I join with thousands of others decrying the violence that took the lives of our troops at Fort Hood yesterday.  My heart goes out to their friends and families.  I pray that something will come of this event that will prevent a similar crisis from ever happening again.

The parallel with healthcare is what compels me to write today.  Laurence Barton, who was VP for crisis management at Motorola, calls sabotage the undisclosed crime in Crisis Leadership Now: A Real-World Guide to Preparing for Threats, Disaster, Sabotage, and Scandal. 

He wrote that today’s saboteurs take many forms that are not easy to identify.  People with access to an organization pose a great likelihood of compromising safety. Colleagues may hesitate to report statements or incidents because they fear embarrassment if they are wrong or retribution if they are correct, leading to inaction until it becomes too late to prevent a tragedy,  similar to what happened at Fort Hood. 

Clearly, there is no way except in retrospect to know when a crisis will hit.  Therefore, it behooves all of us to prepare.  Ian Mitroff and Gus Anagnos wrote in Managing Crises Before They Happen that organizations should review their vulnerability in the following six major areas:

• Economic, for example,  events stemming from the current recession
• Information, for example, loss of proprietary data or protected patient health information
• Physical, for example, a machine that works improperly that puts patients’ and/or employees’ health at risk
• Human resource, for example, loss of key personnel in an accident or due to a pandemic
• Sociopathic, for example, terrorism, kidnapping, or baby abduction
• Natural disasters, for example, fire, flood, tornado, or hurricane

We need a systematic approach to crisis management because in today’s complex interlinked environment, crises in one area may spread to others, for example, a flu pandemic in which 30% of healthcare workers are unfable to work, that compromises patient safety due to inadequate staffing. 

When I traveled to China in 2006 to speak at The First People’s Congress on Healthcare Communication, I learned that two Chinese characters symbolize The English word “crisis”: danger and opportunity.  The opportunity here lies in breaking down siloed communication and providing a forum where all stakeholders, including physicians, can make their complementary views known.

What do you think?

• Although it is natural to attribute blame when something goes terribly wrong, what are the systemic things that we can do ahead of time to prepare for and possibly prevent sabotage and other crises where we work
• Have you experienced situations where one crisis led to another
• Years afterward, what positive aspects emerged from going through a crisis with your coworkers

As always, I welcome your input to improve healthcare collaboration.

Kenneth H. Cohn

© 2009, all rights reserved