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Predictable stages of a crisis
Story Number is : 040604100
Consultant, Columnist
Hospital Newspaper

Most crises that I have experienced or read about go through predictable stages. I have listed them here in the order in which they usually occur.


It could be a sudden, unforeseen event A basically healthy patient dies. because of a medical mistake or a procedural error. A fire breaks out and causes an evacuation of a portion of the building.

But there are other instances where the crisis should NOT have been a surprise. If the workforce is unhappy, a job action or strike shouldn’t be unforeseen. An unusual number of cases of an airborne illness which began after patients were admitted should alert someone that there is a problem brewing.

Insufficient Information:

When the crisis breaks – whether sudden or anticipated – those expected to deal with it rarely feel they have all the facts they need. People normally prefer to have all the pieces of the puzzle fit into place before giving out a statement. But in a crisis, there is never enough time to thoroughly assess the situation. The challenge is to quickly confirm what facts you can, provide an early statement on that, and move as rapidly as possible to find out as much as you can so you can provide periodic updates. Make it clear to the affected audiences, including the media that you are working hard to verify the facts so you will be giving them accurate information. Assure them you will disclose additional information as quickly as you can.

Scrutiny from the Outside:

Sometimes the media is on site before you are! They want answers. In this day of 24-hour news channels and the 24/7 nature of the Internet, deadlines have lost their meaning. The pressure is on for immediate news. The spokesperson knows his/her every word will be captured at once for all the world to see or hear or read. It is a frightening prospect – especially for someone not yet trained in how to deal with the media.

Escalating Flow of Events:

Once the media gets involved, the demand for the information you don’t have begins to pick up speed. More people become concerned and start pressuring you to solve the problem or provide them with answers. One problem leads to another. Resources are stretched thin. Nerves fray.

Loss of Control:

It is likely that you will feel and act very disorganized, especially if you have not planned ahead of time for this particular type of crisis now raging around you. You realize the perception is that you don’t know what to do. Your competence as a leader is questioned. Your self-confidence plummets.

Siege Mentality:

The temptation is to circle the wagons and hide behind a wall of “no comment.” Statements are heard in the crisis management team meetings such as “People just don’t understand the technicalities of this situation, so we can’t talk to them about it. Why don’t people just TRUST us to do our jobs!” This can all lead to....


You may not go screaming down the halls, but you know you’re not making good decisions or directing your people competently. The “panic” can be the silent type where you exhibit paralysis. Lawyers advise not saying anything and you think that sounds like the safest approach, regardless of how much damage may be done to your reputation.

Institutional Myopia:

The pressure has built to such a point or gone on for so long that it becomes unbearable. In this atmosphere, decisions can be made to just do whatever will “get it over with.” It is possible that crisis managers will lose sight of the long-term goal: to maintain the confidence of the public in your institution.

Not a pretty picture, is it? A crisis never is pleasant. But you will have an advantage when you have to deal with a crisis if you have:

-- thought specifically about the types of things that could go wrong in your institution;
-- laid out a plan of who would be called upon to help:
-- identified the roles and responsibilities of various staff members; and
-- determined the main approach to problems identified as likely to cause issues.

Don’t wait until it is too late. On a great day at work, when your hospital has just won an award or been recognized for a great patient satisfaction rating, it may be hard to think about the need to prepare for the times when the thunderclouds suddenly appear. But remember: it wasn’t raining when Noah built the ark!!!
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