It takes years to build, but can be lost in an instant.

Nothing can eat away at a hard-earned reputation like a crisis — a crisis that plays out in the 24-hour news cycle, on Facebook and Twitter, and in line at Starbucks.

For the past couple of months, the Ebola crisis has shown how fragile that trusted bond with the public is and how quickly it can erode as facts gave way to emotions and conjecture.

To be sure, mistakes were made in the way Texas Health Presbyterian Hospital handled the first diagnosed case of Ebola in the United States. Executives and clinicians from the hospital have admitted as much. Officials from the Centers for Disease Control and Prevention and other public health agencies also fumbled the process along the way. I recall watching CBS' "Face the Nation" one October Sunday and Bob Schieffer asked his guests — including AMA President Robert Wah, M.D., and AHA President and CEO Rich Umbdenstock — if they still had confidence in the CDC.

Both unequivocally said, "Yes." Still, the mere fact that the question was asked was telling in and of itself.

The Ebola postscript is still being written and will undoubtedly be reviewed for some time. As we move beyond the immediacy of what happened in Dallas, though, the crisis is a stark reminder of how important it is for hospitals and health systems to have a well-designed and well-tested crisis management plan.

"In any health system, there are issues that you are not planning for," says Susan Alcorn, senior vice president, Jarrard Phillips Cate & Hancock, a strategic health care communications firm based in Nashville, Tenn. "A crisis plan helps you to keep your perspective and keep focused on your mission and values."

Alcorn, a 30-year veteran of hospital communications and the former chief communications officer of Geisinger Health System, says that hospitals are in the unique position to be a calming voice in the wake of a man-made or natural disaster. That's true even if the hospital becomes part of the story. Achieving such stature takes time, Alcorn says, and demands a concerted effort to be responsive to staff, the media and the public; to share good and bad news. When a crisis arises, hospital leaders need to get the facts; be transparent; educate staff, the public and media; and respond quickly. In fact, those are core tenets of Jarrard Phillips Cate & Hancock's eight cardinal rules of crisis communication:

1) Develop a communication plan.
2) Know when to apologize or show empathy.
3) Stay true to your values.
4) Tell it first.
5) Tell it all. Or as much as you can.
6) Tell it yourself. Avoid the information vacuum.
7) Get others — board members, physicians, third-party high-quality sources — to tell it.
8) Communication doesn't stop when the crisis has passed.

"It goes back to the organization's reputation," Alcorn says. "The more you can do to make sure you have the pieces and parts in place, the better positioned you are to maintain that reputation."

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