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Crisis Management. A presentation by Bruce Hugman Consultant to the Uppsala Monitoring Centre Pretoria, September 2004. What is a crisis?. In general? For an organisation? For government or bureaucracy? For a private company? In healthcare? In drug safety ?. Topics.

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crisis management

CrisisManagement

A presentation by

Bruce Hugman

Consultant to the Uppsala Monitoring Centre

Pretoria, September 2004

what is a crisis
What is a crisis?
  • In general?
  • For an organisation?
  • For government or bureaucracy?
  • For a private company?
  • In healthcare?
  • In drug safety?
topics
Topics
  • The nature of crisis
    • Crisis management model
  • Planning
    • Risk assessment
    • Risk management
  • Crisis communications
  • Risk Communications
key features of a crisis
Key features of a Crisis
  • Low probability
  • High impact
  • Uncertain/ambiguous causes and effects
  • Differential perceptions
high level threats
High level threats:
  • Safety
  • Health
  • Environment
  • National security
specific threats to organisation
Specific threats to organisation:
  • Operational viability
  • Reputation
  • Credibility
  • Financial stability
  • Legal action
consequential effects
Consequential effects:
  • Uncertainty/ambiguity
  • Urgency of response
  • Strategic effects of decisions
common features of a crisis
Common features of a crisis:
  • 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
purpose of crisis management
Purpose of crisis management:
  • Prevention
  • Survival
  • Successful outcomes
successful outcomes
Successful outcomes:
  • Positive balance of success/failure
slide11

Incident

Success outcomes

Failure outcomes

EXXON VALDEZ

- Financial losses were bearable

- Costs relating to clean-up were less than pre-emptive costs

- Image management recovered the Company’s reputation in business community

- Long term costs were transferred to public

- Delays in implementing clean-up leading to loss of wildlife.

- Image management failed to fully recover the Company’s reputation in wider community

TYLENOL TAMPERING

- 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

three criteria of success
Three criteria of success:
  • Has organisational capacity been restored?
  • Have losses been minimised?
  • Have lessons been learned?
crisis management model
Crisis Management Model

Antecedent

conditions

Intrinsic crisis

Perceived crisis

Immature crisis

response

Mature crisis

management

Review and Feedback

existing conditions
Open bow doors /

poor safety culture

Smoker / poor cleaning standards

Existing conditions:

Culture or

environment

existing conditions16

Existing conditions:

Crisis-prepared

or crisis-prone?

intrinsic crisis
Total situation as seen by neutral observer with all the facts

As seen by all individuals from particular viewpoints

Intrinsic crisis:

Perceived crisis:

crisis management model18
Crisis Management Model

Antecedent

conditions

Intrinsic crisis

Perceived crisis

Immature crisis

response

Mature crisis

management

Review and Feedback

immature crisis response

Immature crisis response:

Instant and irrational (denial/shock/panic)

mature crisis management
Mature crisis management:
  • Grasp of intrinsic crisis
  • Implementation of plans and procedures
mature crisis management21
Mature crisis management:
  • Technical intelligence
  • Emotional intelligence
review and feedback
Review and feedback:
  • Assessing success and failure
  • Feeding learning into future planning
crisis management model23
Crisis Management Model

Antecedent

conditions

Intrinsic crisis

Perceived crisis

Immature crisis

response

Mature crisis

management

Review and Feedback

management objective
Management objective:
  • Ad hoc emergency reaction?

OR

  • Building management capacity to handle unforeseen events?
crisis management model28
Crisis Management Model

Crisis

Management

Planning

Crisis-

prepared

culture

Antecedent

conditions

Technical

Intelligence

Emotional

Intelligence

Intrinsic crisis

Perceived crisis

Authorisation

Procedures

Immature crisis

response

Crisis

Management

Implementation

Mature crisis

management

Integration

of learning

Review and Feedback

gathering intelligence
Gathering intelligence:
  • Who?
  • What?
  • When?
  • How?
who for government
Ministers

Officials

Political parties

Sponsors

Voters

International allies

The public in general

Tax-payers

Consumer and lobby groups

Lawyers

The media

?

Who for Government?
who for medicine and drug safety
Manufacturers

Regulators

Politicians

Employees

Health professionals

Pharmacists

Academics

The public

Patients

Consumer and lobby groups

Lawyers

The media

?

