Intro: The following SHSMD Podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD podcast, we're talking about resilience in real time and what it takes to lead communications during a true crisis. Here's the story. On September 27th, 2024, Hurricane Helene brought unprecedented flooding across the Ballad Health service area, devastating rural communities in Northeast Tennessee, Southwest Virginia, and Western North Carolina.

We're going to talk about real-time crisis communications in the midst of a full-scale emergency where conditions are changing by the minute in this SHSMD Connections preview. Joining us is Molly Luton, Chief Strategic Communications Officer at Ballad Health. It's all coming up on the SHSMD podcast right now.

This is the SHSMD Podcast, Rapid Insights for Healthcare Strategy Professionals in Planning, Business Development, Marketing, Communications, and Public Relations. I'm your host, Bill Klaproth. Molly, welcome.

Molly Luton: Well, thank you so much for having me. I'm pleased to be here and share a little bit about our Ballad Health story.

Host: Oh my goodness, and what a story it is, Molly. So, your session is called Resilience in Real Time: Navigating Crisis Communications During Hurricane Helene. So, I'm going to ask you to take us back to September 27th, 2024. When did you realize that this was not a routine weather event, but a full-scale communications crisis?

Molly Luton: Absolutely. So, I'm going to take you back even further than 2024. I was born and raised in Southwest Florida, so hurricanes were somewhat of a norm for me. I grew up through Hurricane Andrew and several significant hurricanes and storms in the Gulf Coast. But never did I imagine that I would be managing crisis communications in Tennessee for a hurricane that hit the mountains.

And there are many of us in the area of Northeast Tennessee even Southwest Virginia that also was impacted by the storm that had to deal with this. So, we knew pretty early on that this was going to be a significant weather event as soon as we started getting the notices from the National Weather Service and from the state governments both in Tennessee and the Commonwealth of Virginia, that something was going to be different about this storm.

If anyone might remember back in 2024, the storm kind of sat in the south for quite some time. It churned quickly and then it just stayed in one place and did not move fast once it kind of got over the Carolinas and parts of Georgia. And unfortunately, Tennessee had already been receiving significant rain for several days leading up to the storm. So, our grounds were already very saturated. So, adding a weather situation like Hurricane Helene on top of saturated ground, that's not used to taking on that much water, we knew very quickly that morning of September 27th, 2024 that this was really going to be an unprecedented event.

Host: So, in your mind you're like, "Oh boy, going to have to really be on this because we're going to have to communicate really well because there's going to be a lot of questions, a lot of confusion. We better be on this." Is that right?

Molly Luton: That's right. I received a call early that morning, which is our typical crisis process. I received a call from the incident commander on site, who actually was an emergency medicine physician, and the blessing upon blessings, he was also an Eagle Scout earlier in his life and had experience in swiftwater rescue. Two things that we didn't exactly think would pay off, in a regular everyday healthcare environment, but they certainly did. And he gave me a call, said, "Molly, hey, I'm headed to the hospital. We're going to have to evacuate the hospital because there's significant water coming off the mountains, and we just want to be careful and be cautious."

Now, the hospital he was referring to was Unicoi County Hospital, a 10-bed critical access hospital, just beautiful facility that we opened, Ballad Health opened in 2018. So, it was a brand-new hospital. In all intents and purposes, there are very few new hospitals in our country, and it was the newest rural hospital that had been opened. And he called and said, "Hey, we're going to have to evacuate." I was about 30 minutes in distance from where he was and just started to hunker down and pull my team and resources together report up to our incident command, kind of station area and start grinding out thoughts and processes for what we thought might be coming.

Host: You know, that is one of the most dramatic parts of the story. You're talking about Unicoi County Hospital. Apparently, 70 people were stranded on the roof and in nearby rescue boats. So as you're telling this story, Molly, in moments like that when information is coming in fast and conditions are changing by the minute, you said, "I had to grab my team and hunker down." How did you decide what to communicate, when to communicate, and how much to say?

Molly Luton: That's right. Good question. So in these types of evolving weather events, we're at the mercy of truly the weather, of so much unknown. We didn't know if we would have Wi-Fi service. We didn't know if we would have cell service. We didn't know what kind of connectivity we would have to people at the hospital.

And Bill, you're correct. There were 70 people that were stranded on the roof of a one-story hospital that had a rooftop that was 22 feet from the ground. The water moved so quickly that Hurricane Helene dumped on us then caused just this runoff from the mountains and extensive damage in infrastructure to nearby homes and buildings.

The water rose so quickly, it was actually running at a speed twice that of Niagara Falls from a nearby river, that very quickly flooded, and that water rose to 18 feet. Again, that building was 22 feet from the ground, and the water rose to 18 feet. So, there were 70 people that were evacuated, quickly to the rooftop by back. They were carried on ladders. again, this is a one-floor hospital, so there's not an elevator. And the stairwell unfortunately was blocked by river debris from that rushing, you know, speed.

