Your hospital is in the news — but not for good news

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MODERN HEALTHCARE: Now, let’s dive into our conversation with Rosemary Plorin. She’s sharing her insight on how health systems can prepare for and navigate bad press.

MODERN HEALTHCARE: Hello, Rosemary. How are you doing?

ROSEMARY PLORIN: I am so well, Kadesha. Thanks so much for having me.

MODERN HEALTHCARE: Thank you. So, to kind of frame our discussion, I want to start with three data points before we get into our questions. At the height of the pandemic, 9 out of 10 Americans approved of how hospitals were navigating the crisis. That’s the first data point. Hospitals’ handling of COVID-19 was rated the highest among institutions — above schools, above the government, and above the media.

And lastly, nearly 70% of consumers say a hospital’s reputation is either very or extremely important in choosing where they receive care. We’re talking about how hospitals can deal with publicity that is not so good. So, let’s talk about preparation first. When they know something will lead to bad press like a lawsuit or a CEO leaving unexpectedly, how should they prepare for it and who should be involved in that preparation?

ROSEMARY PLORIN: Hospitals tend to think of those issues that you just referenced and many more as being crises. In fact, urgent crises are actually really pretty rare. Most crises start as issues that organizations have a line of sight to for weeks or months. You know, like a leadership change. Barring a tornado or other types of truly urgent emergencies. Many organizations and particularly hospitals — they’ve been just so overwhelmed, much more than people understand. They’re busy. So, they’re losing precious time in hoping that an issue won’t materialize into a crisis. And put off planning, and you really hinder yourself. Anticipating what types of crises you might experience and having a response structure is really key to anticipating the scenarios and trying to avoid the operational impacts, the reputational impacts, etc. that come along.

You can’t contemplate every possible crisis. I can tell you that two years ago, the overwhelming majority of hospitals never contemplated an actual pandemic. Now, they may have had something in their emergency response plans about a very virulent illness or something along that. But we never anticipated this would be what our world will look like for such a long period of time. You have to have a good understanding of where your organization is, where it has potential vulnerabilities, and contemplating what your response structure will look like. So, who will be involved and when? A crisis response team. And a good plan will think through all of those steps so that you have a structure in place. And it’s not the same group every time, right?

MODERN HEALTHCARE: Right.

ROSEMARY PLORIN: If it’s a clinical issue, you need to have clinicians at the table. If it’s a regulatory issue, you need to have lawyers and compliance people at the table. Honestly, you probably need to have lawyers at the table for almost all crises. But a good plan thinks ahead on those types of things and gives people good, clear lines of address as to how you’re going to tackle the issue, how you’re going to plan for it, how you’re going to respond when it happens, and how you’re going to manage your recover.

MODERN HEALTHCARE: As much as you can plan, absolutely do that so that you’re not blindsided by things that were already in the works. Let’s talk about what types of things are sort of not worth your time. You know, the bad press happens or the bad story hits, and maybe it’s not worth whipping out your crisis plan for it because it’ll blow over. Can you think of types of bad press fallout that are just not worth the time and which ones health systems should pay attention to?

ROSEMARY PLORIN: It’s probably harder to contemplate the ones that aren’t worth the effort. The types of things that I would say almost always need to get very serious response and very quick are pretty reliable. Things like serious care allegations, abuse or neglect accusations, any kinds of allegations of discrimination — discrimination in care, in employment, in financial treatment, etc. Inappropriate billing and harsh collection policies, situations involving children. You know, those should almost always set off alarms for a hospital because of the way they’re going to be perceived and potentially distorted in the press. Those are also going to have a longer life.

It’s going to have a more serious implication for the hospital. Now is not the time to be really optimistic that your hospital is gonna squeak by and not get that attention, right? So, you need to be looking at your policies. You need to be looking at it from the lens of a critical viewer. And hospitals that do that find themselves in a much better situation. And able to shorten that news cycle from a week-long discussion that ends up triggering a call from the mayor, and city council, and your biggest donor — to keeping it contained to something much smaller.

MODERN HEALTHCARE: A good punch list of what to pay attention to and plan for. If you’re a rising leader and you find your health system caught in a storm of negativity, what are some of the top three key ingredients that health systems need to include in that plan and in that response?

ROSEMARY PLORIN: I’m going to sound a little philosophical here. The reason responses can feel tone-deaf or templated is because a lot of times, the organization behind it has said we need to check off these boxes and, you know, their lawyers have said, “Say nothing more than that.” And please, I’m not trying to discourage lawyers. We work with lawyers literally every day. In most instances, we’ll defer to a smart, thoughtful lawyer and say, you know, we’ll make the communications piece and work around that. As opposed to saying, you know what? Damn the torpedoes, we’re going to increase the risk of discovery for the organization.

