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Media Strategies of Health Care Inspectorates in Europe: Dilemmas and Dynamics

This study explores the media management strategies of health care inspectorates in Europe, highlighting the dilemmas they face in balancing accountability, public perception, and effective communication. The research examines the impact of media coverage on the work of inspectorates and offers insights into developing effective media strategies.

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Media Strategies of Health Care Inspectorates in Europe: Dilemmas and Dynamics

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  1. Dilemmas and dynamics of media management An explorative study on media strategies of health care inspectorates in Europe • Prof. Mark van Twist • Presentation at 20th EPSO Conference Helsinki, Finland • (September 30th2015)

  2. EPSO conference in Utrecht (2012)

  3. Starting point: a personal puzzle • Dutch Health Care Inspectorate closes down intensive care units in hospitals, to end life threatening situations. • (Former) Inspector General is asked to come and explain this action on national television in the Netherlands. • Expecting applause for showing decisiveness, instead he is criticised severely: unexpected shift in ‘blame game’

  4. Paradoxes of media management • 1st paradox: The essence of inspection is making sure everything is allright - by exposing what is wrong. • 2nd paradox: Inspectorates are invisible in the media if nothing is wrong - and (so) their work is successful. • 3rd paradox: Inspectorates become visible when things are wrong; then easily framed as ‘failing’ in ‘blame game’. • 4th paradox: not only critical reports make Inspectorates vulnerable, supportive reports do so even more.

  5. Mediatization perspective • Preliminary research on perceptions of media influence by EPSO members, first presented in 2012 in Utrecht… • Informational biases in the media (Bennett, 2009): • Dramatization • Personalization • Authority disorder bias • Fragmentation • Media logic ‘invading’ and ‘colonizing’ other domains?

  6. Conclusions of preliminary research • Perceptions of media-attention by EPSO-members (2012 EPSO conference in Utrecht) • Increasing media attention for supervisory work • Can be productive but also counterproductive for the work of the health care inspectorates • Media coverage and frames can be influenced by the health care inspectorates • Inspectorates should reflect on how they develop effective media strategies

  7. EPSO conference in Brussels (2013)

  8. Theoretical perspectives on influence of media

  9. Framework for research on media management • Distinction between strategies for: • Impact enhancement: attracting positive publicity on the organization. For instance by publishing information, press conferences, pre-arranged interviews. • Damage control: protecting the organization against negative publicity. For instance by the spinning of potentially damaging stories or the suppressing of potentially damaging information.

  10. Research on media management • Study on relation between EPSO-members and media (2013 EPSO conference in Brussels), first results: • Ambivalent relationship between media and health care inspectorates. • Both serve as ‘watchdogs’ in the public domain, but they do not so in a concerted effort. • The media can create windows of opportunity and provide a platform for sending messages to public. • But the media can also interfere with inspectorates efforts e.g. by holding them accountable for incidents

  11. EPSO conference in Porto (2014)

  12. Research approach • Step 1: Discussing experiences with the media • Step 2: Collecting cases • Step 3: Performing a vignette study (questionnaire) • Step 4: Discussing and interpreting results

  13. 21 Respondents from 11 countries

  14. 16 vignettes tested by EPSO contacts: most of them relevant in different national contexts

  15. Vignette: example • Your supervisory organization is conducting its regular periodic review of all major hospitals. There are no specific complaints or negative sources of information. • You receive a request from a television broadcaster wanting to make a program about the work of your inspectors. • Strategic option: Do you collaborate with the makers of the television program, who will show the work of the inspectors inside the hospitals?

  16. EPSO conference in Helsinki (2015)

  17. Media management: dilemmas (1) • An Inspectorate should always actively inform the public on incidents through the news media even when this greatly damages the trust in the health care sector. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  18. Dilemmas and dynamics of media management

  19. Media management: dilemmas (2) • An Inspectorate should always actively inform the public on incidents through the news media, even if there is the risk of ‘backfiring’ in the blame game. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  20. Dilemmas and dynamics of media management

  21. Media management: dilemmas (3) • An Inspectorate should always publish reassuring news about health care organizations, even when it makes the public sceptical about the inspectorates independence. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  22. Dilemmas and dynamics of media management

