There is a well-known saying in consumer-driven industries that a reputation can take decades to build and only minutes to destroy. Yet, we continue to see examples of how a poorly managed crisis can bring down a reputable company and its revenue overnight.

Does reputation really matter in the hospital industry? Yes, according to a recent report by National Research Corp. that measured the relationship between hospital reputation and consumer preference. A favorable overall reputation is as valuable in the acute care industry as it is in any other business-to-consumer industry. In fact, three out of five consumers report that hospital reputation is "very important" when they are considering a hospital for future needs.

With regard to cancer care preferences, a hospital's image can matter more than its doctors, its amenities and patient safety. Similar results were found to be true in preferences for heart care, maternity and neurology.

A Reputation at Risk

There are reports in the media almost daily of incidents that put a hospital's reputation at risk. Just as often, we see hospital administrators lose control of the situation and relinquish the hospital's reputation to critics and competitors. For example, last fall when John Peter Smith Hospital in Fort Worth, Texas, upheld state law by keeping alive an unborn child in its brain-dead mother, Marlise Muñoz, administrators appeared unprepared for the onslaught of negative coverage that followed in the national media.

From the start, the relatives of the patient, not the hospital, drove the public discourse. For weeks, the hospital's reputation was juxtaposed to images of a brain-dead mother and her loving family — emotionally and psychologically wrecked by the actions of allegedly unfeeling hospital executives and doctors. This imagery, graphic and disturbing, ultimately helped to compel a judge to order the hospital to disconnect the brain-dead patient from life support, ending the David-and-Goliath situation in favor of the family and at a loss for the hospital.

While high-profile incidents like the Muñoz case may be rare, lower profile incidents can be just as damaging locally. Take the recent rise in workplace violence. The Bureau of Labor Statistics reports that violence against health care and social assistance workers increased by 13 percent from 2009 to 2010, the most recent data available. This trend has prompted several states, including New York and Illinois, to require employers to run workplace violence programs.

Prepare for the Worst, Act for the Best

Many believe that a crisis of public proportion cannot be predicted, that it is impossible to anticipate the actions of an insane person or a product's failure or the media's fickle appetite for what constitutes news. Yet, the Institute for Crisis Management reports that executives and managers consistently have triggered 49 percent of all corporate crises (nearly half!); employees account for more than 30 percent. So yes, while it may be difficult or even impossible to predict when a crisis will occur and what it will be, one can predict confidently that it will happen. Fortunately, the key to minimizing damage and speeding recovery following a crisis is knowing who will speak and what will be said well in advance; this is crisis management.

The most effective crisis management plans are constructed with a cross-functional philosophy and comprise three integrated elements: infrastructure, training and action.

Infrastructure. The first step in preparing for the inevitable is to establish a team. A well -thought-out internal crisis management team can conceptualize a list of likely and unlikely crises as well as construct, prepare for and rehearse response plans. The Federal Emergency Management Agency offers a step-by-step approach to building a crisis management team in its publication "Emergency Management Guide for Business and Industry." The Journal for Quality and Participation also offers valuable insight on this topic.

Once your hospital has assembled a team, designate a physical space where the team can meet and operate in a crisis — a war room. There, team members can gather information, hone messages and prepare spokesmen or women, so the space must be equipped to monitor the media and emergency services and be staffed with trained crisis team members who go operational only in a crisis. 

Training for transparent communication. In the face of a crisis, balancing responsibility between a commitment to shareholders and to the community becomes even more difficult. Plan in advance with an agenda of transparency, so you can clear the channels for communication after a crisis. Preparing spokesmen to address transparency will be essential as research has shown that organizational leaders who demonstrate ethical conduct and maintain open communication are better equipped to help their organizations move beyond crises.

Believable communication that achieves a balanced outcome during a crisis requires intelligence, practice and control. An organization must have the knowledge to understand the issue at hand and the audience involved early on. It must be prepared to respond in crisis as though it were second nature, and it must control messaging across communication platforms — broadcast media, social media and face-to-face exchanges — to ensure message continuity. Commit to a quarterly practice of possible responses with internal and external audiences that might be affected by a crisis. Because of the rapidly changing nature of an acute care facility (e.g., staff changes, new patients, plus the high-profile attention health care is enjoying in the media), you cannot discount practice and retraining.

Action. Whether it is an on-site act of violence, a controversial handling of a patient case or a data breach, your constituents want to know what happened from you as "the" trusted source. Take ownership of the situation and deliver the story accurately, professionally and consistently in a caring and compassionate way.

The news media is notoriously fickle when it comes to how it covers a crisis. If it occurs in a slow news period, the coverage will be extensive to the point of tedium. If it's a busy period with lots of news, the opposite can be true. Holding off communication to see how the incident plays in the media is dangerous. Health care is one of the most closely watched industries in the news these days, and a hospital must act with that in mind. Issue a statement immediately, even if that statement is that other statements are to follow shortly. This indicates to the media and to the community that an open line of communication is in place and ready for use.

Never disregard the power of social media. The Pew Research Center reports that more than 60 percent of people younger than 40 get their news from social networks, including Facebook and Twitter. In fact, Twitter has played a pragmatic role in communication exchange during several recent high-profile crises, including the capture of the Boston Marathon bombers and the Fort Hood shooting. Social media channels are constantly monitored by content-starved media outlets, as well. Factor in social media when constructing a crisis communication plan.

Keeping Damage to a Minimum

As mentioned previously, 60 percent of patients surveyed in a recent study said a hospital's reputation is very important when they are considering a hospital for future needs. Many indicated that the overall reputation of a hospital is as meaningful to them as the quality of care, doctors or amenities at that facility. Unfortunately, a hospital's reputation is as vulnerable to damage as any consumer-driven business. The isolated act of a madman, an industrial accident or workplace violence can destroy a hospital's reputation in minutes if the organization manages the crisis poorly.

With media coverage of the health care industry on the rise and the unprecedented influence of social media, acute care facilities no longer can afford to be unprepared for the inevitable. Having the right team in place and the commitment to train and practice response regularly, a hospital can minimize damage and speed recovery by acting decisively and with confidence following a crisis.

Susan Neisloss is the president of Big Bite Inc., a crisis management and media training firm in Santa Monica, Calif.