Reputation  Checklist:    An  Introduction    

 Governance  Centre  of  Excellence    

September  27,  2013    

Reputation  is  Essential  To…    •  …Fulfilling  our  Missions    

•  …Community  Confidence    

•  …Getting  things  Done    •  …Fundraising  Ability  

•  …Partnerships  and  Integration    

Challenge:  

•  It  is  not  clear  that  all  hospitals  in  Ontario  adequately  recognize  how  critical  reputation  and  trust  are  to  the  success  of  our  hospitals    

•  E.g.  Every  instance  of  Supervisor  appointment  in  Ontario  has  involved  issues  related  to  community  confidence  and  trust    

•  Here  are  our  stories…      

Who  We  Are    •  Brady  Wood:  

–  CCO,  Niagara  Health  System  since  2011    –  Seconded  from  St.  Joseph’s  Health  System  during    

NHS  C.  Difficile  outbreak    –  Healthcare  administration  since  2003    –  Aids  other  organizations  with  reputational  issues,                                                                    

e.g.  Board  Member  of  Canadian  Arab  Institute    

•  Mario  Joannette:  –  VP,  Joseph  Brant  Hospital  since  2009  –  Joined  team  after  C.  difficile  controversy,  and  tasked  with  

launching  ‘New  Era’  for  the  hospital    –  Previously  worked  in  municipal  administration,  political  

communication,  and  mental  health    

Background    •  Joseph  Brant  Hospital  (Burlington,  ON)    

–  Decreased  trust  and  reputation  harmed  after  C.  difficile  outbreak  in  2006/2007  –  Great  deal  of  leadership  turnover  –  Concerted  effort  to  improve  quality  and  image  –  Major  redevelopment  commenced  with  provincial  and  municipal  support    

•  Niagara  Health  System  (Niagara,  ON)    –  Historic  resistance  to  merger  of  7  hospitals;  10+  years  of  controversy  –  Following  C.  difficile  outbreak  in  2011,  Province  appoints  Supervisor    –  Concerted  successful  effort  since  to  regain  community  confidence,  improve  quality,  and  

improve  political  and  media  relations  –  New  million-­‐square-­‐foot  hospital  opened  in  March  to  much  fanfare  

•  St.  Joseph’s  Health  System  (Hamilton,  ON)    –  Multi-­‐hospital  system  in  Hamilton,  Brantford,  Kitchener,  Guelph  –  Historically  maintained  strong  reputation  in  communities  served  –  Successful  in  attracting  provincial  investment  and  achieving  national  profile  for  

improvements  –  International  Outreach  Program  achieved  great  recognition  for  work  in  developing  

nations        

Trends  Informing  the  Checklist    

•  Global:  – Decreased  trust  in  corporations  – Corporate  governance  focus  on  reputation  – Evolution  of  public  relations  function;  increasing  professionalization    

– Greater  public  scrutiny;  informed  consumers;  social  media  use  

– Rapid  media  cycle;  greater  media  scrutiny  on  organizations  in  crisis    

– PR  “Spin”  is  Dead;  Authenticity  is  In  (e.g.  AW  Page  Society  Report)    

Trends  Informing  the  Checklist      •  Local    –  Trust  as  central  to  therapeutic  relationship    –  Need  for  community  confidence  in  local  hospitals    –  Economic  downturn;  Ontario  austerity  and  hospital  budgets    

–  Reputations  of  hospital  sector  partners  tied  together    –  Complex  political  environments  in  most  communities      –  Inconsistent  PR  ability  and  approaches  in  Ontario  hospitals  

–  Community  engagement  is  a  government  priority,  enshrined  in  ECFAA  

   

What  Could  the  Checklist  Change?    

•  Increased  trust  with  communities  and  patients  we  serve;  less  surprises  in  planning  and  implementing;  mutual  understanding    

•  Ability  to  manage  crises;  ‘reputation  capital’  accumulated    

•  Increased  positive  and  decreased  negative  media;  improved  media  climate/relations  

•  Greater  ease  in  dealing  with  issues  requiring  backing  from  elected  officials;  strengthened  partnerships    

Using  the  Checklist  

•  In  the  next  section  of  the  presentation,  Brady  will  give  a  quick  overview  of  how  the  Checklist  might  be  used  in  practice  

•  A  few  sections  of  the  Checklist  will  be  explored  in  greater  detail  as  examples      

Inspiration    •  2007  Atul  Gawande  in  the  New  Yorker  covered  the  us  of  

ICU  checklist  in  US  hospitals      •  2010  MOH  &  Ontario  hospitals  adopt  surgical  checklist  

•  2012  Institutes  of  Medicine  launches  ‘A  CEO  Checklist  for  High-­‐Value  Health  Care’  –  Shows  utility  of  checklist  to  corporate  functions  –  Covers  Governance  vision,  culture  of  improvement,  IT,  evidence,  resource  utilization,  itegrated  care,  shared  decision-­‐making,  targeted  services,  embedded  safeguards,  and  internal  transparency  

–  Lacks  discussion  of  Reputation  Management    

Individuals  Informing  the  Checklist  

•  Hospital  CEOs  &  Executives    •  Hospital  PR  Professionals/Leaders  •  OHA  Leadership    •  Government    •  Academic  Partners  /  Mentors    – McMaster  University    

 Masters  in  Communications  Management    (MCM)    

Governance  

How  Does  the  Board  Get  Involved  in  Reputation?    

