PIO FORUM

by Joann Rodgers

Crisis Communications: Do You Know Where Your Flashlights Are?

Minutes before the terrorist attacks on Sept. 11, I was walking from the Johns Hopkins Hospital parking lot to a weekly management committee meeting. A colleague, en route to the same meeting, called out, "Did you hear about some plane crashing into the World Trade Center in New York?" She was hopeful that the media relations director would know more than she did. I didn't, of course, and we walked on, speculating idly about how such an "accident" could happen.

We reached the meeting room and were met with CNN and radio reports being anxiously watched and listened to in nearby offices and hallways. My pager was activated as local press called to find out if Hopkins emergency medical personnel were going to New York. (Yes, Virginia, all news really is local.)

After the second plane crashed into the South Tower, the management committee's meeting agenda unraveled as secretaries paged vice presidents, and emergency medical personnel sought guidance on whether other cities, including Baltimore, were vulnerable. It was clear that the demand for internal and external disaster communications was trumping every other activity for the public-affairs staff.

Shortly after the crash of the third hijacked aircraft into the Pentagon, Health and Human Services Secretary Tommy Thompson called the dean of the medical school to alert Hopkins it might receive casualties. Within minutes, Hopkins activated the disaster-control centers at its three hospitals, ceased elective surgeries, and began to identify candidates for early discharge to increase bed capacity. At that point, the dean, along with the president of the hospital, convened the full crisis-management and communications team for the first of several sessions that day to address the emergency and its immediate impact on faculty, administrative and medical staff, patients, students, and visitors.

When Flight 93 crashed into a field in Pennsylvania, our regional burn center was placed on high alert. Over the next several hours, the public-affairs team developed press contingency statements and arranged for internal blast faxes and e-mails to alert employees to new levels of disaster activity and preparations for assisting victims of the Pentagon and Pennsylvania attacks. Some of our emergency doctors with Oklahoma City experience were asked by FEMA to help at the Pentagon. Hopkins also sent teams to support the Red Cross blood drive across from the White House.

The press wanted details, and doctors, nurses, and staff wanted information about everything from whether they should fly home early from meetings and vacations to where to meet the bus for the White House blood drive.

By mid-afternoon it was tragically clear that most of the seriously injured succumbed before rescuers could get to them and that most emergency response teams at Hopkins could "stand down." But officials continued to communicate, responding to more media calls, thanking staff for their efforts, announcing more blood drives, and doing what they could to reassure patients, visitors, and students alike.

The Communications Enterprise After Sept. 11

Conversations with communications colleagues around the country have convinced me that we all share a common experience in the aftermath of Sept. 11. University communities and medical centers are, more than ever, expected to keep their environments safe and secure, and to communicate their plans for doing so to employees, the press, and the public. In addition, these audiences look to us as appropriate and credible sources of the information they need to be able to separate fact from fiction, and to provide knowledge and support for our communities.

So how can we organize, or better organize, our communications enterprises in a post-Sept. 11 world? Many of us have heard the loud and clear call to clarify, upgrade, or in some cases, re-invent, communications plans, and capabilities.

In doing so, questions abound: Where do we locate a press center on campus if the prospect of contagion from a biological-weapons attack is likely to take the usual sites offline? How do we communicate with office mates and leadership if satellites that enable cell-phone use are shut down or overloaded? How best can we use mass media, toll-free telephone lines, or other communications tools to get word to thousands of doctors, nurses, lab techs, and other essential personnel about work assignments in the event of a disaster the size and scope of Sept. 11?

How do we coordinate information with city, state, and federal agencies? How do we organize faculty scientists' time to respond to dozens of daily requests by journalists for access to experts on everything from smallpox vaccines and the diagnosis of Ebola-virus infection, to Islamic fundamentalism, the history of the military-industrial complex, post-traumatic stress disorder, and children's Sept. 11 nightmares?

If reporters ask (as they did of Hopkins) if the university houses any labs that work with anthrax spores, what's the answer? Should you respond (as Hopkins elected to) to inquiries from TV networks about whether the FBI is questioning any of your faculty or students, or from a patient's family about whether we have an evacuation plan for people on the eighth floor of the outpatient center? Does someone in your office know how to hook into remote servers in the event campus computer networks are out of commission? If you had to get this kind of information in the next five minutes, do you even know who has it?

