In a real emergency, one size can't fit all

In incidents such as the Boston Marathon tragedy, the PR pros involved struggle with the balance between privacy and reaching out to the public, media, or other sources to get help. Weighing the risks and benefits is essential to achieve the best possible outcome.

During the recent tragic events at the Boston Marathon, the emergency response team at the event and area hospitals faced tremendous pressure to care for the more than 250 injured patients coming into emergency rooms with little notice.
 
Given the nature and speed of the crisis, the difficulty of obtaining accurate patient information and connecting with family members cannot be overstated. The priority at the moment is to save as many lives and limbs as possible. Effective communication to patients and families is secondary in such a situation. At the same time, families are frantic as they try to learn whether their loved ones are safe. In the end, one could not be surprised by the tragic case of Krystle Campbell.

The 29-year-old's parents were initially told she had survived with serious leg injuries, but when they went to identify her, they realized it was her friend carrying an item with Campbell's name on it. The bombings, they would soon learn, took their daughter's life. Logically, it is very easy to comprehend how – in the midst of utter chaos – doctors could misidentify someone in this situation. That doesn't lessen the parents' shock, grief, and anger one iota.
 
Patient privacy is protected by the federal government under HIPAA (Health Insurance Portability and Accountability Act) and taken very seriously by hospital staff. In some cases, however, patients may arrive at the hospital unconscious and/or with no identification. Often hospitals and law enforcement work together to identify a patient, especially if the situation is grave, in order to find and notify family members. Unfortunately, there is no “one-size-fits-all” communications strategy.  
 
Recently, a patient who had come to our emergency department died from a gunshot wound. Emergency-room staff acted swiftly to try and save him, but after he died we learned he had no identification on him. Our police department worked with the coroner's office to get his fingerprints and discovered that he was the former husband of one or our employees – or so we thought. In speaking with our employee, we learned that her former husband was alive and well. It turned out that the Ohio man's identity was stolen.
 
After lengthy internal discussions, it was decided the best option to identify him was to reach out to law enforcement and share the man's photo. Given all the incidents of gun violence over the last few months, we did not want his picture going public and were hopeful that he could be identified through sharing it only with law enforcement. The nature of his injury was quite severe, so we had the additional concern of the photo possibly being too upsetting to the public. That approach worked and he was identified as a man from Oklahoma. We were then able to find his family.

Thankfully, our strategy worked in this instance, but there's no guarantee it would work the next time a similar situation arose. In incidents such as this and the Boston Marathon tragedy, the PR pros involved struggle with the balance between privacy and reaching out to the public, media, or other sources to get help. Weighing the risks and benefits is essential to achieve the best possible outcome. Despite the immediacy and fluidity of emergencies such as these, it's essential to evaluate all options and understand the potential downside or upside of your actions.

As hospital communicators, doing right by the patient is truly a paramount concern. As such, we often have to stretch ourselves beyond our comfort level to bring families and patients together in difficult times. It's an imperfect science to say the least, but I commend my colleagues in Boston. In nearly impossible circumstances, their outreach to the public not only helped those who were injured and their families, but also comforted all those affected by the tragedy.

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 sheile@ccf.org. 

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