Different conversation, but back to the key ingredients — and again, I’m going to say they’re maybe three key philosophies. First and foremost, you’ve got to have humanity in your response. Spokespeople need to be able to communicate and speak in a way that resonates with audiences and reflects an organization’s humanity. We care for people in life and death situations. And if you lead with the legal defense first, you are going to sound tone-deaf and inhumane every time. Not all spokespeople inherently have that sort of empathic skill. Some can be trained on it, some cannot. But it’s an important attribute both for individuals and for organizations, particularly if an organization has some actual fault in an issue.

A second sort of philosophical ingredient here would be authenticity. How does or should your organization’s mission impact your media responses and your public statements? How are your internal policies and your code of conduct reflected in how you’re speaking about or responding to a crisis? A hospital can really dig a hole for itself if there is a gap between what it is saying and how it operates. And we saw that last year in the responses to the George Floyd protests. Everybody rushed to get statements out, and sometimes there was no substance behind them. And organizations did themselves more harm than good. It is important to say things that are warm, and empathic, and empathetic as I said earlier. But if you say something that’s just flagrantly inconsistent with your operations, you’re going to bring on disservice to yourself.

Third ingredient I would say is authority. Organizations need to have authority both in their organizational purview and in who the spokespeople are, right? Because at the end of the day, most statements need to be attributed to an individual. So, how that plays out — nonclinical spokespeople should not make statements or answer questions of a clinical nature. And that’s not always the case. You know, we see CEOs wander a little too far into the clinical area sometimes. Be authentic. Make sure your organization and your spokespeople are authentic.

Similarly, marketing directors should not speak on behalf of a board of trust. And that’s a default for a lot of organizations, especially smaller ones. They put their marketing directors or their communications people in front of everything because quite frankly, leadership doesn’t want to do it. But there are things that a CEO needs to own. There are things that a board needs to own. Having the authority match the situation is also a key ingredient that if it’s left out of the equation, your messaging and your response posture can really fall short.

MID-SPONSOR MESSAGE: Before we continue our discussion, I’d like to again recognize Ontrak, the sponsor of today’s episode.
 
With just 5% of people accounting for 44% of healthcare costs, Ontrak identifies and treats those people for up to 52 weeks. With this unique sort of support, your members can achieve true behavior change and better health that can last a lifetime.
 
Learn more, save more, help more. Visit ontrak-inc.com.
 
Now, let’s get back to our discussion.

MODERN HEALTHCARE: You’ve mentioned sort of the time of reckoning that a lot of health systems have had to have over the last year around equity and social justice. You know, as health systems are kind of navigating a contentious history or background that can lead to what they see as bad press, how can they have these important conversations honestly, and then also plan for the future as they hopefully make progress?

ROSEMARY PLORIN: I’m just going to speak from the heart and be as serious as I can on this.

MODERN HEALTHCARE: Yeah.

ROSEMARY PLORIN: This is one of those areas that is so much bigger than communications or PR. And organizations — particularly hospitals which are mission driven and often not-for-profit organizations — they’re very emotional places where their patients and their customers have very strong relationships to their hospitals, right? Hospitals have got to embrace that DE&I discussions are much, much bigger than communications and PR. If any organization of any size or stripe is relegating issues of diversity and inclusion to the marketing or PR department, they’re missing the point — and it will show. I’m not trying to deflect this, but DE&I initiatives have got to start at the top. Back to that authenticity piece, they have got to saturate an organization. If you don’t have endorsement from the board, it is not going to fly. You’ve got to have relevance and involvement from all key areas of operations.

This is not something where you can say, “Marketing director, put together a plan for us on how we’re going to talk about these things.” Because nothing will change by the way, right? So, not just within your organization but within society. Your organization will feel a reckoning, eventually. It needs to be throughout an organization and when it is, and an organization is serious about it, the communications come very easily. Everyone is thinking about an organizational approach of how we can do better. So, the communications about DE&I are just icing on a cake. Very few people want to be served just icing.

And let me say — may or may not impact you when it comes to your ED or perhaps other services. But it is going to affect you in your recruiting, it’s going to affect you in your retention and down the line, it’s going to impact your revenues and how you perform.

MODERN HEALTHCARE: Absolutely. Let’s talk about other channels. What are your thoughts on how health systems should deal with these more homegrown forms of media? Blogs, podcasts where individuals are just sort of airing their views, but it’s reflecting negatively on the health system.

ROSEMARY PLORIN: You know, this is an area that I feel like healthcare communicators embraced early in the evolution of social media, which in the big scheme of things is really still fairly recent compared to other areas of hospital operations. Many of those best practices are still the same — three key points here that we always share with clients. Number one is, respond quickly. Social media moves so fast and bad news travels extra fast. Right?

