Communicating change without losing public trust

When it comes to healthcare, what might be a sound business decision can be misunderstood as intentional disregard for the community.

Hospitals are complex organizations that can be challenging for patients to navigate, let alone understand how they work behind the scenes. From billing processes to long waits in the emergency department, it's easy to see how the public-at-large, as well as patients, can perceive hospitals as behemoth institutions leading them to the brink of madness. When it comes to healthcare, what might be a sound business decision can be misunderstood as intentional disregard for the community.

If you extend that to communicating about substantial changes within a healthcare system that affects a broad community, a difficult task becomes a monumental one for any PR pro. Consolidating a service from one hospital to another can be seen two ways — expansion in one community and scaling back in another. One is to be celebrated and the other protested. Trying to explain these decisions to a wide range of community stakeholders, as well as the general public, is a struggle on many levels.

Even with the best intentions and careful planning, communication has to be proactive, transparent, simple, and consistent — all while engaging a diversity of audiences. At the same time, a PR pro must consider all the factors influencing public perception, such as community demographics, economic problems, high unemployment levels, transportation issues, disease burdens specific to a population, and the straightforward business reasons that contribute to the change.

A while back, we made a decision to move trauma services away from one of our community hospitals to another, larger hospital a few miles away. That facility is in a growing community, the other in a declining one. Patient volumes are down at one and wait times are up at the other. At the same time, talented surgeons and other medical providers don't have enough patients to keep them busy. Surgeons do more than trauma. In fact, general surgery constitutes the majority of their practice. That means they're not busy enough to keep their skills sharp.

What lesson can be drawn from this?

For communicators, the essential job is to engage stakeholders in conversations early on, in person, and with transparency at every step. Education and dialogue go a long way to reducing negative effects on your reputation and helping maintain public trust. If you hold open discussions with the community about the challenges you're facing, let them know how you're going to serve their community going forward and listen to their fears and challenges. That will make them much more likely to understand the decision, even if they don't agree with it. At the same time, be well prepared and have a fully integrated communications strategy that keeps the messages clear and simple, while providing context around the decision.

Finally, choose your spokespeople carefully. Be sure they know how to tell your story across multiple levels to a variety of audiences, because you don't want to be in a position where you have too many narratives and it becomes a game of herding cats.

Eileen Sheil is executive director of corporate communications at Cleveland Clinic, one of the country's top nonprofit academic medical centers. Her column will focus on the myriad challenges of healthcare PR and topics related to the management of the comms function. Sheil can be reached at

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