
 Crisis Planning:
 Assess risks
 Produce plans
 Define roles and responsibilities
 Appoint crisis management team
 Draw up communication plan
 Produce contact and organisation chart
 Promote crisis-ready culture
 Publish plans and conduct training
 Test, review and practise
End of Part 2
Part 3:
Crisis Communications
 Communication plan:
Core elements are:
 Identifying audiences (Who?)
 How communication is to take place (How?)
 What messages are to be communicated (What?)

The core process is:

 Active, two-way communication
 Who matters and how will they
be contacted?
 Ministers  Patients
 Officials  Shareholders
 Political parties  Stock-market
 Sponsors  Regulators
 Voters  Senior executives
 International allies  Experts
 Tax-payers  Employees
 Manufacturers  The public
 Politicians  Customers
 Health professionals  Consumer and lobby groups
 Pharmacists  Lawyers
 Academics  The media
 ?
 e r Gr o up
Dear C onsum t h e
a n ag i n g
d th a t m .
de rs t a n s in e s s
w il l u n m p le x bu r
You u g s i s a c o
e s c a r e s o
n ’s d r he r e a r
natio to t im e t
n c e r n t o
m t im e u c h c o
Fro ch c a u s e m
e s w h i f
cris h a n d l in g o
ne . t h e
everyo e n t o d i sc u s s
n t ly w i t h y o u
k e j o i
We are s , a nd t o p l a n
s t
v e n t h t b e
such e h ow w e m i g
h
o t h e r s in s u c
and w it h y ou t a b l is h
u n ic a t e k e t o e s
comm W e’ d li e m b e r
t a n c e s . e e n a m
circum s c t b e t w
e c on t a
- o n
one-to a m a n d o u r s…
r te
of you
 Gather
Intelligence

Complete a
risk
assessment

Produce Promote
plans to crisis-ready
address risks culture

Publish plans
and conduct
training

Test, review
and practice
 Message Options [What?]
1) Full apology
2) Corrective action
3) Ingratiation
4) Justification
5) Excuse
6) Denial
7) Attack the attacker
 What does the world want to
see?
 Acceptance of responsibility
 Willingness to take positive steps
 Message Options:
1) Full apology
2) Corrective action
3) Ingratiation
4) Justification
5) Excuse
6) Denial
7) Attack the attacker
 Critical activities:
 Initial response
 Lines to take
 Initial response:
Tell the truth as it is known
 Facts beyond question
 Actions being taken
 Acknowledgement of
emotions/psychological needs
 Lines to take:
 Essential responses planned
 Each new authorised response is logged
Database
Book
Wallchart
Message board
Question Is there a specific risk Is the medicine
to aged patients from known by any
the medicine in other trade
question ? names?
Source / Date Regional Health Feature editor
Authority secretary Daily News by
by phone 1/2/02 phone 2/2/02

Line to take Patients over 65 and of Action to trace

frail health are other trade marks
considered to be high is urgently
risk proceeding
Source / Date Professor Chang Crisis team leader
letter dated 2/2/02 document dated
1/2/02
 Media demands [How?]
 Accuracy and simplicity
 Statistics which are explained
 Context of information
 Comments from highest authority
 Some controversial elements
 Both sides of the issue
 Speed, speed and speed
 The ideal spokesperson:
 Polite and patient
 Well-informed and authoritative
 Accurate and reliable
 Articulate
 Available
 Trustworthy
 Evidently committed to the process
 Continuing public information
and education
 ‘No drug is 100% safe’
 Many drugs have potential side-effects
and adverse effects
 Complexity of benefit-harm /
effectiveness-risk
 Rational use of drugs
 Elements increasing media
interest:
 Dramatic emotional impact e.g. thalidomide and
children
 Large numbers affected
 Unexpected links e.g. MMR vaccine and autism
 Polarised opinions
 Conflict e.g. health professionals vs.
pharmaceutical companies, or between
professionals
 Geography e.g. proximity to own country, hospital
etc
 Emotive pigeonholes e.g. ‘miracle drug’, ‘poison’
 Links to celebrities
Methods Primary Purpose
Transmission Access
Telephone X X
Hotlines X
Interviews X X
News Releases X
Conferences X X
Emails X X
Enquiry Desks X
Web Site X X
Mobile Offices X
Crisis Management Model
Antecedent
conditions

Intrinsic crisis Perceived crisis

Immature crisis
response

Mature crisis
management

Review and Feedback

 Crisis Management Model
Crisis Crisis-
Management Antecedent prepared
Planning conditions culture

Technical Emotional
Intelligence Intrinsic crisis Perceived crisis Intelligence

Authorisation Immature crisis

Procedures response

Crisis
Management Mature crisis
Implementation management

Integration Review and Feedback

of learning
 Gather
Intelligence

Complete a
risk
assessment

Produce Promote
plans to crisis-ready
address risks culture

Publish plans
and conduct
training

Test, review
and practice
End of Part 3
Part 4:
Communicating Risk
 Communication of risk
 Very poor public grasp of risk and risk
statistics
 Confusion between
relative/absolute/reference/
attributable risk
 Variable perception/tolerance of
different kinds of risk
 Fantasy of a ‘safe drug’
 Perception of risk
Factors increasing intolerance:
 Involuntary - e.g. exposure to pollution rather
than voluntary, such as smoking or playing
dangerous sports
 Unfairly distributed - some benefit whilst other
suffer
 Inescapable - cannot be avoided by one’s
personal actions
 Unfamiliar - arising from a novel source
 Man-made - from other than natural sources
continued…
 Perception of risk
Factors increasing intolerance:
 Hidden/irreversible - e.g. effects damaging but
concealed for years
 Affects posterity - threatens children, births or
future generations
 Particularly dreadful - e.g. distressing
symptoms or social rejection
 Victims identifiable - e.g. a particular blood type
or social group
 Scientifically obscure - new or rare
 Contradicted - argued by responsible sources
 Problematic issues in drug
safety:
 Adverse effects
 Risk as a concept in medicine
 Benefit-harm
 Effectiveness-risk
 Public health versus profit
 Access to medicines
continued...
 Problematic issues in drug
safety:
 Individual patient variation and
susceptibility
 Polypharmacy
 Relationship of allopathic and traditional
medicines
 Resistance
 Diagnostic errors
 Prescribing errors
 Compliance issues
 Risk Factors for Government
Officials
 Political expediency
 Culture of secrecy
 Accountability
 Bureaucracy and inertia
 Hierarchy
 Process versus performance
 Complexity
 Workload
 Corruption
 Summary
Topics covered:
 The nature of crisis
 Crisis management model
 Planning
 Risk assessment
 Risk management
 Crisis communications
 Learning from experience
 and good luck!
(though luck has nothing to do with good
crisis management!)