So, our physicians, our nurses, quite literally put people on their backs, carried them. Many patients, in this case, were non-ambulatory. They couldn't move on their own to get up to the roof. they had to be carried on their backs. You might ask why there were so many people there with a 10-bed hospital. You hear these stories from September 11th and other tragedies where people run towards the emergency, right? And that's oftentimes what happens in healthcare, right? A code is called in a hospital, and people run towards the emergency to help. Well, it's no different in this case. You think that during an evacuation, people would leave. And those who needed to leave did leave. But in this situation, people wanted to come help. So, we had the police chief there. We had the fire chief there. We had first responders from all over the community there, wanting to help because the hospital was that kind of central core of that community and mountainous community. So, the typical population day to day of that hospital swelled in size with people who wanted to help. But then, unfortunately, they ended up getting stranded, too, because the water rose so fast.

Host: You mentioned that high rising water, your river there apparently was surging at more than 1.4 million gallons per second, twice the flow of Niagara Falls. So, this was really on you quickly and you had to act fast for sure.

Molly Luton: That's right. That's right. And we were very fortunate to actually maintain cell phone service. And that same physician, his name's Dr. Sean Ochsenbein, a hero in my mind and in the eyes of many others. He was in constant communication with me and other members of our team. I ended up being the scribe that day, as typically communications professionals end up doing that.

I took copious notes every time he would call or text me or a member of our team, I would write down exactly what he said. We were fortunate to have FaceTime working, which was a shock. He and I thought ahead pretty quickly and immediately opened up a shared drive so that he could drop photos of what was going on on the scene to a shared Apple drive, which is certainly something I would recommend.

And as we get together in September for the SHSMD conference and talk more about presentation, I'm looking forward to sharing more of those tips because that was one of those things that we thought in real time that has absolutely paid off, not just for our communications purposes, but for insurance purposes, for business purposes, for safety.

We do plan to rebuild this hospital that was completely destroyed from the flood. And some of those things that we thought about in that moment of how to communicate, who to involve in our communications, why we communicate certain things, we'll go over that in the presentation. But that's certainly one of those tips that has paid off tenfold.

Host: Yep, for sure. So, transparency in these emergencies is critical, but so is accuracy. So, how did your team balance the need to keep the public, the media, employees, patients, and the community partners informed while also making sure you didn't get ahead of verified information?

Molly Luton: Sure. So, I was tasked with crisis communications during the COVID pandemic. And as any of us might remember, we thought at times that the COVID crisis might be short-term. You know, we all hunkered down in March of that first year of 2020 and thought, "This might last a few weeks. We'll be on lockdown, that'll kind of be it." And I committed to myself and to my team and to Ballad Health, my health system at that time, we're going to be a source of truth in this process of the pandemic. We're going to make sure that we can be a source of truth of what's going on right now, how many events we have, many patients we have, those kinds of things, and what kind of accurate scientific information was available at that time.

Well, COVID, as we all know, the pandemic itself lasted for quite some time, three years. And we quickly realized we needed to be more than a source of truth. We had to be the source of truth and really publish a lot of information. So, we learned a lot through that experience, and I applied much of that to this Hurricane Helene disaster.

And with a hurricane, there were not a lot of helicopters flying around, as you can imagine, so visuals were somewhat limited. We did end up releasing visuals ourselves that our team members had captured and, again, sent to us through our cloud service and issued those to media to be transparent and say, "Hey, this is what's going on." But the only helicopters that were able to fly were Black Hawk helicopters that ended up being the surviving and the saving grace that saved and rescued all 70 of those people. Not one person perished from the rooftop of our hospital that day in September, which is an incredible blessing.

But media helicopters weren't flying around. There were not a lot of media trucks on the ground because the winds were so intense the water was moving so quickly. So we had to be the source of truth. We tend to be quite a transparent organization in general, and in a crisis, that's even more important.

So, often as a communications professional, you ask yourself, "Am I sharing too much? Is this appropriate for these audiences?" In that time, you really need to ask yourself, "What's the most important thing that has to be said, and how quickly can I do it but also be accurate with what I know at that moment?" So, those were constant questions we asked ourselves.

Host: Misinformation can spread so rapidly in situations like that, so I understand when you say we had to be the source of truth. It had to be accurate. We had to be the one place that people could turn where they knew they would get credible information. So in your session, Molly, you're also going to talk about supporting executive leaders, communication teams, and personal well-being, which has to be thought of as well during sustained crisis operations. Can you just give us a brief look of what that looked like in real time, and what did you learn about protecting the people who are responsible for basically protecting the message?

