Evaluar la estabilidad de las harinas mix en almacenamiento para su comercialización.

The list of worst-case scenarios was used by the focus groups charged with creating categories of crises. Each of the three groups was able to complete this task. Below are the results from the modified focus group process.

Overall the categories formed by the three groups were very similar. Two of the groups identified 7 distinct categories; the other group identified six crisis families. There was unanimous agreement of the placement of twenty-six crisis scenarios (57%) into five similarly titled categories. These categories were titled: “Personnel”, “Political”,

“Emergencies / Disasters”, “Legal” and “Plant / Building / Equipment.”

The categories were most different in their placement of situations that had to do with public relations and employee issues. Two focus groups identified a need for a separate category for public relations issues, while the third felt that these situations could be included with the politically based crises in a merged category called “Political / Image” crises. The situations in question included: public anger over a health policy or action, board of health member arrested, mass media criticism, activism, and rumor of poor department response. Whether or not these situations were in one category or two separate groupings, all three of the focus groups agreed that the main characteristic that tied these situations together was the potential for the community to have a negative image of the health department. This potential outcome would necessitate an effective public relations response.

The other area of disagreement between the focus groups was in the grouping of scenarios related to employees. All focus groups included a personnel category but two

groups felt that quality assurance issues should be included as category distinct from

employee misconduct. The root cause of the items included under “Quality Assurance” was incompetence on the part of staff or unintentional error (e.g. death of a client due to

incompetence, medication errors.) This is distinguished from situations that were intended or purposeful (e.g. dismissal of an employee, staff exhibiting racism). One group also felt that a third category of employee health issues was also significantly different from the other crises to warrant its own category. This group included death of an employee, HIV infected worker and infectious disease outbreak in staff as part of a separate crisis family. These differences in crisis categories were remedied when the various crisis response strategies were discussed and some scenarios that required similar response strategies were then grouped together.

The final typology of potential crises for health departments agreed upon by the members of the focus groups consisted of seven (7) crisis families/ categories. These are: “Disaster”, “Legal”, “Quality Assurance”, “Personnel”, “Plant / Equipment”, “Political”, and “Public / Public Relations”. Table 5.2 lists these categories, including the placement of the individual worst-case scenarios.

Table 5.1 Potential organizational crises in local public health departments 1. Accidents

2. Activism action 3. Asbestos in building

4. Board of Health member arrested 5. Bombing of a Building

6. Breech of confidential information 7. Bribery of a health worker

8. Budget cuts

9. Chemical gas release in building 10. Client stealing supplies / equipment 11. Computer failure, loss of telephone lines 12. Death of a client

13. Destroying files under investigation 14. Dismissal of an employee

15. Employee death 16. Equipment malfunction 17. Fire in the building

18. Government action to require new services without funds 19. HIV infected health professional

20. Inadequate resources to deal with a situation (e.g. not enough vaccine) 21. Infectious disease outbreak in staff

22. Kidnapping / hostage taking 23. Lack of support from politicians

24. Mass media criticism of the health department 25. Mismanagement of funds

26. Natural disaster that affects the buildings: Hurricane, tornado, flood 27. Outdated /inadequate equipment, e.g. Autoclave, defective condoms 28. Poor response to public health problem resulting in injury or death 29. Poor security in facility

30. Poorly maintained building, unsafe buildings 31. Poorly skilled staff/ unqualified staff

32. Privatization of public health services (externally driven) 33. Public anger or a public health policy or action

34. Rape

35. Rumor of poor response 36. Sabotage

37. Sexual harassment 38. Staff exhibiting racism

39. Staff molesting client or other worker

40. Staff participation in unprofessional activities (unethical behavior) 41. Staff promoting political agendas unrelated to health

42. Staff stealing supplies, pharmaceuticals 43. Terrorism

44. Violation of law (e.g. open meetings law, Fair Labor Standards Act) 45. Workplace violence

Table 5.2 Crisis scenarios for each crisis family

FAMILY / CATEGORY SPECIFIC CRISIS EXAMPLES

DISASTER _{• Kidnapping / Hostage Taking}

• Chemical gas release in the building • Bombing of building

• Workplace violence

• Natural disaster that affects the building • Sabotage

• Fire in the building • Terrorism

LEGAL _• Violation of law

• Rape / Staff molesting client or other worker • Destroying files under investigation • Staff stealing supplies

• Bribery of a health worker • Breech of confidential information • Mismanagement of funds

• Sexual harassment

• Client stealing supplies or equipment • Staff exhibiting racism

PERSONNEL _• Dismissal of a key employee

• HIV infected health professional

• Employee death – not caused by a work situation • Infectious Disease outbreak in staff

PLANT AND EQUIPMENT _{• Poor security in the facility}

• Poorly maintained building, unsafe building • Asbestos in the building

• Equipment malfunction

• Outdated, inadequate equipment • Computer failure, loss of telephone lines

POLITICAL _• Budget cuts

• Inadequate resources to deal with a situation

• Privatization of pubic health services (external force) • Lack of support from politicians