Who for medicine and drug safety?
intelligence
Intelligence:
  • Continuous scanning (networks/media/ppublic opinion, etc)
  • Outward focus
  • Collaboration
  • Positive relationships
risk assessment is
Risk assessment is:
  • Identification
    • define and describe
  • Estimation
    • likelihood and consequences
  • Evaluation
    • acceptability of risk
slide36

Identification

Estimation

Evaluation

Medication in question could be mistaken for sweets by young children

Medium chance leading to severe health problems or death

Unacceptable

Recall of a defective batch of medication may lower consumer confidence and take-up rate

High chance that public and media criticism will arise

Acceptable

slide37

Identification

Estimation

Evaluation

Planning

Medication in question could be mistaken for sweets by young children

Medium chance leading to severe health problems or death

Unacceptable

Product needs to be re-designed to prevent the possibility

Recall of a defective batch of medication may lower consumer confidence and take-up rate

High chance that public and media criticism will arise

Acceptable

Priority actions to sensitively withdraw product whilst reassuring honestly and openly

risk management is
Risk management is:
  • Planning
  • Resourcing
  • Monitoring
  • Controlling
crisis planning
Crisis Planning:
  • 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
communication plan
Communication plan:

Core elements are:

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

The core process is:

  • Active, two-way communication
who matters and how will they be contacted
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

?

Who matters and how will they be contacted?
slide45

Dear Consumer Group

You will understand that managing the nation’s drugs is a complex business.

From time to time there are scares or crises which cause much concern to everyone.

We are keen to discuss the handling of such events, and to plan jointly with you and others how we might best communicate with you in such circumstances. We’d like to establish one-to-one contact between a member of your team and ours…

message options what
Message Options [What?]
  • Full apology
  • Corrective action
  • Ingratiation
  • Justification
  • Excuse
  • Denial
  • Attack the attacker
what does the world want to see
What does the world want to see?
  • Acceptance of responsibility
  • Willingness to take positive steps
message options
Message Options:
  • Full apology
  • Corrective action
  • Ingratiation
  • Justification
  • Excuse
  • Denial
  • Attack the attacker
critical activities
Critical activities:
  • Initial response
  • Lines to take
initial response
Initial response:

Tell the truth as it is known

  • Facts beyond question
  • Actions being taken
  • Acknowledgement of emotions/psychological needs
lines to take
Lines to take:
  • Essential responses planned
  • Each new authorised response is logged
    • Database
    • Book
    • Wallchart
    • Message board
media demands how
Media demands [How?]
  • 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
the ideal spokesperson
The ideal spokesperson:
  • Polite and patient
  • Well-informed and authoritative
  • Accurate and reliable
  • Articulate
  • Available
  • Trustworthy
  • Evidently committed to the process
continuing public information and education
Continuing public information and education
  • ‘No drug is 100% safe’
  • Many drugs have potential side-effects and adverse effects
  • Complexity of benefit-harm / effectiveness-risk
  • Rational use of drugs
elements increasing media interest
Elements increasing media interest:
  • Dramatic emotional impact e.g. thalidomide and 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
slide58

Methods

Primary Purpose

Transmission

Access

Telephone

X

X

Hotlines

X

Interviews

X

X

News Releases

X

Conferences

X

X

Emails

X

X

Enquiry Desks

X

Web Site

X

X

Mobile Offices

X

crisis management model59
Crisis Management Model

Antecedent

conditions

Intrinsic crisis

Perceived crisis

Immature crisis

response

Mature crisis

management

Review and Feedback

crisis management model60
Crisis Management Model

Crisis

Management

Planning

Crisis-

prepared

culture

Antecedent

conditions

Technical

Intelligence

Emotional

Intelligence

Intrinsic crisis

Perceived crisis

Authorisation

Procedures

Immature crisis

response

Crisis

Management

Implementation

Mature crisis

management

Integration

of learning

Review and Feedback

communication of risk
Communication of risk
  • 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’
perception of risk
Perception of risk

Factors increasing intolerance:

  • Involuntary - e.g. exposure to pollution rather than voluntary, such as smoking or playing dangerous sports
  • Unfairly distributed - some benefit whilst other suffer
  • Inescapable - cannot be avoided by one’s personal actions
  • Unfamiliar - arising from a novel source
  • Man-made - from other than natural sources

continued…

perception of risk67
Perception of risk

Factors increasing intolerance:

  • Hidden/irreversible - e.g. effects damaging 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
problematic issues in drug safety
Problematic issues in drug safety:
  • Adverse effects
  • Risk as a concept in medicine
  • Benefit-harm
  • Effectiveness-risk
  • Public health versus profit
  • Access to medicines

continued...

problematic issues in drug safety69
Problematic issues in drug safety:
  • Individual patient variation and susceptibility
  • Polypharmacy
  • Relationship of allopathic and traditional medicines
  • Resistance
  • Diagnostic errors
  • Prescribing errors
  • Compliance issues
risk factors for government officials
Risk Factors for Government Officials
  • Political expediency
  • Culture of secrecy
  • Accountability
  • Bureaucracy and inertia
  • Hierarchy
  • Process versus performance
  • Complexity
  • Workload
  • Corruption
summary
Summary

Topics covered:

  • The nature of crisis
  • Crisis management model
  • Planning
  • Risk assessment
  • Risk management
  • Crisis communications
  • Learning from experience
slide74

Thank you -

and good luck!

(though luck has nothing to do with good crisis management!)