Molly Luton: That's right. So first and foremost, we spent a lot of time ensuring that our team, including my communications professionals, understood that we had access to 24/7 behavioral health support. Oftentimes crisis communicators and folks involved in our line of work can be forgotten, in terms of what we're exposed to.

I can tell you, and I'll share more of this in my session, but I wrote things the day of Hurricane Helene of September 27th that I never in my wildest dreams thought that I would write. As the crisis was unfolding, we had multiple scenarios that we had to think through. We thought through the best case scenario, certainly, that all 70 people survived, but we thought through several other scenarios that are difficult to recount. And that still lingers with me. That's still my team, that still carries with us when anniversaries of this storm come around. We still think about that. Unfortunately, people in the community did perish that day that were not associated with our hospital, but that were different situations and circumstances.

So, it's certainly a traumatic event. So, making sure that our team had access to counseling. I held some really lovely—I think—some really lovely counseling sessions as a group with my team a few months later once we let the dust settle a little bit, where we could all really lean on each other. But we forget sometimes the exposure that we have as professionals of the stories that we have to tell, the photos that we had to take. I was in conversations with people on that roof who I might've been the last person they spoke to in their life. That's what they were thinking.

So, that's a lot to carry. So, ensuring they had that kind of support was very important. We did mandatory time off and things like that shortly after the storm to make sure that people had time recover and recoup. But as far as hard type responsibilities and things that we ensured that people had support, communications materials, just what can we say, what have we said, ensuring that our executives knew what we'd been releasing far as headcount and dead count and those kinds of things.

We just had to continue to beat a drum regularly. We tried to release information on a regular cadence, which is something I would absolutely recommend if you could commit to a certain timeframe of how often you're going to communicate. That was important to us. But it was important and it continues to be important that we think about how your team can handle and carry the information themselves when you're in a crisis.

You can sometimes only take so much of it, you know, as a human, and that was important. We got into a situation where one of our executive team's families was missing. And I know this person very well and, fortunately, she was okay. She was found, was safe and physically unharmed. But you go through these things as a business essentially that Ballad Health is the largest employer in the area where I serve in northeast Tennessee and southwest Virginia. And so, we're seen as a business. But we're humans that run this business, Bill. So, it becomes really real when you're thinking about your own neighborhood or your community. I helped build that hospital that was destroyed that day. I was on the team when we built and opened that hospital in 2018. So, it's very personal. So again, making sure that our team had access to that behavioral health support was paramount for all of us and continues. We still have that access and that service to our team.

Host: So when you say you wrote things you thought you would never write in your life, will you share some of those in the session?

Molly Luton: I will, I will. And they're difficult things talk about and think about. Obituary-type announcements, you know, again, worst-case scenario type announcements. It's speeches that I had prepared for my CEO. I had executives that I worked with during this crisis say to me, "Molly, why are you writing that? Why are you thinking that? That's not positive." I have to. That's our role. We have to be ready. I don't want my incident commander to call me and say, "Molly, all 70 perished," and me not be prepared and be caught in that emotion and have to write then. I need to write on the front end with preparedness, right? That's part of what we have to do.

Host: Well, Molly, thank you so much for your time today. We are definitely looking forward to your session at SHSMD Communications. Before we wrap up, one last question for someone listening. To you, what is most important to remember when it comes to hospital crisis communication?

Molly Luton: My advice is you don't have to be the expert, but you need to know the experts as a crisis communications professional. It's not our role to know the materials that roof was made of from that hospital, right, that was being flooded. It's not our responsibility to know the waterways of the river that flooded that day. It's not our responsibility to know the background of each employee who was at that hospital and their capabilities to rescue people that day. But it is my responsibility to know who those people are that can get me that information. I have to be able to find the information. I can't be afraid to ask questions.

So, I don't have to be the expert in physical planning and in geography all the things that added to that day, but I need to know who those people are and be willing to build relationships with them and ask questions and stay calm in that situation.

Host: So, you don't need to be the expert, but you need to know who the experts are and who the people are that can get you that information. Really good point.

Molly Luton: That's right.

Host: Molly, thank you so much for your time. We are looking forward to your session at SHSMD Connections 2026 in Baltimore. Thank you again.

Molly Luton: Thank you, Bill. Appreciate this opportunity.

Host: You bet. And once again, that is Molly Luton, Chief Strategic Communications Officer at Ballad Health. And for more information and to dive deeper into strategies like the ones we just talked about and Molly's session, make sure you register at shsmd.org/education/annualconference to learn more and to connect with healthcare marketing and strategy leaders from across the country.

And if you found this podcast helpful, please share it on your social channels, and please hit the subscribe or follow button to get every episode. And to access our full podcast library for other topics of interest to you, visit shsmd.org/podcasts. This has been a production of Doctor Podcasting. I'm Bill Klaproth. See ya!