Bill Klaproth (Host): This is a special podcast produced on site at SHSMD Connections 2023 Annual Conference in Chicago as we talk with keynote speakers and session leaders direct from the show floor. I'm Bill Klaproth and with me is Suzanne Hendery, Chief Marketing and Customer Officer at Renown Health.

And we have Alan Shoebridge, Associate Vice President, National Communication, Providence, and we're going to talk about a session they did at the AHA Leadership Summit called Strengthening Risk Communications and Mitigating Misinformation in Health Care Emergency Management. Suzanne and Alan, welcome.

Suzanne Hendery: Bill, thank you so much for being here today, and we really appreciate your support.

Host: Thank you.

Alan Shoebridge: So happy to join you, Bill. Thanks for being here.

Host: Thank you, Alan. It's always a pleasure to talk with you. You're like, the best. Anyway, I'm, like, in the Alan Shoebridge fan club. Me too. Can I say that? Is that, am I allowed to say that? Yeah. The, okay. I need to charge for that. I, you should.

Yeah, I mean, well, I'm already, I'm already, you know, I, read the blog all the time and all the posts. So, anyway. So, Alan, let me start with you. Healthcare leaders must be prepared for increasing threats to public safety and, of course, modern media has created a pressing need to manage misinformation, especially in emergencies where accurate information can be life saving.

So what specific emergency communication plans and processes need to be in place prior to an emergency happening?

Alan Shoebridge: Yeah, well, you know, the importance of this topic really goes to the fact that, if you're not ready to manage that type of situation, you're going to do some serious damage to your brand. So, I think it starts with figuring out what type of system you're in, are you in a multi hospital system, are you in a single hospital system? You know, it's very different for us at Providence because we have a 50 hospitals across the country and things that are happening at the local level and at the system level.

And so my job is really helping prepare those local people on the ground with whatever system assets we can. So, trying to get some structure in place, trying to make sure they have what they need if something goes wrong. And then, they're going to do a lot of the actual response in the local area.

So, I think you analyze this from what type of system we're at. If you're at, again, a single hospital system, you're going to just be doing it on your own, but you need to build a plan. You need to think about what the scenarios are that you're likely to encounter. As Suzanne will probably say too, so much of what comes up, we don't really know about, but there are things we can prepare for in advance.

So, one that we've seen that's just going to be happening every single year is wildfires, right? If you're on the West Coast. You're going to have wildfire somewhere in your geographic footprint anytime during the summers, and I hate to say that, it's sad, but it's going to happen. We know too that there's unfortunately going to be a mass shooting somewhere in your geographic footprint probably over some place in the course of a year.

So, the more spread out you are, I think the more you have to really be prepared for those things, but really assessing what your likely risks are, sort of those known risks, and building plans that you can. And then just making sure you have the right systems in place in your organization.

Some organizations are very sophisticated in their emergency management approach. Others, I think, again, they're just kind of figuring out a little bit ad hoc. So I feel there's a lot of value in just getting all that planning you can for the scenarios you're likely to encounter. And making sure that your communications people, your executives, are prepared to respond when something happens.

Host: Absolutely. So, try to understand what scenarios you may encounter in your geographic location. So that totally makes sense. And then, Alan, do you have separate plans for internal and external audiences at Providence?

Alan Shoebridge: Well, I would say that generally it's part of the same plan, but you have it broken out by audience. So there might be a section of the plan saying, here's what we're going to do internally. And that's a really important audience, especially, I'll use the example of Providence. Again, we have people over seven states. If something happens in California, you know, the people in Oregon, Washington, Alaska, a lot of times they want to know what's going on.

So we have to figure out, not only how do we notify people in the internal audience, in the area where something's happening, how do we get information out across the system? And one of my roles on my team is making sure that those local people don't get burdened with all these requests coming from outside the area because just, it's well meaning.

But if you're like, well, how are we responding? How can we help? And so trying to handle that and coordinate that so the local area isn't over besieged. But then at the same point, the external audience is really important as well. And I feel like COVID has really opened my eyes to the fact of how important it is to have this sort of internal, external cadence.