Know Where Your Flashlights Are Kept

Here are tips, gleaned from Hopkins and elsewhere, with thanks to many PIOs:

• Claim a communications seat on your institution's crisis-management and disaster-planning teams. Although institutions may have plans for tornadoes, earthquakes, and train wreck-style disasters, communicating information in the event of an epidemic, mass casualties, or civilian panic requires rapid-notification systems and coordination with law-enforcement and public health entities, as well as infectious-disease, emergency-medicine, and security specialists.
  Know where you are expected to fit in, and advise institutional leadership about communications realities and limitations. For example, at one team meeting at Hopkins we learned that the disaster-control plan called for public-relations staff to provide casualty information to families-a role that clearly belonged to social workers and others authorized to collect privileged medical data on patients!
• Develop a written plan. Why? Because the exercise of writing (or rewriting) one offers a quick way to nail down responsibilities, authority, and budgetary impact. If the Hopkins experience is typical, and I think it is, it will reveal as much about what you don't know as about what you do. For example, we found black holes in our blast-fax address lists, in our list of internal administrative contacts, and in our instructions for remote access to computer networks and rumor-control hotlines.
• Create a small team to keep on top of disaster communications and public relations. The Office of Communications and Public Affairs at Hopkins assigned this team to attend all of the institutional meetings, as well as rewrite our out-of-date Disaster Communications Guide in conjunction with the crisis-management and disaster-control team.
• Exploit institutional budgets now available for post-Sept. 11 preparations and get what you need to do your jobs. Looking over our needs at Hopkins, we discovered that although many staffers had cell phones, these might be inoperable in the event of a disaster. Therefore, we purchased state-of-the-art cell phones-cum-two-way radios and upgraded home-computer capabilities for several key staffers. We also made sure that low-tech devices such as a typewriter, carbon paper, and extra flashlight batteries were assembled in a locked box of equipment for stocking a press center.
• Back up the written plan with an Operations Guide for everyone on the communications staff. This should contain information on staffing policies (who must report and where); staff assignments; press-center operations; definitions of crisis and disaster operations approved by the institution; lists of supplies and their locations; updated telephone trees for calling staff; maps of the campus; critical media contacts; and state and city emergency contacts.
• Develop a contingency plan for an off-campus communications center in the event that key staff can't get to the usual locations in an emergency.
• Have an evening or weekend drill. Test how well staff members can implement the plan. Organize a tour of key locations and facilities where public information staff will be assigned (at Hopkins, that includes the morgue, emergency rooms and the hospital's operations headquarters). We learned that half a dozen members of our staff didn't know how to use campus tunnels and bridges to find these places.
• Recruit other staff to the task of crisis and disaster communications. The folks who publish the quarterly alumni magazine, the weekly and monthly staff publications, the pubs that go to referring physicians and donors, need to be up to speed on how to operate when nothing qualifies as business as usual. Do they have a plan if their usual vendors are unavailable to print and distribute information updates? Can they quickly step in to help the media team if PIOs are unable to respond?
• Create preprinted emergency signs and posters and prerecorded messages for dedicated information hotlines. Many institutions already have these systems in place to handle weather emergencies, and they can be adapted easily.
• Create an intranet site for information about preparedness and push the site so that employees and faculty come to depend on it for information. At Hopkins, the site includes detailed information on hospital infection control; emergency-preparedness information for clinicians; updated information from the American Red Cross and the Civilian Biodefense center; relevant news releases and articles; information from the U.S. Centers for Disease Control; expert resources; security tips; links to other relevant Web sites; employee and physician preparedness plans; city, state, and federal contacts; statements and regulations; security procedures; guidelines for detecting post-traumatic stress disorder; and information about faculty and employee support. Repackage relevant, non-sensitive parts of this package for your public Web site and for media.
• Get to know-really well-key disaster-control officials. These include information technology experts, security personnel, facilities engineers, etc. Know where and how to reach them at all times.
• Develop an integrated and annotated list of institutional experts on subjects related to terrorism and preparedness. Our colleagues in the public-affairs offices at the School of Public Health, the Applied Physics Laboratory, and the university arts and sciences campus have shared lists of experts with us so that we can give the press one-stop shopping.
• Assume that everything communicated internally will get to the outside community. Establish a "third ear" for common-sense communications that inform but don't scare, and that quell rumors without stonewalling.
• Within hours of the first anthrax case reported in the press, a student in one of our university health divisions came to the emergency room with a white powder on her hands and clothes. The powder came, she said from a roll of toilet paper in a restroom and she had inhaled it! The information quickly spread that we had a "case of anthrax" in the house. Rapid notification of our office by hospital officials helped Hopkins keep the record straight internally and externally, and averted needless anxiety among staff, students, and the public.
• Finally, keep your flashlights handy.

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Joann Rodgers keeps track of the flashlights in the Office of Communications and Public Affairs at Johns Hopkins Medicine, where she is director of media relations.