A Crash Course in Crisis Communications

Leaked plans for a new California hospital are setting off alarm bells.

Whatever actually went on behind the scenes at Sutter Health and California Pacific Medical Center regarding plans for construction of two affiliate hospitals, it does not look good.

Internal documents leaked last week make some observers wonder if the Sacramento-based health system was secretly planning to purposefully drive down CPMC's bottom line, which would allow it to prematurely close San Francisco safety-net St. Luke's Hospital.

The documents in question detail the medical center's plans to re-build the hospital so that it is seismically sound, in order to comply with a new state law. CPMC also plans on building a brand-new 555-bed facility called Cathedral Hill Hospital.

The deal CPMC struck with the city of San Francisco states that construction of the new facility is contingent on St. Luke's remaining open for at least 20 more years.

As the current deal stands, St. Luke's must stay open for a minimum of 20 years unless the medical center's operating margin is less than 1% for two years in a row. In that case, an escape clause in the organization's contract will allow leaders to shut its doors.  It doesn't seem like this should be a problem since CPMC's current operating margin is at about 14%.

The leaked documents' long-term financial projections, however, inexplicably include a scenario where the medical center's operating margin begins to plummet in 2013, resulting in a situation where St. Luke's could close in 2020—less than four years after Cathedral Hill Hospital's planned 2016 opening.

Board of Supervisors President David Chiu characterizes the financials as "highly suspicious,” according to the San Francisco Chronicle.

San Singer, a spokesperson for California Pacific Medical Center, has since explained that this particular financial projection was merely a draft that was never seriously considered. This defense sounds plausible.

But Singer's remarks went further:

The notion that CPMC is cooking the books is, he said,  "a leftist conspiracy that makes no sense to anybody who lives on planet earth.” And: "For those of us on planet earth, nobody spends nearly $300 million to make a project go under. This is a financial draft that we never contemplated, never used, and is now helping people who have fantasies of disaster.”

Perhaps these comments are driven by frustration, but they come off as plain defensive. And as far as crisis management goes, they are not helpful.

For our purposes, CPMC's response to the document leak and fallout can serve as a crash course in public relations and crisis management.

Create your message and stick to it

It's clear that the medical center's leaders are going to deny the allegations until the cows come home, but how they deny them are all over the map. Singer's explanation, as previously noted, is that the leaked documents were merely drafts and taken out of context.

But on Monday, St. Luke's chief of staff, Edward Kersh, MD, told the San Francisco ABC News affiliate, "I would like to see people put their politics aside and stop grandstanding between the mayor's office and the board of supervisors."

In the same report, CPMC CEO Warren Browner said, "I'm not willing to sign an agreement that would tie the hands of the CEO of CPMC in the year 2030 or 2035."

These statements don't contradict each other, exactly, but neither are they on the same page. Is the problem a lack of context, dirty politics, or an inflexible contract? All representatives of the organization should have a cohesive message when speaking to the media.

Find other people to have your back

A St. Luke's patient told the ABC affiliate, "You feel relieved that [St. Luke's physicians] take care of you and I think that it's very important to feel like a human being."

This statement is much, much more impactful than anything Singer, Kersh, or Browner has said so far. And that is mostly because the patient is viewed as an impartial third party and, therefore, a more trustworthy source.

That's why it's critical in any crisis situation to identify patients, organizations, and other credible stakeholders who have your back and are willing to say so on the record. The public will be more inclined to believe you if sources they trust confirm your story.

Foster a culture of preventing crises

As of this writing, CPMC has not addressed the leak itself. To me, the part of this story that sets off the most alarm bells is the question of whether someone inside Sutter Health or CPMC intentionally leaked these documents to the city of San Francisco.

This is pure speculation on my part, since CPMC hasn't said anything to the contrary.  And since no one else has said otherwise, I have to entertain the notion that it was an inside job, which doesn't sit well with me or, I imagine, CPMC's patients, staff, or benefactors.

Or perhaps a political foe or an alien not from the planet Earth (wink, wink, San Singer) snuck into the CEO's office and stole the documents, which was actually one of several drafts generated by some computer model.

If you don't want to have to deal with a public relations disaster, don't create a potentially disastrous situation. And for the times when it can't be avoided, when it's truly out of your hands, make sure you have a fool-proof crisis communications plan in place.

At the very least, don't accuse your detractors of being Martians.