And, you know, your internal audience needs to know what's going on first. They're going to be getting asked questions. You don't want them to have the wrong information. And then very quickly, sometimes in a matter of minutes or hours, whatever, you're going to send the same information out externally.

But you have to have it broken down. I think the channels are different, the steps are different. But the audiences go hand in hand, but I would say it's all part of the same plan. Just really broken out by audience with how you're going to get to reach who you want to reach.

Host: Mm hmm. And then I'm wondering, as I'm hearing you talk about this then, so is misinformation then minimized through already having plans and processes in place?

Alan Shoebridge: Well, I think you're better to respond to it when it happens. I mean, we, kind of know issues that are going to bring people out of the woodwork that are going to spread misinformation. COVID is a great one, right? I mean, unfortunately, um, COVID cases are picking up a little bit. We're going to have a vaccine available soon. Booster, sorry, we already have a vaccine, but the booster is going to come, the latest booster. And we know when we start promoting the latest booster, we're going to have people who are putting out misinformation on it, I think we're really well prepared to address that and talk about why these things are safe and have our experts out there.

And we've learned from experience, but it's important to put all that messaging together. We're doing that now as we get ahead of this and think about getting our own employees the boosters up to date and helping promote people in the community. So I feel like a plan helps you respond instead of having to just come up with responses in the moment and also identifying, and this is something that's helpful too, you know, again, what are your trusted media outlets and people that you can rely on to spread the message?

And then others who you might know that, well, what's going to come from them is going to be a problem and let's get ready manage it.

Host: Yeah, that's an important component to remember as well. And then, Suzanne, can you tell us about your emergency communication plan at Renown Health and the factors that were taken into account while crafting your plan?

Suzanne Hendery: Sure. Thank you, Bill. And thank you, Alan. Great comments. Well, I would say that like good Girl Scouts, we feel like we always need to be prepared. So, as Alan mentioned, it may be any number of internal or external situations, but there's a number of things you can put in place now. And when you envision what happens when the computers don't work, when the cell phone towers are out, when all of the strategic communications methods that we've put in place don't work, and you're actually physically using a copy machine to put together newsletters that you're handwriting, and you're delivering them to surgeons in the operating room. And some of the things that we dealt with during those first days and weeks of the coronavirus, or the wildfires, or the climate issues, or hurricanes, or earthquakes, or other things that go, we often think, oh, we'll just text message everyone.

We will do all of these things. But we've not spent the time on the infrastructure to gather everyone's cell phone numbers, or their home addresses, or heat map in terms of, we have a number of five acute care hospitals. We have patients in our hospitals that we may need to evacuate. We have families we need to talk to.

So, what could we do now and put in place in terms of holding statements, microsites that we can build with resources now, when it's knock wood, a quiet time. Because these are things that we'll need to do, no matter what. But often, we wait until the last minute, or we're in the middle of a disaster, and then systems fail. And we're left scrambling. So, whatever we can do to prepare now for the eventual certainty of what will be happening is really important.

Alan Shoebridge: Yeah, and I know Suzanne and I have talked about this too. We talked about it at the AHA Summit. But, also identifying who your spokespeople are going to be. Because in the moment, it's not a good time to figure out, is this person camera ready, can they deal with the media. Sometimes you have to do that, but it's better to think about it in advance.

Really assess their comfort level and ability to do it, and then potentially doing some media training so they're comfortable ahead of when they have to do it. Again, sometimes we press people into action, but it's always better if we can figure it out a little bit ahead of time.

Host: I love that you brought that up, because when you think about plans, you're thinking about the communication, but you're talking about like, infrastructure. What happens when the computers don't work? What happens when the cell phone towers are down? What happens if we don't have all of the text numbers. So that makes a lot of sense, and Alan, you as well, said, hey, beforehand, let's figure out who our spokesperson is going to be that can effectively communicate the messages we need to communicate.

