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The crisis is coming, be ready

Emergency situations are inevitable; how organisations handle them depends on how they prepare. 

“If you choose to not deal with an issue, then you give up your right of control over the issue and it will select the path of least resistance.”

So states Susan Del Gatto, in her book, Creating Balance in a World of Stress: Six key habits to avoid in order to reduce stress. Yes, a self-help book. By all accounts, it is selling quite nicely but not well enough. Why? Because although there are many people who identify signs of escalating issues in their lives and do something about them, there are many more who don’t until the stress has reached crisis point. We ignore our friends and colleagues. We tell ourselves the breakdown won’t happen to us.

Organisations are the same – aged care providers included.

The proposition that an aged-care provider will face an issue with the potential to seriously affect its operations and reputation is not an if but a when. The range of potential issues is rich and varied. Providers serve community members who are some of the most vulnerable, at-risk members of society. The stakeholder landscape is complex; the public scrutiny extreme; business failure has an immediate impact on lives.

Some issues, such as gastroenteritis outbreaks, are not uncommon but the media and general public view them with fear. The larger the gap in knowledge and understanding, the greater the outrage.

Why then, do so few aged-care providers have issues-management plans in place and staff drilled in responses for that day when they will be needed? Are we so certain it won’t happen to our company?

Over the past few months, there have been a string of issues the media has reported on, ranging from poor management practice to abuse and neglect. In all cases the providers have been large, reputable organisations. If issues-management planning had been in place, the crises might have been avoided. Monitoring and staff education could’ve kept the incident from taking place or enabled staff to handle it more effectively and expediently.

It is an obligation of aged-care providers who are responsible for the wellbeing of clients, residents, families and staff to ensure the company is prepared to face an escalating issue with confidence. Mismanagement not only harms the company and its brand, it affects community confidence and sector resilience. Consumer research and media reporting consistently point to uniformed and negative perceptions of aged care. An issue is like an earthquake: it may strike at one facility, but tremors are felt throughout the sector.

Issues and answers

There are several issues aged-care providers may face. Most can be foreseen and fall into certain categories. These include:

  • sanctions applied by the Aged Care Standards and Accreditation Agency (Aged Care Quality Agency) and other effects of non-compliance with regulations
  • rape and/or assault charges against carers, residents or family members
  • fraudulent activity by management and staff
  • fires or facility failure triggering operational emergency responses
  • disease outbreaks
  • real or contrived media tip-offs from disgruntled family members or ex-employees.

Issues management falls into three broad phases, each with a core set of actions.

The worst position to be in when facing an issue or crisis is unprepared. People notice; and their confidence in your ability to manage the situation quickly evaporates, making it harder for you to secure stakeholder support.

Have an issues-management plan in place. The plan should map likely issues, identify all stakeholders, define scenarios, outline response processes and articulate roles. Align this plan with your emergency and communications processes so that, when every second counts, they complement one another, rather than competing. Clearly define all aspects of issues management: people, systems, communication channels, materials, monitoring and messaging.

Ensure that staff members know their roles, and brief them on their responsibilities. These roles should be built into the position description and induction process for senior staff so they are aware of their responsibilities from the beginning. Staff should act out scenarios annually.

When crises hit, if facility leaders don’t feel supported, they will leave. There is a domino effect in which a lack of confidence in management and the sudden pressure felt by facility management leads to employees resigning, compounding the situation. In contrast, when employees are well prepared, valuable time is saved executing tasks.

Key personnel must also be clear on the roles of representatives from the department, agency, nurse adviser, regulators, emergency services and consumer advocates.

The media often plays a critical role in the escalation and management of a crisis. The CEO and/or senior leadership must be ready to face the media. They will have to be calm, well-informed and wise to journalistic tactics. Fidgeting, freezing, mumbling and stumbling all shout ‘incapable’. Anyone who doesn’t understand the job of the journalist – the objectives of each media outlet – and isn’t trained in responding to media inquiry under pressure, is highly likely to make mistakes. And once they are reported they never go away. Media training is match fitness for executives; don’t send them out unprepared.