  23. Media management: dilemmas (4) • An Inspectorate should always publish reassuring (good) news about health care organizations, even if this makes the sector & Inspectorate vulnerable in a later stage. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  24. Dilemmas and dynamics of media management

  25. Media management: dilemmas (5) • An Inspectorate should collaborate with television broadcasters if they propose to make a ‘real life’ program on the work of inspectors. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  26. Dilemmas and dynamics of media management

  27. Media management: dilemmas (6) • An Inspectorate should inform the media on findings in their reports even before the work is complete, to help create the ‘right’ story lines. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  28. Dilemmas and dynamics of media management

  29. Media management: dilemmas (7) • If the Inspectorate is being criticized in the media it is best to wait for attention to ebb, not to start defending the Inspectorate by bringing out new information. • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  30. Dilemmas and dynamics of media management

  31. Media management: dilemmas (8) • An Inspectorate should stick to the facts and never engage in ‘framing contests’ or make use of biases in the media logic (e.g. dramatization, personalization). • Yes or no? Why? • What are opportunities and threats of each option? • What conditions would you set to either yes or no? • Who should be involved in discussing, deciding and reflecting on this particular media strategy?

  32. Dilemmas and dynamics of media management

  33. Research on media management: conclusions • Study on dilemmas and dynamics of media management (2015 EPSO conference in Helsinki): • Important role for the inspectorate leadership • A well-functioning organization • Connecting media strategies with other actors • Connecting internal and external media strategies • Attention to facts and framing • Establishing continuity during crisis • Prevent disasters after the disaster • Structural media management: toggling time horizons

  34. EPSO conference in …. (2016)

  35. Social Media & Inspectorate 2.0? Social Media Inspection 1.0 Inspection 2.0 • Strategic challengefor health care inspectorates: toidentify • the tensionbetweenorganizationalcapacities and the need to adapt to the nature of open and/or citizengenerated data andsocial media • the potential of big, open and/or citizengenerated data andsocial media tocreate public valuethroughinspection

  36. Innovations in health care inspection? • Looking for innovative media management practices deemed relevant, appropriate and useful in the context of being ‘watchdog in the public domain’: • More interactive: • e.g. Wheredoesmymoneygo.org, Zorgkaart.nl • More citizend initiated: • e.g. Mypolice.org, Patientslikeme.com • More dynamic: • e.g. Twitter day, Recovery.gov

  37. Interactive Accountability • User generated content on quality of health care • Patient centered • Personal experience • Soft information • Rating of doctors • Number of likes… • Comparing providers • Potential harm • New challenges: selection bias & social desirability bias • ‘Crowd validation’ & important source for Inspectorate?

  38. Citizen Initiated Accountability • Online • Local knowledge • Crowdsourcing • Interactive • Using open data • Prosumers • Wiki wisdom • GIS & Mash ups • Self organization

  39. Dynamic Accountability • Information on quality of public service organizations • Problem spotting • Detect fraud/waste • Visualization • Predictive value • Engage citizens • Coproduction • Opportunities to participate • Upload/download information • Developing new and innovative strategic options

  40. Process model of communication in traditional media: • Network model of communication in social media: Sender: message Reciever: effect

  41. Inspectorates & Social media strategies: disruptive innovation? • Optimistic view: user generated state, cocreation • Open innovation (Chesbrough, 2003) • Wisdomcrowds (Surowiecki, 2004) • Wikinomics(Tapscott, 2006) • Crowdsourcing(Howe 2008) • Critical view: big brother, soft sister • Cyberocracy(Ronfieldt, 1992) • Monitorydemocracy (Kean, 2009) • Armchair auditors (OPI, 2013)

  42. Contact Erasmus University Rotterdam Departement of Public Administration Prof. Dr. M. (Mark) van Twist Postbus 1738 3000 DR Rotterdam Telephone: +31 70 30 24 932 e-mail: m.vantwist@fsw.eur.nl or twist@nsob.nl Netherlands School of Public Administration J. (Jorren) Scherpenisse Msc Lange Voorthout 17 2514 EB The Hague Telephone: +31 70 30 24 933 e-mail: scherpenisse@nsob.nl www.nsob.nl/en

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