So then, Suzanne, when determining how to best respond to varying emergencies, what are some of the initial considerations or strategies that you use at Renown Health to determine the appropriate course of action and or with which audiences to engage?

Suzanne Hendery: Great question. So the first thing we ask when the sky is falling and people are calling us is, is this our problem to solve? Because many times people will call us when something urgent or critical is happening in the environment and it may not be my problem to solve. So, for instance, it could be a member of the medical staff who has done something that's not great. And our folks get whipped up in terms of what's our holding statement going to be?

Who's going to be making that statement? What are we going to say internally or externally? And when we dial it back, we're like, you know, this is not our problem to solve. This is our problem to support. Because that doctor has his or her own doctor's office. They are not employed by us. They are only affiliated with us through their medical staff privileges.

So, don't react too fast, because you need to make sure this is indeed your problem to solve. Often, we're in a support role to either our EMS, or our REMSA, or police, or sheriff's office, or State Department of Defense, or FEMA, or someone else. So, just making sure whose problem is it to solve. And then, are we leading the effort, or are we supporting the effort?

Most often, we're brokers of bringing all the right people to the attention of the media, or setting up that press call or conference, and making sure that all of the defined audiences are represented. When we think about vulnerable audiences, and making sure is there someone there to sign language for hearing impaired. Is there someone who speaks Spanish? 30 percent of my market are native Spanish speakers. So, as we prepare for these urgent communications, are we making sure that everyone is involved in hearing what's critical?

Host: Yeah. Wow, I love the detail of that. Really thinking of everything beforehand. It just makes it easier when something does happen. And like Alan said, something is generally going to happen. So you better be prepared for it. Okay, so then let me ask you this, Suzanne. How do you balance the need for transparent and open communication during emergencies with the potential challenges of managing sensitive or confidential information?

Suzanne Hendery: Another great question. And I think COVID was a wonderful opportunity for us as a senior management team, get aligned on how comfortable were we, listing the number of patients who are hospitalized every single day, the number of patients on respirators, and it chills me now, but the number of people who had died in our hospitals every day.

That is information as public health communicators, we would never have spoken about how many people die on a daily basis in any of our hospitals. But suddenly, we were all giving daily roll call to the media, to our employees who cared very much about the safety of their environment as they came to work.

And we were looking at the analytics and what was wonderful about that transparency is we were able to come together as a country and be able to say what's happening in New Jersey and Texas and Florida and Seattle, is now coming to the Midwest and coming to Nevada and other states. So, as colleagues, we were able to jump on calls twice a week, I think it was, Alan, and share best practices so that what Alan was dealing with in Seattle, which I knew would be coming to Reno soon, he was able give us preparation in terms of, oh my goodness, again what we were dealing with.

You know, your morgue may not be large enough to handle all of the people who are passing away in our hospitals. How are you going to work with that? Here's what we did. So we came together as an industry in a way we've never done before, with that transparent information, which led to us being a trusted voice.

Which I think, now the challenge is how do we take that forward? What have we learned about transparency with the public and with our employees that we'll take on with the next challenge?

Host: Yeah.

Alan Shoebridge: I think that transparency is important for the misinformation component we were talking about earlier. Cause I think we wrestled with the do we list the deaths too? And that didn't feel good in a lot of ways, but on the other hand. You have people who are disputing the fact that anyone was dying at all. You had people that were saying the hospitals are fine. You know, look, there's no one in the waiting rooms.

They're making this up. And at the same time, our frontline healthcare workers were just distraught by seeing how many people were passing away. So publishing those numbers was tough, but it helped provide the right information when so much misinformation was out there.

Host: Yeah, so transparency and data certainly helped with that. And really helped really paint the picture of what was happening across the country. So let's stay with misinformation for a minute, Alan. So, social media can be a breeding ground for misinformation. Am I breaking news here? No, I don't think I've heard that. No, have you heard that? Okay. So then, how do you mitigate that while properly utilizing the positive advantages of social media?