Relationships in time of need

Whilst the spectre of media attention is enough to have people second guessing protocol, it is important to remember the media is not vital to the success of your operations. Consistency of care and stakeholder support will ensure the sustainability of the organisation well after the media has moved on to a burnt flambé on My Kitchen Rules.

Important relationships with stakeholders need to be nurtured throughout every year: the deeper the relationship, the greater the trust in management competency and the more vocal the support. Have well-articulated strategies and plans for engagement with community, health services, volunteers, donors and government. Should an issue arise, stakeholders will view the situation within the context of the company’s proud legacy and valuable contribution to society if good relationships are in place. If relationships are shallow, stakeholders will not risk their reputation on yours.

Think ahead. Secure written endorsements from opinion leaders such as MPs and local identities, for your good work, now.

When the crisis hits, press go on the issues-management plan. It requires rapid, regimented responses and reactions. Staff need to work together to mitigate risk to reputation and ongoing operations. The media policy needs to be reiterated.

The company must lead the response. The CEO must be visible, if not to the media, then to stakeholders. Talk to the families of residents involved; speak to them individually on the day of the incident. It is important that the family hear the news direct from management, not through the media, social media or a third party.

It is important to manage relationships critical to the facility’s safe operation – it’s not just about reputation and ‘PR’, it’s about the sustainability of operations. If the business fails, lives are at risk.

And this is when that media training pays off. Management is able to assess each inquiry; if required, the CEO is ready to face the public, providing succinct, clear responses to questions, helping to mitigate the risk to the reputation of the provider, as well as the sector. Co-ordinate media responses with peak industry associations, as they will bring balance to reporting. And don’t believe everything the media says. A clever leading question has oft resulted in a provider unintentionally creating a story that wasn’t previously there.

During the crisis, monitor the media, in-bound calls from stakeholders and engagement on social media. Ensure each is assessed for impact and, where necessary, adequate responses given.

Never stop communicating with staff. Issues can be protracted, starting in the facility and ending in a court room years later. Staff, acting professionally and within regulations, can be left exposed. Stay by their side and the rest of the workforce will thank you.

Ultimately, families will be supportive – particularly of facility staff – as long as they feel they have been kept up to date and are aware of progress being made. Providers should keep communication consistent and, even when families appear disengaged, make an effort to connect.

After the storm

Once the crisis is over there is still work to do. The worst thing a company can do is sigh and return to business as usual. People need to see change to feel confident the issue will not recur.

Put in place a regime of regular communication. The initial purpose will be updating stakeholders on progress; later it will become a valuable platform for ongoing engagement and other activities, such as fundraising and marketing.

Recovering and re-building an organisation’s reputation after a highly publicised issue can take time. Unfortunately, the public is trained to see and remember bad news. They never forget and some will never forgive. Do not walk away from past issues or try to bury them. Be clear that it was a trigger for learning, development and growth.

Establish milestones for promoting company success and demonstrating the competence of staff. Create opportunities for families and residents to tell the story for you.

Keep monitoring at regular intervals. In certain situations, it may be worth looking at references to the company that come up on search engines. Strategies may be required to push negative coverage deeper into the web.

Most people forgive a mistake made once, but rarely one made twice. Make sure issues don’t recur or escalate. Assess the conditions as well as the subjects at regular intervals. Ensure the correct processes are in place and that staff training is repeated. Highlighting the incident in internal communications is an effective way of maintaining diligence among all staff.

Challenging issues are a fact of life in aged care. How we manage them defines us. Next management meeting, consider a little self-help. Invest in an issues-management plan and choose to deal with the issue. Don’t rescind your right to control the agenda.

Rhod Ellis-Jones is principal of Ellis Jones and founding  chairman of the Shared Value Project. sharedvalue.org.au

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