Friday, February 7, 2014

The Triage Model for Crisis Communications

Anyone with even the most casual interest in medical television shows or movies has heard the word “triage” bandied about at some point.  More often than not in an emergency room setting, or when the scene involves wartime action or if first-responders are at the site of some horrific event or natural disaster.

Triage is the process of determining the priority of medical care based on the patient’s condition.

Over the years, I’ve often thought of the triage model when looking at communications crises.  The analogy has worked for me.  The organization is the patient. The triggering event that caused the crisis is the equivalent to the medical event that put the patient into distress.  We, the crisis communications team, are the emergency room, each with something to contribute.

It must be noted that the crisis communications team is not made up only of communicators, just as a medical triage team is not made only of doctors. Each member has a role to play. So, just as an anesthesiologist has a role to play in triage response, so, too does the lawyer, the HR person or the operations chief on the crisis communications team.

So why triage?

A little more background may be necessary to make this analogy work.

Triage rations patient treatment efficiently when resources may not be sufficient to completely satisfy all of the most urgent needs at the time.  The linguistic origins of “triage” is rooted in the French verb “trier,” which means to separate or select.

When medical teams use triage, they are following a process to determine the order and priority of emergency care, the order and priority of emergency transportation, and even the destination to which the patient will go.

The heart of triage is the ability to immediately assess the most threatening risks and know the quickest and most efficient way to minimize those risks.  This ability or process manifests itself in levels of risk.  These levels are well-understood across the medical profession and helps responders know immediately what’s expected of them when they enter the picture.

When seconds matter, the common language and terminology of triage enables paramedics to quickly prep the emergency room staff while the patient is en route. Emergency room staff can effectively communicate with and prep surgical staff, and so on.

The Levels

At its most basic, triage tends to be broken down into three levels:

  • If the patient is likely to live, regardless of the care required.  This is the lowest-risk patient.
  • If the patient can benefit the most from immediate and urgent care, and stands a chance of making the biggest positive impact.  This is the high-risk patient who still has a chance to survive.
  • If the patient is likely to die, regardless of the care received.  This may be the highest-risk patient, but if responsible and proper diagnosis is made and still this patient is deemed unlikely to survive, then the difficult decision is made to apply medical rescue resources elsewhere.

Of course, the medical field has evolved over the years and triage is in practice much more complex than basing all decisions simplistically according to these terms.

Considerations may need to be made based on the wishes of the victims and their families if known.  And a good segment of triage decision-making today has to take into account what the latest medical technologies and treatments can accomplish and what the possible outcomes can be.

One of the more recent and common triage models is called START, or Simple Triage and Rapid Treatment.  So here are the priority levels:

·   Deceased – Victims who are not breathing and efforts to resuscitate have failed.

·   Immediate/Priority I – This is sometimes called “Code Red,” where evacuation by any means possible is required.  These victims need medical care in less than an hour. They may die without immediate assistance.

·   Delayed/Priority II – This is sometimes called “Code Yellow.”  Medical evacuation can be delayed until after all Code Red patients have been transported.  They require urgent medical assistance, but their current condition may be considered stable.

·   Minor/Priority III – This is called “Code Green.”  These individuals are not evacuated until all Code Red and Code Yellow victims have been transported.  They will likely not need advanced medical care, at least for a few hours, though they likely should be monitored for an unexpected worsening of their condition.

The Communications Triage

Typically, in crisis situations, while it’s easy to think of the entire organization as “the patient,” when applying a triage-style process, in fact it becomes the issues that make up the crisis that become individual patients.  Or perhaps key messages, departments or even geographies that can serve the role of patient.

For example, let’s say a company makes fax machines, along with other office products.  Yet, for some reason, the company was slow to give up on the manufacture of fax machines as communications technologies have advanced.  The fax machine division has drained company capital and resources.

Now it is filing for Chapter 11 bankruptcy protection.

Using a triage model, the fax machine business is deceased and not worth spending valuable communications resources or energies.

But perhaps the plant where those machines were made has a work force of 100 people who can still cost-effectively make something else.  It may be worth considering some communication around company efforts to keep that operation alive with the proper retrofits.  Leave hope that either the company could continue to operate the facility or sell it.  Such an effort might require urgent attention, if not immediate.

Most likely what will require Code Red attention is the company’s stock price, which will show the most immediate damage if the company doesn’t do something to maintain some level of confidence on Wall Street.

Then, there may be that work horse division, the one that has carried the company through good times and bad – its photocopier division.  This may be Code Green, something to monitor, but more than likely it will survive intact once the company emerges from bankruptcy.

That’s a quick description of how the triage can be applied to crisis communications planning and response.  I know it scratches the surface, but as with any analogy, its purpose is to serve as a starting point for thinking. With that in mind, I’d love to know your thoughts on this. 

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