Alan Shoebridge: Yeah, well, I think that the important role that we have to play is making sure that the right information does get out there so that our experts are out there talking about what really matters. It does in some ways become kind of this shouting match between the misinformation and the right information.

But if you're to leave the platforms and not be out there promoting anything, I think you're kind of advocating your duty to do that. And, right now, I think the challenging thing is just always evaluating the platforms and saying; are these platforms still giving us the right exposure? Is the audience still there? It's shifting, you know, like I know that a lot of places are analyzing Twitter. I can't, call it X. I still struggle with that. But like, is it still the right platform? And so, is it reaching the right people? I mean, you're always having that, discernment, but you can't advocate and not be a voice.

You have to put your voice out there. And when things are, a lot of misinformation is going on, I feel like you kind of have to do it more than ever. So we have a role and the role is getting the right information out there, amplifying other trusted voices, you know, when there's expertise from the CDC or others, sharing that, doing what we can with our local health departments.

That was a big thing, I think, in COVID where local health departments kind of struggled. They were getting information out, but they didn't have large audiences. Well, the health system does. So can we help partner with them in a region or whatever? And just trying to amplify that, get the right message out and amplify it.

Host: So there is a role in pushing back. You can't just abdicate it like you said. Suzanne, your thoughts on social media and misinformation, if I could quickly.

Suzanne Hendery: Sure. Well, one of the good things that comes out of any emergent situations is that you get the evidence based specialist who can speak to the fact that there are lots of ways to look at medicine, but as an academic institution, we only rely on FDA approved evidence based medicine.

And what we know today is X or Y.

Host: Right.

Suzanne Hendery: And as you remember, all through the pandemic, what we understood about cloth masks. Then moved into N95s. And now there's a lot of discussion. Do masks really do anything to help spread? So, part of it is to be humble in our approach that we are an academic healthcare institution and we're learning, but we only are going to practice evidence based, peer tested medicine.

That we're not going to be practicing any new treatments or drug regimens on anyone because there's two sides to every story. But at least to be trusted, credible, and respected, accurate, and timely in your approach, even if you haven't gotten everything figured out. And having the right experts at the table to have those discussions.

Host: Mm-hmm.

Suzanne Hendery: Is a wonderful opportunity to educate.

Host: Absolutely. Yep. That makes sense.

Alan Shoebridge: I was just thinking one other thing based on what Suzanne said. The mask story is a really good reminder that when you're talking about communications, that if you put out something in the first place, it's really hard to pull it back. So trying to have as solid information as you can, because once you get it out there, it's not like you say, oh, we were wrong. People will have a hard time processing this. Well, you told me that wasn't right. So, the mask thing is a great example, because, okay, we all know that N94s and N95 masks are pretty safe, but at the time, people were making masks out of anything, and it was so hard to educate them, the message wasn't just, it became nuanced.

It was like, well, not all masks are good. You need this kind, you need to use it in the right scenario. That's really hard to do, and that credibility piece, if you don't get it right from the beginning, it's very hard to reestablish it.

Host: Yep, that totally makes sense. So then let's talk about after the emergency Suzanne. How do you leverage the experiences and lessons learned from incidents to drive positive change and enhance resilience within your organization and the broader community?

Suzanne Hendery: Well, we use, like most hospitals, the Health Incident Command System, which is developed by FEMA for all crisis situation and emergencies, which, as you say, Bill, has a feedback loop.

So, every day at the end of the day, all of the teams that are chartered, including communications, which is the public information officer's realm, and they report directly to the incident commander who makes decisions. At the end of every day, people are reflecting, what did we do well? What could we have done better?

At the end of every week, same briefing to go into that. And then once the initial emergency is dealt with or being dealt with, taking away those lessons learned for the next time. And the hope is, just like as human beings, as we get more experiences, we do better. And as healthcare communicators and people who deliver health information to a public who is very thirsty for knowledge, we need to get better.

And we only get better by practice and rehearsal and actually going through these crisis situations and then learning together, like this conference is proving today. That when you share best practices, that you can go back now, take what you've learned, and apply it in real life.

