What COVID-19 Taught Us about Risk and Crisis Management

Risk is inevitable, but how you assess risk and manage a crisis is essential to the success of your business. Many of us are so hyper-focused on the myriad of variables associated with providing quality patient care that we forget we are in the business of healthcare.

Risk is categorized as either preventable, strategic or external. The COVID-19 pandemic was an external, uncontrollable risk that had a remote probability of occurring within our lifetime. On the other hand, a hurricane is a high-probability crisis in the forefront of our minds from June through November. While you may create a preparedness plan for hurricane season each year, how intricately do you assess the details? I challenge you to map every process of your hurricane plan and provide what-if scenarios. If done properly, this exercise is a roadmap for other crises, including the COVID-19 pandemic.

The number one rule of risk and crisis management: If you don't write your story, someone else will. Each crisis is an opportunity for your medical practice to engineer its own story and to enhance its business practices. The COVID-19 pandemic taught us four strategic lessons about risk and crisis management.

1. Communicate Clearly and Effectively

Any crisis is an opportunity to build trust with your internal and external customers. Both are essential for the success of our practices. Employees are our internal customers. When a crisis emerges, take action by assembling the essential experts on your team, but keep the number small. Delegate decisions beyond your experience to those few trusted individuals, but retain oversight of them. Explain to your overall staff what you are doing to fix the problem. I remain the primary spokesperson for the pandemic. Once I realized that COVID-19 would be named a global pandemic, I started sending weekly "Life in the Time of Corona" emails to my entire team. These weekly debriefs detailed the company’s perspective and the actions we were taking to protect and care for our employees. Recruiting employees feels impossible during this time, so employee retention is crucial. Continue to communicate with your staff to instill confidence and security during uncertain and ever-changing times.

Patients and referral sources are your external customers. Continue to create touchpoints with your revenue sources. Whether it is the doctor calling in-office infusion patients to explain why they need to continue their treatment or your clinical team calling patients to coordinate care and inform them that you are open and available to help, you must be proactive to protect your business. For those unable or unwilling to see you in-person, offer alternatives. Explain what you are doing to protect and care for patients who come into the office. Your team cannot give a shoulder injection, take an x-ray or perform an in-office infusion remotely.

Communicate regularly with your patients by sending emails, updating your voicemail message, posting signs, updating your social media accounts (website, Facebook page, Google Maps listing) and making phone calls.

2. Create a Business Continuity Plan

To safeguard the future of your practice, it is essential to have a business continuity plan. If you do not have a plan, create one as soon as possible. If you have a plan, update it annually. Your business continuity plan is multi-tiered to prepare for all external crises. Ensure you have a duplication of knowledge should a key member of the practice be incapacitated. I am a control-freak, so I understand that many are afraid to trust others with their responsibilities, especially financial responsibilities. Even I have someone who can be my back-up to process payroll, coordinate with our business banker and be

accessible to our vital vendors. Additionally, create a cheat sheet of usernames and passwords that can be accessed by a trusted individual in case of an emergency.

According to the National Cyber Security Center, cyber-attacks tripled in April 2020. Ensure you have the necessary cybersecurity, life, disability and business interruption insurance. Review your coverage annually, as needs change based on your company's growth.

Be financially prepared. If your providers or owner(s) do not squirrel away money, be sure to set up a sufficient line of credit. What if there is no revenue or a decrease in expected revenue? What do the providers need to pay staff and bills and support their personal expenses? You will not pay interest on an unused LOC, but it is available for emergencies and crises.

3. Prepare and Manage Third Party Delays

While COVID-19 has become our focus, there are many other causes of global supply chain interruption. Keep a superstock of items essential to your practice's revenue. In the 14 years of managing The Hirsh Center, I have experienced back-orders on injectable steroids, needles and infusible drugs. Assess your practice's usage and determine if you need a 1, 3 or 6-month supply of key items. Do not overbuy, be cognizant of expiration dates, and use the oldest items first, constantly rotating your superstock. Create purchasing thresholds and designate someone to monitor your supplies. Review your usage annually, as bringing on additional providers or downsizing will affect your usage. Keep your supply options open by contracting with at least three suppliers; do not close accounts, even if you sign a 1 or 3-year GPO contract.

4. Embrace Remote Workers

Remote workers are here to stay. While we thought many of our practice's positions could not transition to a remote opportunity, this pandemic taught us that we were wrong. Have a plan with your IT company to quickly set up a remote work environment. Keep a laptop available for those without a computer. Continue to motivate, engage and show appreciation to remote employees to propagate your company culture.

Accept that change is inevitable. As medical professionals, we provide hope to patients each day, asking them to be resilient. A crisis is an opportunity for us to swallow our own advice pill. Crises provide opportunities to create stronger bonds and better business practices.