• Government action to require new services without funds PUBLIC / PUBLIC RELATIONS _• Public anger over public health policy or action

• Board of Health member arrested

• Mass Media criticism of health department • Activism action

• Rumor of poor response

QUALITY ASSURANCE _{• Poorly skilled staff / unqualified staff} • Staff participating in unprofessional activities • Poor response to health problem – injury/death • Death due to incompetence or negligence • Wrong medicines given to a client • Unintentional accidents

Each of the crisis families is distinct in at least one significant way. For example, one family includes situations that focus on the organization’s building or equipment while another includes situations that are precipitated or caused by external political factors. The key differences between the crisis families also reflect differences in needed response

strategies. Table 5.3 highlights how each of the crisis families is seen to be different and how the primary response strategies differ for each group.

Despite the differences between categories and response strategies, it is important to note that there are critical crisis response strategies common to all crises. For example, while public relations crises, in particular require a communication strategy, all organizational crises will require a rapid, effective communication response. It is also worth noting that crises don’t always fit into distinct categories. It is possible, and in fact, likely, that a situation would fall into multiple categories. For example, the criminal act of planting a bomb in a building could fit into the Plant / Equipment category or into the Legal category or even, the Disaster category. This does not diminish the usefulness of the typology but highlights the benefit of using it for crisis preparedness. If an organization has prepared for legal crises, plant/equipment crises and disaster situations – it will be prepared to respond affectively to a bomb threat.

Table 5.3 Key characteristics and response strategies of each crisis family

FAMILY CHARACTERISTICS RESPONSE STRATEGIES

DISASTER Situations with the potential for

immediate mass destruction and multiple casualties. These situations affect everyone. Many people are needed for a coordinated and well orchestrated response.

Requires the mobilization of multiple resources instantaneously. May require protective equipment, evacuations, psychological counseling, extensive communication to multiple target audiences. May require the inclusion of representatives of outside agencies for an effective response.

LEGAL Situations that include an element of the law. Typically an infraction of the law.

Requires outside expertise from the judicial system.

PERSONNEL Situations that are employee focused but are not legal in nature

Requires an internal response, such as changes in work assignments and effective communication with staff. Public

communications require protection of employee rights.

PLANT / EQUIPMENT

Situations that impact on either the availability or working condition of the organization’s equipment or facilities.

Requires complete knowledge of the facilities, grounds and equipment. May require evacuations and changes in service delivery locations or strategies. Requires outside assistance from technicians and other experts. May require obtaining new equipment quickly such as generators, telephones, computers, laboratory equipment, etc.

POLITICAL Situations caused by external political agendas or actions. May involve changes in laws, rules or regulations which affect the functioning of the health department.

Will require changes in the service delivery and organizational structure. Will require effective communication efforts directed at policy makers and decision makers.

PUBLIC RELATIONS

Situations focused on the perceptions of the community and may result in a damaged public image for the agency.

Requires a focus on public communication using both face to face interactions with key individuals and mass media outreach to the public.

QUALITY ASSURANCE

Situations caused by or related to staff incompetence

Requires an internal operational response to correct the situation and communication messages that highlight intolerance of the problem and fast actions to remedy the problem

While each of the focus groups was instructed to sort the crisis situations by the similarities in response strategies, groups tended to categorize crises more on the basis of root causes rather than response strategies. For example, an employee caught embezzling money and an HIV infected health care worker may both need a strong public relations and

communications response strategy. However, these situations were put in two different categories (Legal and Personnel, respectively). Each group felt that the root cause of the incident would affect how the situation was perceived by outsiders and hence, would dictate the types of communication messages delivered and to which target groups. They felt that the cause of the incident is an important factor in identifying the most effective response strategy.

The root cause of a crisis has also been used as a key characteristic in the Pauchant & Mitroff crisis topology (1992). The two factors deemed important in their model for

identifying the appropriate response strategy are: External-Internal causes and Human/Social – Technical/Economic causes. An application of the final crisis families from this study to those dimensions can be seen in Figure 5.1. This crisis typology formed the basis of the rest of the study.

Figure 5.1 Crisis typology for public health departments

5.3 Summary Human/ Social Technical/ Economic External Internal Personnel Political Legal Plant / Equipment Failure Disaster Public Relations QA

This chapter presented the findings of the two steps taken to answer the first two questions of the study. Step one was to engage in a process which would generate a list of potential organizational crises that a health department may encounter. A list of forty-six (46) worst-case scenarios was generated. Step two was to use a modified focus group

methodology to sort these situations into a categorization framework that would could help an organization strengthen it’s ability to prevent and respond to these situations. Three separate focus groups categorized the crisis scenarios into a seven family typology. The distinct families of crises were titled: “Disaster”, “Legal”, “Quality Assurance”, “Personnel”, “Plant / Equipment”, “Political”, and “Public / Public Relations”. These categories were used as the basis for the remainder of the study.