Leading in Crisis: The 4 traps of decision making
Download Leading in crisis – 4 traps of decision making Dec 2013
Author: Lucien Canton
Sustainable water: San Francisco on the right track
What do a City Attorney, an evironmental specialist, and an emergency manager have to do with the San Francisco Water Department? It was, admittedly, a very unusual partnership but we all shared a common interest: deep wells.
One of the main concerns I had as Director of Emergency Services for San Francisco was water. San Francisco sits at the tip of peninsula and the end of a pipeline that extends into the mountains 167 miles away. In an earthquake, that means that our water supply is subject to interruption. Water for drinking and for firefighting was a primary concern for us as emergency planners.
This led us to the deep wells and the shrinking aquifier under the City. San Francisco had a series of deep wells but they were non-potable and had been capped for years. Part of the problem was that so much water had been pumped out of the aquifier to water neighboring golf courses that the wells were not viable and we had seen dramatic drops in the water level at Lake Merced, one of our few above-ground resources. And so I found myself working with our Department of the Evironment, a City Attorney who had an interest in the wells, and our Water Department to recharge the aquifier and reopen the deep wells.
I left office before we made any major breakthroughs but I have followed the work of my friends with interest. The City successfully negotiated alternative water options with the golf courses and Lake Merced has been largely restored. The Water Department has also established the San Francisco Groundwater Supply Project, which is intended to produce 4 milllion gallons per day of local, sustainable water. While this is small compared to our daily consumption of about 73 million gallons per day, it would be a welcome addition to the supplies in our cisterns and holding tanks in a disaster. Phase I of the project, which will create four new wells and supporting infrastructure is scheduled to begin shortly with the goal of providing 2.8 million gallons per day.
It's gratifying to see that there are still people in government that can pursue a long-term dream. To all of those who made this happen, well done!
Robin Hood and conflict resolution
One of my favorite heroes growing up was Robin Hood. I was nurtured on the TV show starring Richard Greene (yeah, showing my age) and later enjoyed reading the stories about Robin and his Merry Men, particularly those in my "Best in Children's Books" that had some really neat artwork. And when I saw Errol Flynn as Robin – well, who wouldn't want to be that cool?
As I grew older, I became interested in the historical Robin Hood and the origins of the stories. This childhood interest may well help to explain my strong interest in history, particularly medieval history, and my hobby as a medieval reenactor.
However, the story of Robin Hood also teaches a lesson in perspective. Most people think of Robin Hood and his band as merry rogues, living a life of freedom and fighting oppression. But let's change the pespective a bit. We ignore the fact that Robin and his men were outlaws, men who made their living by assaulting and robbing travelers. If we look at Robin from the point of view of middle class law-abiding citizens, we might well see a group of ruffians who stole public funds, made the roads unsafe for travelers, and didn't hesitate to discharge lethal weapons at the local authorities.
My intent isn't to denigrate the legend of Robin Hood; he's still my hero and I still love the stories. My point is that is if you change your perspective, you can sometimes see things in a new way. The failure to see both sides of an argument, even if you don't agree with your opponent's view, creates and perpetuates conflict.
Understanding your opponent's viewpoint is the first step to conflict resolution. You don't have to agree with it or surrender your own beliefs but unerstanding what motivates each side of a conflict allows you to find common ground and begin establishing trust. It opens the door to compromise. That is why the strongly-held positions by our political parties is so distressing and counter-productive. With neither side is willing to admit that there is some truth to their opponents' position, there is no possibility of progress.
So the next time you root for Robin Hood or Jack Sparrow or your favorite anti-hero, give just a little thought to how these "heroes" might have appeared to their contemporaries. A small change of perspective can make a world of difference.
In a crisis maintaining an operational focus is key to success
At the recent annual conference for the International Association of Emergency Managers I was fortunate to hear presentations by a number of the major academics supporting our profession. One thing that struck me was the similar views expressed by Dr. Dennis Miletti, a sociologist, and Dr. Brian Fagan, a historian specializing historical climate change. Both emphasized the need to take the long term view when dealing with crisis. While they were dealing with different time lines, the message was the same, "you need to see the big picture."
This is a major concern for those working at the operational level in crises. The tactical concerns are immediate and highly visible and it is easy to get drawn into trying to resolve these types of issues. I once saw a big city mayor become very involved with the rescue of passengers stranded in a subway after regional power outage, something that was a fairly routine problem for the transportation agency and the police department. On another occasion, a mayoral staff member began setting up an evacuation of the local airport on September 11th and establishing shelters for stranded passengers. The fact that there was a well-trained shelter branch available in the emergency operations center and that the problem was being handled by the airport management team completely escaped her.
It is easy to dismiss these examples as the result of untrained officials who neglect to participate in exercises and that would certainly be the case in many instances. However, focusing on the tactical rather than the operational issues is a common failing in many crisis management situations. We need to recognize that tactical issues are best handled by first responders and we must trust them to do their jobs. The best way we can help resolve tactical issues is to provide needed support to responders but, most importantly, to anticipate future needs.
This long-term view is essential in a crisis. The time available for decision making at a scene is measured in minutes and seconds. At the operational level, we have the luxury of hours and often days in which to consider the situation and make decisions. We need to acknowledge that our job is to move ahead of the crisis, identify emerging issues, and determine future resource needs. If we do our job well, it makes dealing with tactical issues much easier on everyone.
Hospital death continues to teach crisis management lessons
San Francisco Sheriff Ross Mirkarimi Photo: SF Chronicle
As many of my readers know, I generally do not follow stories, preferring to draw lessons from events rather than to report them. However, the story of the missing patient found dead at San Francisco General Hospital several weeks ago continues to evolve and to offer some excellent examples of different approaches to crisis communications.