•  Checklist  is  aimed  at  bridging  Governance  and  Executive  Management,  much  in  the  same  way  as  Strategic  Planning    

•  ‘Generative  Governance’    from  Governance  as  Leadership                                                by  R.  P.  Chait  (2005)    

FIDUCIARY  

Reputation  and  Strategic  Planning?    

Today's  Hospitals'  Strategic  Plans  

Reputation  

Quality/Safety  Employee  Engagement  

Patient  Satisfaction  

Financial  Stewardship    

Measurement  

St.  Joseph’s  Data  |  2009/10    

•  123  media  hits  tracked  since  May  2009  – Positive:  92  (75%)  Negative:  18  (15%)  – Research  &  Innovation:  33  (27%)  – Haiti  Relief:  20  (16%)    – Mental  Health:  16  (13%)  – H1N1:  10  (8%)  – ER  Wait  Times  /  ALC:  7  (6%)  – Outbreaks/Infection:  6  (5%)  –  Labour  Issues/Budget:  5  (4%)  

St.  Joseph’s  Data  2009/10    

•  Data  from  Hamilton  Spectator  (most  challenging  media  partner  at  the  time)  

BEST PRACTICES Dr.  Terry  Flynn  at  McMaster    

 Flynn:  ‘organiza<onal  a=ributes  that  predicted  how  prepared  an  

organiza<on  was  to  manage  a  crisis’  (2009):      •  Leadership  •  Culture  •  Crisis  management  procedures  •  Public  rela<ons  capacity  •  Crisis  mindset,  and    •  Organiza<onal  learning      

Flynn  has  studied  Maple  Leaf  and  Toyota  …  

Title of the presentation May 16, 2012

                                               

Reputation Scorecard (Quarterly) August 2013

•  Things  have  calmed  down  completely  •  We  are  in  support  of  the  plan;  waiting  to  hear  about  

urgent  care  centres    •  New  Site  name  should  re<lect  our  contribution    •  You  are  in  a  catch-­‐22  regarding  the  need  to  deal  with  

budget  and  satisfy  the  public    •  I  am  looking  for  meaningful  ways  to  get  involved    •  The  Minister  should  make  a  decision  as  that  would  

deal  with  some  of  the  controversy  de<initively    

T  Flynn  Report    

Patient  Satisfaction  Data,  Cleanliness  Data  (audit  &  perception),  Employee  Feedback/Engagement,  Rounding  for  Outcomes  

0  20  40  60  80  100  

Jul-­‐11  

Oct-­‐11  

Jan-­‐12  

Apr-­‐12  

Jul-­‐12  

Oct-­‐12  

Jan-­‐13  

Apr-­‐13  

Jul-­‐13  

Oct  |13  

Positive  

Negative  

MEDIA METRICS COMPLAINT / COMPLIMENT METRICS

INFLUENCER INPUT McMaster  July  2011  

Telephone  -­‐18.50%  

Online  -­‐77.20%  

Paper  -­‐80.30%  

Average  -­‐58.67%  

REPUTATION POLLING

OTHER CONSIDERATIONS

Pollara    June  2012  

Avg  Impression  4.5/10  

Analysis:  36%  negative  /    26%  Positive    =  potential  improvement  of  8.5%    (-­‐10%)    

Coverage  This  Quarter:  (+)  environmental  initiatives,  new  CT  at  GNG,  new  Board  of  Directors;                              (-­‐)  parking  changes  at  Welland;  406  interchange        

Leger    2013  

Avg  Impression    N/A  

Analysis:  39%  positive  /    34%  negative  =  potential  improvement  of  15%    (+5%)    

NHS  Reputation  Data  Analysis    

•  Average  of  20  positive  to  90  negative  per  month  in  quarter  2  of  2011/12  

•  Average  of  62  positive  to  10  negative  in  quarter  1  of  2013/14  

•  Polling  indicated  8.5%  positive  improvement  in  reputation    

•  Qualitative  inputs  reflect  positive  relationships  with  political  class  and  influencers    

Crisis  Communications    

Crisis  Communications  Methodology    •  Timothy  Coombs’  (2007)  algorithm  –  ‘Situational  Crisis  Communications  Theory’  :  Primary crisis response strategies Deny crisis response strategies Attack the accuser: Crisis manager confronts the person or group claiming something is wrong with the organization. Denial: Crisis manager asserts that there is no crisis. Scapegoat: Crisis manager blames some person or group outside of the organization for the crisis. Diminish crisis response strategies Excuse: Crisis manager minimizes organizational responsibility by denying intent to do harm and/or claiming inability to control the events that triggered the crisis. Justification: Crisis manager minimizes the perceived damage caused by the crisis. Rebuild crisis response strategies Compensation: Crisis manager offers money or other gifts to victims. Apology: Crisis manager indicates the organization takes full responsibility for the crisis and asks stakeholders for forgiveness. Secondary crisis response strategies Bolstering crisis response strategies Reminder: Tell stakeholders about the past good works of the organization. Ingratiation: Crisis manager praises stakeholders and/or reminds them of past good works by the organization. Victimage: Crisis managers remind stakeholders that the organization is a victim of the crisis too.

Media  Relations    

Comments  and  Questions?    •  We  don’t  consider  the  Checklist  a  

closed  project;  if  you  have  suggestions,  we  are  all  ears!    

•  We  are  grateful  for  the  opportunity  to  present  to  this  distinguished  group.  

•  We  are  willing  to  present  to  individual  Boards  or  groups  in  greater  detail  regarding  how  to  use  the  Reputation  Checklist  to  improve  performance    

mjoannette@josephbranthospital.ca  brady.wood@niagarahealth.on.ca