Host: And that enhances your credibility that Alan was talking about. Thoughts after the emergency, Alan?

Alan Shoebridge: Yeah, I think that it can be an easy step to skip the debriefing and lessons learned. And that's a fact with not only just crisis situations, but almost any large body of work, you know. Nothing ever goes perfect, so it is important to step back and talk about that, but I, it can be a really easy step to just, either gloss over real quickly or sometimes even forget about all together. But it's essential. And I think building that into your process to make sure that's something that you check off is really important.

Host: And like Suzanne said, always trying to get better.

Suzanne Hendery: And to celebrate.

Alan Shoebridge: Yeah.

Suzanne Hendery: And to celebrate those people, because any crisis has the opportunity to create new bonds, new relationships, new ways of doing things, and to be able to celebrate what you've created as a team together, and be able to recognize that milestone is something that we all will never forget.

Host: Yeah, absolutely.

Alan Shoebridge: It's nice not to repeat mistakes. Yeah. You know, like we just had our keynote speaker and he talked about celebrating failure, which I think is actually a good thing, but part of the process is You might not make the same mistake again to talk about it.

Host: Yep. So as we finish up talking about strengthening risk communications and mitigating misinformation in healthcare emergency management, let's get final thoughts from each of you. Suzanne, let's start with you. Anything you'd like to add?

Suzanne Hendery: Just thank you again, Bill, for being here and bringing this knowledge to a whole new audience who can't be with us in the exhibit hall tonight. Really appreciate that. And just a reminder that we often in communications think in concentric circles. So when you're communicating, being able to think about who needs that information first, and then second, and then third, and then building those concentric circles of information. Because you talked about transparency, but sometimes it's confusing to give people information without giving them an action to be taken.

So, often, we'll have a lot of physicians who say, oh, we need to say this. Please get on all of your broadcasting and say that. And my team will often say, well, what can people do as a result of hearing that information? If they can't take actionable information to help or support, why don't we just hold on it for now?

And similar to what Alan said is there's a real rush to judgment and for people to get ahead of themselves. And I think our job as communicators is to hear all the voices, to be able to put together solid, accurate, timely statements, make sure that we're getting to all of our audiences, but that we're not moving so fast that we have to go and retract what we've said.

Host: Right, which Alan said is very hard to do. So, concentrate on building those concentric circles of information. And Alan, as we wrap up, final thoughts from you.

Alan Shoebridge: Well, I'm just going to go back to a really silly saying, but it's so true. It's like you never get a second chance to make a first impression, right?

And if you're making a first impression during a crisis situation and you don't handle it well, you're going to damage your brand. And it could be almost impossible to get those people back interested in your organization, thinking you did the right thing. So think about that brand reputation and even with existing partners and patients and consumers and all that, if you don't handle it right, you can do serious damage to your brand.

So I feel like preparing helps cut down the possibility of that a lot. And just thinking about that, if you don't handle it right; you may never get that patient or consumer or partner back in the same way. They're not going to trust you. And so, don't take that risk. It's a big risk.

Host: Absolutely. I love that. You never get a second chance to make that first impression. So important. Well, Alan and Suzanne, thank you so much for your time. This has really been great.

Suzanne Hendery: Thank you, Bill.

Host: You bet. Once again, that's Suzanne Hendery and Alan Shoebridge. And sign up for the SHSMD Connections Virtual Conference, October 20th, 2023. Plus, on demand through the end of the year. The Virtual Conference will feature access to 50 plus sessions recorded right here from the in person conference. Plus all new live sessions. All you have to do is go to shsmd.org/annual to learn more and to get registered and make sure you join us at next year's SHSMD Connections 2024. Breaking news! It's in October. It's in Denver. You can say you heard it here first. And of course, if you found this podcast helpful, please share it on all of your social channels and to access our full podcast library chock full of goodness and great topics of interest to you, visit shsmd.org/podcast.

And, as always, thanks for listening.