Crisis Communications Management

When Duke University Health System discovered in December 2004 that patients at Durham Regional Hospital and Duke Health Raleigh Hospital had been exposed to instruments accidentally cleaned with used hydraulic fluid rather than detergent, the system had a classic public relations (PR) crisis on its hands.

In a PR best practices approach, Duke should have told the truth, told it all and told it fast. However, this is not the approach that Duke University chose to take. Instead of reining in the runaway freight train, Duke stepped back and let the patients and the media charge ahead and tell the story themselves, and the result was not favorable to Duke.

When the worst happens, one of the first steps a company should take is to act quickly and decisively to tell their side of the story to the media. Usually this strategy ends the PR crisis much sooner than simply remaining silent, because saying nothing can often be the worst way to handle a crisis.

Duke said nothing to the media, and that error plunged them into a morass of negative publicity. When news reports began to surface of patients with post-operative problems they thought might have been caused by the tainted instruments, Duke’s reaction created the impression that the hospital was trying to conceal the facts or evade responsibility.

The Art of Crisis Management

1. A leader must step forward and take ownership of the problem.
2. The spokesperson should tell the truth, tell it all and tell it fast.
3. The spokesperson should not take a defensive, defiant stand, but instead, offer the wronged party a sincere apology in as personal a manner as possible.
4. The organization must take steps to ensure the problem never occurs again and let everyone know what these steps are and that the organization is taking them.

In letters sent in early January to patients, Duke did provide the name and number of a medical officer as a contact for patients experiencing problems. But the PR crisis was exacerbated when the hospital appeared to be dismissive of patients’ concerns, stating that a certain percentage of surgical patients experience complications, and besides, Duke’s November and December statistics were not any higher than the norm.

Citing cold statistics did not make any of the affected patients rest easier. An apology would have worked far better. A grassroots advocacy group, Sorry Works! indicates that hospitals and physicians should never withdraw behind a wall of silence, but should talk to families freely and openly. Patients want to hear an apology and an explanation of what happened. They want to be reassured that corrective action has been taken so that someone else will not be forced to go through what they did.

Patients often turn to lawyers out of anger and frustration when doctors and hospitals stop communicating with them. The widely-held belief among health professionals that admitting responsibility and apologizing will bring on malpractice suits and be used against them in court is a myth, according to Sorry Works!

What is surprising is that Duke failed to handle the hydraulic fluid incident any better after having gone through a previous PR crisis in 2003, when doctors transplanted a heart and lungs with the wrong blood type into a patient who subsequently died. The hospital also stayed silent for several days in that case.