MODERN HEALTHCARE: Yup.

ROSEMARY PLORIN: And if you’re not monitoring your organization’s presence on social media — on both your own and your non-owned assets — if you’re a day late, you could be a thousand comments deep. You’ve got to stay on top of monitoring how your brand is being portrayed on social media. And if you’re not, you’re rolling the dice.

Number two — and again, this is what we were saying ten years ago and it’s still very, very true — take the discussion offline. It’s amazing how a politely worded response like, “We’re so sorry to hear about your experience and we want to better understand what happened. We’ve sent you a DM privately.” Or “Here’s our patient advocate’s information. We’d really like to talk to you,” says that you care about the person and it sends a message to everyone who comes behind them.

Left unaddressed, that negative post is much more likely to generate more negative posts. We see it all the time. The last piece — it’s amazing how many organizations, businesses, individuals, etc. just can’t embrace this when the heat is on. Resist the urge to remove negative posts. It’s really a very extreme condition when we would suggest removing a post and taking other draconian measures like turning off posting capabilities, etc. If someone makes a critical comment on your hospital’s Facebook page and you remove the post, you’re effectively begging them to take their complaint to a different Facebook page or a different medium, and you have even less control over it there.

MODERN HEALTHCARE: Last question is similar but a different type of platform. So, we have review platforms. People come to these review platforms like Yelp, Google, specifically to check references on the healthcare organization. What about bad reviews? If hospitals are noticing an influx of bad reviews on these platforms, should they respond there as well? And if so, what should that response look like?

ROSEMARY PLORIN: This is an area that a shocking number of hospitals, physician practices, ASEs, etc., are still neglecting and it’s really surprising to me. Let’s take Google, in particular. You search for something on Google and you get the search results, and over on the top right, you’ve got something that Google calls their knowledge panel. And that knowledge panel includes the reviews and the star rating. That’s going to show up every time, right? So, if you have a 2-star review, especially if it’s on 50 or more reviews, you are telling people don’t go any further. Search for my competitor. I mean it’s right up there and we’ve been trained to see it. So, reviews and review sites are another area where an ounce of prevention can really, really pay off.

Certainly many hospitals that have really positive reviews and positive scores, high scores — they generally have at least two things in common. So, first an institutional commitment to positive patient experience and service recovery. When a hospital has a 2-star review on more than 50 reviews and they tell me it’s one disgruntled patient, I’m like sorry, you have a problem and you’re in denial. So, you actually have two problems. And then most of them have got some kind of review solicitation program where they’re asking all patients. How was your experience? We want to know. For a lot of providers, they say you know we already do HCAPs or Press Ganey. Of course, that’s important. You have to do that, you have to preserve that process.

But lots of hospitals and many physician practices, especially the ones that have really good reviews out there have figured out how to do this internally through a homegrown effort or more commonly, through an external process. And yes, it’s a little complicated. You know, Google is smart and if they see that all your positive reviews come through one conduit, they’re going be like, “We don’t believe these reviews.” Those are not going to show up. You’re going to be penalized for it. You have to invite all reviews — good and bad.

But back to the first point, if you’re delivering excellent service and you’re asking people for feedback, right there you are encouraging an open dialogue and encouraging positive along with the negative. It puts you in a position to not only improve your ratings but to learn a little something, right? And figure out where you’re disappointing or you’ve got gaps in service that you can address.

Hospitals are an ever more important and relevant player in their community. As difficult as this past year has been, hospitals are trusted places with high approval ratings. And communities know, even if they have a love-hate relationship with their hospital, they know they want a hospital in their community. And boy, if you give your team a little bandwidth and some resources to make sure they’re managing things like reputation — online reputation, community reputation — it really, really pays off in the long run because you’ve got fewer fires to put out.

MODERN HEALTHCARE: That’s right.

ROSEMARY PLORIN: Good reputations are not by accident. They’re really not.

MODERN HEALTHCARE: Awesome. Well, thank you so much for your time. Thank you so much for this insight and this homework. I feel like this is giving people homework.

ROSEMARY PLORIN: Thank you, Kadesha.

OUTRO COMMENTS: Thank you, Rosemary Plorin, for that insight on how health systems can deal with bad press.

We’d also like to again thank this episode’s sponsor, Ontrak.

Again, I’m your host, Kadesha Smith, CEO of CareContent. We help health systems reach their target audiences through digital marketing that focuses on the right content.

Look for more episodes of Next Up at modernhealthcare.com/podcasts, or subscribe at Apple Podcasts, Google Podcasts, or your preferred podcatcher. Thank you again for listening.

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