Commentary from crisis management expert Edward Segal, author of the recently published The Crisis Casebook: Lessons in Crisis Management from the World’s Leading Brands” and the bestselling and award-winning “Crisis Ahead: 101 Ways to Prepare for and Bounce Back from Disasters, Scandals, and Other Emergencies. He is Leadership Strategies Senior Contributor for Forbes.com.

Corporate America could be in a better position to respond and communicate about crisis situations if more companies had to take crisis management plans and other preparations as seriously as thousands of hospitals are required to do.

Those preparations have certainly been needed by health care organizations. Recent cyberattacks, staffing shortages, and federal funding cutbacks have put some hospitals on what appears to be a constant emergency footing.

Crisis Management Plan Requirements

`“Hospitals are required to maintain emergency operations plans to ensure compliance with key regulatory bodies like the Joint Commission [an independent organization that seeks to improve patient safety] and the Centers for Medicare & Medicaid Services. Most of those plans include a crisis communications component to guide the way an organization manages and responds to high-risk, high-stress events that could impact patients, employees, community and organizational reputation,” Amanda Maynord, CEO of Lovell Communications, observed in an email interview with me.

Those plans must be ready to be implemented at a moment’s notice and can be triggered by any number of events. “From my perspective, hospitals are keen to have very robust crisis and disaster management programs and plans. These can be activated for any number of issues and reflect an all-hazards approach. In other words, many of the elements need to be consistent for a flood in the basement or for a mass influx of casualties during times of shootings, etc.,” Dr. Michael Anderson, a member of the board of advisors for the Georgetown University School of Health, told me via email.

The Joint Commission requires hospitals to have crisis management plans as a condition for being accredited. The Commission provides advice on its website to hospitals about emergency preparedness, which it defines as “a continuous cycle of planning, organizing, training, equipping, exercising, evaluating, and taking corrective [action] in an effort to ensure effective coordination during incident response.” Imagine the state of crisis readiness of millions of companies if they adhered to similar preparation cycles.

In the wake of 9/11 and anthrax attacks in 2001 and other crises, the Department of Health and Human Services’s Administration of Strategic Preparedness and Response established a program to provide the resources participating hospitals need to respond to disasters and public health emergencies. The assistance includes equipment and supplies, real-time information and communication systems.

Testing Plans And Teams

Accredited hospitals must test their crisis management plans to ensure they will work when needed. But some hospitals may have challenges in having their response teams as prepared as possible. That’s because “the level of maturity, frequency of testing, and cross-functional integration [of the teams] varies significantly. Many plans check the compliance box but fall short in execution under real-world pressure. In my work, I’ve led hospitals through tabletop and full-scale emergency exercises—from active shooter drills to severe weather response—and uncovered common gaps like unclear decision authority, undertrained mid-level leaders, and breakdowns in internal communication flow,” David Corbin, owner and principal consultant at Dynamic Security Strategies, told me in an email interview.

“We have seen too many examples where situations occur and the staff on duty is not ready to act on plans that were set in advance,” Doug Levy, who has consulted for hospital systems and led communications at University of California, San Francisco and Columbia University Medical Center, recalled via an email message. “I have have long advised every organization that I’ve worked with to do quarterly tabletop exercises involving multiple sectors of emergency management teams.”

There are several reasons why hospitals can fall short of being 100% ready to respond to a crisis, according to Corbin—which may strike a responsive cord with business executives who have to contend with similar challenges at their organizations.

• “Plans fail without people. The success of a crisis response hinges more on team readiness and communication than on the written plan. When a crisis strikes, it’s too late to start reading your emergency plans.”
• “Testing is often siloed. Emergency plans are tested, but rarely across all departments or with realistic scenarios. They also don’t always pull in external first responders (local and state).”
• “Crisis response plans often neglect the long-term psychological impact on staff, which can compound future risk. I have seen staff rise to the occasion and perform outstanding work during a crisis. I’ve also seen plans and communications fall apart during a crisis.”

Preparedness

Advance preparations for dealing with different crisis scenarios are as important to hospitals as they are for corporations and organizations. “By anticipating and preparing for a crisis, a hospital is better able to navigate the typical communications lifecycle of a crisis—identifying the issue early, assessing its potential impact, developing response mechanisms, implementing response tactics, monitoring and maintaining operations as best possible, and conducting recovery initiatives,” according to Maynord of Lovell Communications.

Crisis communications is a critical element of crisis management. Most mandated plans ‘include a crisis communications component to guide the way an organization manages and responds to high-risk, high-stress events that could impact patients, employees, community and organizational reputation,” she noted.

There are best practices for preparing and maintaining communication plans, “A multidisciplinary team of executive leadership, clinical providers, environmental experts, security personnel and other key staff is often involved in the development of the plan and its review at least every six months,” Maynord pointed out.

As can be the case in the corporate world, hospitals may not have the in-house resources or skills that are needed to respond to crisis situations. “This is why internal hospital management teams often look to consultants with specialized experience working with hospitals or hospital systems when a crisis arises,” Judi Durand, founder of Judi Durand Consulting, explained in an email interview with me. “And because many hospital crisis situations are legal matters as well, medical facilities often have their legal teams collaborate in finalizing their crisis management plans.”

Regulatory and industry associations do not require companies to have crisis management and crisis communication plans. But that does not mean that corporate boards of directors should not consider making them mandatory and part of the policies and procedures manuals for their organizations. Enforcement provisions to ensure compliance with those requirements is also key. This is why boards could also consider including crisis management compliance standards when evaluating the performance of CEOs—and when CEOs measure the performance of senior staff.