How Do You Communicate When You Can’t Communicate?

Contingency planning is a major part of the information technology industry and a vital aspect of healthcare IT.  What happens if a system cannot be accessed?  How will business be done when the system goes down? How will patients be cared for? Every system has a backup plan and every clinician is prepared to operate in the contingent environment.  It’s not ideal, but it’s necessary and clinicians always find a way to take care of their patients – with or without technology. When all other systems fail, agile communication will determine how quickly your organization can return to normal operation.  Do you have a crisis communication plan?

Most systems, even when they fail, require communication to ensure that everyone across the organization is operating similarly.  When do downtime procedures begin? When do they end? What’s the status of the issue causing downtime? The list of questions and communication needs, especially during times of crisis, seemingly never ends.

So, what do you do when your ability to communicate is the system that has gone down?  How do you communicate when you can’t communicate?  We’ve become so reliant on technology.  Not only in the way we work but the ways we communicate.  And sooner or later technology will fail.

Typical modern forms of communication are completely reliant on technology.  Email, VoIP telephones, Vocera devices, printers, medical devices, etc. all rely on connectivity.  So, what happens when your entire network goes down?  You can’t send out organization-wide emails to let everyone know what’s going on.  Clinicians and staff can’t call the help desk for support.  You can’t call the operators to let them know to make an overhead page – if that system is reliant on the network in some form.

So, what do you do? You could face this real-world situation at some point in the future.  Are you prepared for it? Imagine this scenario:

While most of the IT organization is out at lunch, a devastating auto accident at major intersection takes out power lines and severs the connection between the organization and its internet service provider.  The crash disconnects the organization from the outside world, but also from itself.

Send an email! Can’t.  Call the departments! Can’t.  Call the administration! Can’t.  What do we do!

In this instance, as with most others, it’s beneficial to have former clinical staff working in the IT department.  Many institutions keep ‘red’ phones, emergency analog phones, in a cabinet or desk in each department or nurses stand to be activated in the event that all other lines of communication are down.  The problem that arises is that those red phones haven’t been used for so long, many people in the organization may not be aware of the existence of the ‘red’ phones.

Clinicians and nurses, as they always do, revert to their instincts and take care of their patients first and foremost.  The technology can wait.  Initially cell phones, through spotty connections, may be used to contact the administration and departmental leaders throughout the organization.  Then those leaders can set out on foot to notify each department and nurse’s stand of what had happened and what was being done to remedy the situation.  As the rounds are made, each area can be instructed to find their ‘red’ phones and use them when needed.

If you ever find your self in this situation, it becomes painfully obvious that there was no contingency plan in place for this type of event.  Before you find yourself in a similar situation, consider the following steps:

1. Assess the organization
   • An inventory of the entire organization’s communication methods and equipment should be completed and potential risk areas identified. Is the entire organization completely reliant on the network for communication?  Or are there areas that are prepared to use the analog phones?  Will the overhead paging system work during a total network outage? Who can authorize overhead pages in this type of event?
2. Address problem areas
   • After the initial assessment, ‘red’ emergency phones and phone listings should be strategically placed throughout the organization and staff trained on how and when to use them. These phones and their purpose should also be added to onboarding for all staff so everyone will be aware of their importance.
3. Create a Crisis Communication Plan
   • A detailed plan of exactly who should be contacted and when should be developed. Detailed steps should be outlined for every conceivable situation.  Who should be contacted and how from the CEO to department heads, nurse managers, and telephone operators.  The plan should also include secondary contacts if anyone can’t be reached.
4. Communicate the plan
   • Every department, clinical and non-clinical, should receive communication on what is being developed and the steps being taken to prepare the organization for the future. Everyone involved in the plan should go through detailed training on the steps that should be taken if a catastrophic event should occur.

In addition to the internal plan, steps should be taken with external providers to prepare for similar situations and build contingency plans into the organization’s infrastructure.  The threat of catastrophic events such as the one outlined above should lead to the development of a detailed crisis communication plan and mitigation steps that could be used for disaster planning throughout the organization.

Do you have a plan in place for crisis communication?  Don’t wait until its too late and you’re scrambling to talk to anyone in your organization.