Administrative Issues in Outbreak Investigations: Working with the Media OR . . .

1. Administrative Issues inOutbreak Investigations:Working with the MediaOR . . .

2. How to OptimizeYour 15 Minutes of Fame M. Joan Mallick, R.N., Ph.D.

3. Part B Working with the Media during an Outbreak Investigation

4. Introduction • Current discussions about relationships between health departments and the media seem to focus on the issue of strategizing how to communicate during emergency situations • The term stratagem is defined as “an artifice or trick in war for deceiving and outwitting the enemy” (Merriam-Webster Collegiate Dictionary Online, http://www.m-w.com/cgi-in/dictionary?va=stratagem, 2002) • This represents a very negative approach and is more likely to result in poor interagency relationships and negative media coverage

5. Introduction • The most productive approach to working with the media during any situation is to consider them as allies who can perform various assistive activities during an outbreak investigation including • alerting exposed persons who may not know an investigation is taking place • advising the population of the measures that are being taken to determine the causes of an outbreak and their elimination • explaining the risk of exposure to the general population after the initial outbreak

6. Purpose • The purpose of this course is to provide ideas about how to work with media during emergency situations so that the goals of both institutions are met • The ideas come from • practical experience • interviews with a • local television anchor person • partner in a public relations firm who has worked with organizations experiencing health emergencies

7. Objectives • At the completion of this course the reader should be able to describe • current methods used by media to collect information for stories • ways to provide media access to information based on the needs of all organizations, including those being investigated • public relations advice for organizations being investigated • actions that diminish the credibility of health department information • counterproductive methods of restricting access

8. Scenario 1 • One Sunday morning I woke up to banner headlines that read something like this Hundreds Sick After Attending Conference Banquet

9. No one from the health department had been advised of the incident by convention attendees, EMS, or local emergency room staff • We learned of the incident from the press that had issued an important public health alert

10. We also learned from the press that • no one had been critically ill • no one had been hospitalized • people had been transported by the city’s EMS • they were taken to three different hospitals • Since it was the closing banquet of the convention, most people had left the city to return to their homes, all around the US, including Puerto Rico

11. We knew from these reports that the investigation would take an extended period of time because the exposed group was so scattered. In terms of the media this meant that we were in a yin and yang situation: More time to explain the situation Extended media interest

12. We also knew that we had a big Credibility Problem

13. Because we had generally good relations with the media, the health department’s basic credibility was not in question • However, the city owned the banquet center & city council served as the local Board of Health City Hall Convention Center Health Department

14. There were grave doubts that one city department would carefully investigate and/or report on problems in another department

15. How to Maximize Our Media Opportunities • Our choices and possible consequences • keep the media out • raises doubts that investigation will • be thorough • encourages media to meet with “experts” for speculative opinions • made it difficult to prevent disgruntled employees from taking advantage of the situation to undermine the departments • encourages aggressive searches for secrets

16. Choices & Consequences • allow them in but restrict time and place access • has many of the same disadvantages of complete restriction • makes concerns about what is not being revealed as important as what is being revealed • encourages clandestine media research

17. Choices and Consequences • Allow access to various investigative activities • Builds a trusting relationship between organizations • Allows fuller understanding by the media of the complexity of the process and uncertainty of the outcome • The role of outside experts becomes one of commenting on whether media staff have interpreted information correctly

18. Providing Access • We chose to allow a newspaper science reported to follow staff as they developed interview protocols, interviewed exposed persons, and analyzed data

19. Establishing the Ground Rules • Ground rules for access were established as follows • All personal information was to remain confidential • personal information would be restricted to the extent possible • names would be masked when the reporter was reading interview response forms • if the reporter overhead a name while listening to an interview (after informed consent of the interviewee), it was to remain confidential • the reporter was not allowed to contact interviewees based on knowledge of their name or location

20. Ground Rules • Staff outside the immediate investigation staff would be accessible, but the observer should clear the interview with the administration first • medical staff who might not be directly involved should be made available to the observer to clear up medical details • The observer and administrator should meet at the beginning and end of each day • to review planned events • to provide an opportunity to discuss and clarify observations

21. The Outcome • Our experience with the newspaper was a positive one. The stories were detailed and provided a more serious approach to our work. What started out as a sensational story became one that informed the public not only of the details of the investigation but of the nature of public health investigations

22. Scenario 2 At about 3 p.m. on a Wednesday afternoon I received a phone call from a pediatrician in a local emergency room. She said that for the second day in a row, students from a middle school were in the ER with complaints of nausea, headaches and lethargy. She realized the school had not called the health department the day before as they had said they would. By this time the media had also been notified

23. The Media Issues • This situation raised the issue of who communicated with the media • the school system interpreted communicating with the media as controlling the media • they wanted to limit access almost completely • they wanted to control all information that the media received • the health department, having had good outcomes previously was less concerned about providing the media access to information

24. Health department staff controlled the information by virtue of the fact that they were uncovering the details of the cause ot the outbreak. Therefore, we could have mandated that information come from them and not the school board. Would it have been wise to do so?

25. Sounds Like Good Advice • An Ohio public relations firm specializes in working with companies and organizations that are experiencing emergencies that affect the well being of • its employees • its customers • its “neighbors”

26. Sounds Like Good Advice • It gives a three part piece of advice that should guide all public relations activities in communicating bad news Tell it first – Tell it all -- Tell the truth

27. The school system had already ignored most of this common sense advice • The health department and the media had not learned of the problem from them first • the media had learned the second day because the students were sent to the ER on a school bus

28. Our Dilemma? Did we want to be Jiminy Cricket or Pinocchio?

29. Our Strategy • The school system was as reluctant to provide us information after the incidents were reported as they were to report the incidents in the first place • Struggling over access to the media would provide another source of tension between the two agencies • We decided to allow the school system to determine how the media would be informed

30. The Results • As we surveyed the school environment, discussed investigation methods, and/or traveled to and from investigation sites, all media eyes were upon us • We saw pictures on television and in the news that were taken through windows of the school

31. School employees and families became a primary source of media information about what may have happened and why

32. Teachers and staff, some still angry over previous contract negotiations with the school board, took the opportunity to become anonymous news sources

33. As the media story of the event continued the news was all bad

34. School administrators eventually recognized the importance of regular communication with the media !

35. Revised Approach • Though not directly intended as such the final method for working with the media turned out to be quite clever The school board hired a consultant whose job was described as to conduct an independent investigation and report to the board, the parents, and the media

36. The consultant realized he would be duplicating health department efforts by conducting his own investigation • He routinely consulted with health department administrators for information updating the investigation • He saw his role primarily as convincing the media that the whole truth and nothing but the truth was hereafter being told • he realized the importance not only of describing the findings but describing the process

37. The consultant’s resources (= large consulting fee) allowed him to develop fancy audio visual presentations for press conferences and parent meetings

38. His polished approach presenting public health information assured everyone that progress was being made • He was also able to present remedial actions in a positive light and defuse the hostility associated with the problems that caused the outbreak

39. The health department staff were relieved of the stresses of • quickly solving the mystery of the outbreak • convincing the media of its own veracity • struggling with the school board over “media rights” • speaking for the school system

40. Staff were disappointed that they were not give credit for solving the outbreak mystery • However, administratively, the trade-off was well worth the sacrifice • Encouraging use of media consultants appears to be a good piece of advice for use by health department administrators

42. Epilogue—A Personal Note • I hope you enjoyed these stories and gained some insight into techniques to improve the integration of investigative efforts and media relations • Questions about the technical aspects of the investigations or the findings may be directed to me through the Supercourse evaluation forms online Joan Mallick