A presentation by

Amit Sharma

MBA,B.Tech, SAP(HR), SHRM|PHR

 In

general? For an organisation? For government or bureaucracy? For a private company? In healthcare? In drug safety?

 The

nature of crisis
management model

Crisis Risk

Planning

assessment Risk management

communications Risk Communications

 Low

probability High impact Uncertain/ambiguous causes and effects Differential perceptions

 Safety Health Environment National

security

 Operational Reputation Credibility Financial

viability

stability Legal action

 Uncertainty/ambiguity Urgency

of response Strategic effects of decisions

 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

 Prevention Survival Successful

outcomes

 Positive

balance of success/failure

Incident
EXXON VALDEZ

Success outcomes
- Financial losses were bearable - Costs relating to clean-up were less than pre-emptive costs - Image management recovered the Companys reputation in business community

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 Companys reputation in wider community

TYLENOL TAMPERIN G

- Swift reactions reinforced Company reputation for integrity - Stakeholders reported high degree of trust - Product did not suffer in long term

- Perpetrator was never identified - Future attempts cannot therefore be precluded

 Has

organisational capacity been restored? Have losses been minimised? Have lessons been learned?

Antecedent conditions

Intrinsic crisis

Perceived crisis Immature crisis response

Mature crisis management Review and Feedback

Culture or environment
Open

bow doors / poor safety culture

Smoker

/ poor cleaning standards

Crisis-prepared or crisis-prone?

Perceived crisis:
As

seen by all individuals from particular viewpoints

Total

situation as seen by neutral observer with all the facts

Antecedent conditions

Intrinsic crisis

Perceived crisis Immature crisis response

Mature crisis management Review and Feedback

Instant and irrational (denial/shock/panic)

 Grasp

of intrinsic crisis Implementation of plans and procedures

 Technical

intelligence Emotional intelligence

 Assessing

success and failure Feeding learning into future planning

Antecedent conditions

Intrinsic crisis

Perceived crisis Immature crisis response

Mature crisis management Review and Feedback

Ad hoc emergency reaction?

OR

Building management capacity to handle unforeseen events?

Crisis Management Planning Technical Intelligence Authorisation Procedures Crisis Management Implementation Integration of learning

Antecedent conditions Intrinsic crisis Perceived crisis Immature crisis response Mature crisis management Review and Feedback

Crisisprepared culture Emotional Intelligence

 Who? What? When? How?

 Ministers Officials Political Sponsors Voters International

The

parties

allies

public in general Tax-payers Consumer and lobby groups Lawyers The media ?

 Manufacturers Regulators Politicians Employees Health

The

professionals Pharmacists Academics

public Patients Consumer and lobby groups Lawyers The media ?

 Continuous

scanning (networks/media/ppu blic opinion, etc) Outward focus Collaboration Positive relationships

 Identification
define

and describe and consequences of risk

Estimation
likelihood

Evaluation
acceptability

Identification
Medication in question could be mistaken for sweets by young children Recall of a defective batch of medication may lower consumer confidence and take-up rate

Estimation
Medium chance leading to severe health problems or death High chance that public and media criticism will arise

Evaluation
Unacceptabl e

Acceptable

Identification
Medication in question could be mistaken for sweets by young children Recall of a defective batch of medication may lower consumer confidence and take-up rate

Estimation
Medium chance leading to severe health problems or death High chance that public and media criticism will arise

Evaluation
Unacceptabl e

Planning
Product needs to be re-designed to prevent the possibility Priority actions to sensitively withdraw product whilst reassuring honestly and openly

Acceptable

 Planning Resourcing Monitoring Controlling

 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

Core elements are:

audiences (Who?) How communication is to take place (How?) What messages are to be communicated (What?)

The core process is:

two-way communication

Ministers Officials Political parties Sponsors Voters International allies Tax-payers Manufacturers Politicians Health professionals Pharmacists Academics

Patients Shareholders Stock-market Regulators Senior executives Experts Employees The public Customers Consumer and lobby groups Lawyers The media ?

p er Grou Consum Dear ing the g at mana ess. h stand t under x busin e r You will a compl cares o s is ns drug me there are s natio o ti cern to t uch con m time Fro cause m h es whic cris dling of the han ne. everyo discuss ith you keen to o plan jointly w We are t ts, and ven ht best such e we mig w hers ho h you in such h and ot e wit establis municat . Wed like to com member stances ct between a circum a ne cont o one-to- am and ours your te of

Gather Intelligence

Complete a risk assessment

Produce plans to address risks

Promote crisis- ready culture

Publish plans and conduct training

Test, review and practice

1) 2) 3) 4) 5) 6) 7)

Full apology Corrective action Ingratiation Justification Excuse Denial Attack the attacker

 Acceptance

of responsibility Willingness to take positive steps

1) 2) 3) 4) 5) 6) 7)

Full apology Corrective action Ingratiation Justification Excuse Denial Attack the attacker

 Initial

response Lines to take

Tell the truth as it is known Facts beyond question Actions being taken Acknowledgement of emotions/psychological needs

 Essential

responses planned Each new authorised response is logged

board

Question

Is there a specific risk to Is the medicine aged patients from the known by any other medicine in question ? trade names? Feature editor Daily News by phone 2/2/02 Action to trace other trade marks is urgently proceeding Crisis team leader document dated 1/2/02

Source / Date Regional Health Authority secretary by phone 1/2/02 Line to take Patients over 65 and of frail health are considered to be high risk

Source / Date Professor Chang letter dated 2/2/02

 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

 Polite

and patient Well-informed and authoritative Accurate and reliable Articulate Available Trustworthy Evidently committed to the process

 No

drug is 100% safe Many drugs have potential side-effects and adverse effects Complexity of benefit-harm / effectiveness-risk Rational use of drugs

 Dramatic

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

emotional impact e.g. thalidomide and

Methods Telephone Hotlines Interviews News Releases Conferences Emails Enquiry Desks Web Site Mobile Offices

Primary Purpose Transmission X X X X X X X X X X X Access X X X

Antecedent conditions

Intrinsic crisis

Perceived crisis Immature crisis response

Mature crisis management Review and Feedback

Crisis Management Planning Technical Intelligence Authorisation Procedures Crisis Management Implementation Integration of learning

Antecedent conditions Intrinsic crisis Perceived crisis Immature crisis response Mature crisis management Review and Feedback

Crisisprepared culture Emotional Intelligence

Gather Intelligence

Complete a risk assessment

Produce plans to address risks

Promote crisis- ready culture

Publish plans and conduct training

Test, review and practice

 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

Factors increasing intolerance:

than voluntary, such as smoking or playing dangerous sports Unfairly distributed - some benefit whilst other suffer Inescapable - cannot be avoided by ones personal actions Unfamiliar - arising from a novel source Man-made - from other than natural sources

continued

Factors increasing intolerance:

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

 Adverse

effects Risk as a concept in medicine Benefit-harm Effectiveness-risk Public health versus profit Access to medicines
continued...

 Individual

patient variation and susceptibility Polypharmacy Relationship of allopathic and traditional medicines Resistance Diagnostic errors Prescribing errors Compliance issues

 Political

expediency Culture of secrecy Accountability Bureaucracy and inertia Hierarchy Process versus performance Complexity Workload Corruption

Topics covered: The nature of crisis Crisis management model Planning Risk assessment Risk management Crisis communications Learning from experience

and good luck!