As you may recall from my previous posts, a woman patient went missing from her room in SF General at around 10:15 AM on September 21. The hospital implemented a search protocol which included a search by Sheriff's Deputies who provide security at the hospital that failed to locate the patient. Her body was discovered seventeen days later during a routine maintenance check of a little-used fire-escape stairwell.
In contrast to the pro-active actions of the hospital (see my blog of 10/17) the Sheriff's Department has been silent on the incident. There have been no public expression of sympathy or any word of immediate corrective actions or changes to protocols. At the same time, continuing news coverage raised concerns over the actions of the Deputies and the thoroughness of the search.
San Francisco Sheriff Ross Mirkarimi finally broke his silence at a news conference yesterday, detailing numerous errors made by his Deputies – incomplete searches, failure to pass on information, confusion over the race of the patient. His briefing was professional, focusing on the facts of the case. The Sheriff did include an apology of sorts, stating, "We are eager, like everyone else, to get to the bottom line of what happened to (the victim)." He did not take questions but did provide copies of his statement.
Clearly, this incident is far from over and there's no question that there will be a lawsuit. In this light, Sheriff Mirkarimi's willingness to present the facts in this case is commendable. By avoiding the temptation to defend his department or to gloss over mistakes, he may have recovered somewhat from his long silence. However, the lack of a strong apology and a failure to demonstrate any level of corrective action (e.g. protocols have been changed, additional training has been provided) are major negatives.
Remember that in a crisis the public is looking to see real empathy for the victim, immediate corrective action, and a commitment to finding the facts.
Hospital death and crisis management
Last week I wrote about the finding at San Francisco General of the body of a patient who had been missing for almost two weeks. Since then, the team at SF General has done an excellent job of managing the crisis. Here are some of the key lessons:
- Show empathy. Displaying empathy with the victim and her family is crucial and it must be sincere. In this case, the chief medical officer was visibly moved when he said, "What happened at our hospital is horrible. We are here to take care of patients, to heal them, to keep them safe. This has shaken us to our core. Our staff is devastated."
- Avoid speculation. The hospital has resisted the temptation to guess what might have occurred. Representatives have provided the facts they have available but have not offered explanations or theories based on supposition.
- Be transparent. The hospital has launched its own internal investigation and is fully cooperating with investigations by the police and sheriff departments, state health authorities, and an independent review ordered by the Mayor's Office. The chief medical officer has stated, "Quality patient care and patient safety is my top responsibility and I am committed to getting to the root cause of this tragedy."
- Be proactive. The hospital has already made immediate changes to its protocols. The alarm on stairwell doors like the one used by the patient has been changed to require a manual reset. If the alarm sounds near a patient care area, nursing staff take an immediate census of their unit and sheriff's deputies conduct an immediate search of the stairwell. The stairwells are now inspected on a daily basis.
By demonstrating genuine empathy and making immediate changes to prevent a reoccurrence, San Francisco General was successful in changing the story from a front page scandal to one that is reported on in a measured and responsible way. The story is not forgotten and there are still the results of the various investigations to face and no doubt a lawsuit but the hospital has managed to limit the damage to its reputation and preserve the trust of the public.
Hospital death a case study in crisis management
It's every hospital administrator's nightmare: the unexplained death of a patient under the hospital's care. However, it does provide a good case study in crisis management. Read what is known about the case and then share your thoughts in the comments section.
Over two weeks ago, a patient was admitted to San Francisco General Hospital for treatment of an infection. Later that evening, a nurse checked on the patient at about 10:15. When the nurse returned fifteen minutes later, the patient had disappeared. The hospital implemented its missing patient protocol, which involved a search by hospital staff and sheriff's deputies who provide security at the hospital. As the days went by, family and friends canvassed the surrounding area and posted notices across the city, all to no avail.
Yesterday a hospital employee conducting a quarterly inspection of a little-used fire escape stairwell encountered the body that has tentatively been identified as the missing patient. The door to the stairwell is located a short distance from the patient's bed and is fitted with an alarm and locked from the inside. It's not yet known whether the alarm was working at the time the patient disappeared.
Those are the bare facts of the case. Put yourself in the place of the hospital administrator. What are your top priorities? What message will you give to the public and the family? How will you regain public trust over this incident?
I'll share some of my thoughts in my next post.
Who’s setting priorities for the government shut down?
One of the hardest things for a manager to do is to set priorities. We face an array of conflicting demands on our limited resources and are often confronted with things that are urgent but not important as opposed to things that are important but not urgent. It becomes almost impossible to set priorities when you're told to shut down non-essential operations. How do you decide which services are essential?
It seems obvious that there are a number of people in our government that haven't figured out the answer to this question. While I am always hesitant to draw conclusions from mainstream media articles without hearing from the agencies concerned, there are a number of issues connected to the government shut down that give me pause:
- California National Guard aircraft repair crews are furloughed. These crews repair the aircraft used to support wildland firefighters throughout the state. At least four major fires are burning in the state as of this morning.
- The Centers for Disease Control have halted disease monitoring, just in time for the start of the flu season. This means our ability to detect outbreaks of disease or incidents of tainted food are curtailed.
- Scientists at the US Geological Survey who monitor earthquakes are on furlough. While a lot of the detection systems are automated, the ability to interpret that data rests with these missing scientists.
A common mistake when deciding on essential services is to look at the obvious without actually doing a path analysis. What this means is we tend to look at the end service and who provides it without considering that many of these end services are the product of multiple hands. I once took a team of unit leaders to help staff a disaster without realizing that none of us knew how to do simple tasks like prepare slide presentations.
I'm not criticizing the decisions noted above. They may have been made for good reasons. But reducing our ability to support vital services by limiting logistical and intelligence capabilities makes no sense. If this shut down continues, as it seems it will, we need to seriously rethink our priorities.