Crises management

1. Crisis
management
By /MahmoudShaqria
‫شقريه‬ ‫محمد‬ ‫محمود‬

2. OUT LINES
• Introduction
• Definition of crisis
• Characteristics of crisis
• Crisis as opportunity, danger
• Types of crisis
• Phases of crisis
• Crisis management
• Importance of crisis management

3. Cont..
• Crisis management department function
• Crisis Management process
• Crisis management team
• Definition of Crisis Management Team
• Role of Crisis Management Team
• Crisis Management Team components
• The crisis intervention process
• Triage Assessment System

4. INTRODUCTION
• Crisis management includes the development includes
the development of plans to reduce the risk of crisis
occurring and to deal with any crisis that do arise , and
the implementation of these plans so as minimize the
impact of crisis and assist the organization to recover
from them

5. Definition of 'Crisis'
• Crisis is major, unpredictable event that threatens to
harm an operation, staff, customers, reputation or the
legal and financial status of an organization.
• Crisis can strike any time and during this
situation it tends to be confusion , uncertainty,
fear.

6. Characteristics of Crisis
• Occur suddenly.
• when person, family , is inadequate prepared to handle
the event or situation.
• Normal coping method falls ( tension rises, feeling of
anxiety, fear, guilt, anger, shames- hopelessness.
• Most crisis are generally short in duration lasting 24 to
36hrs & rarely last longer than 4 to 6 weeks.
• Presence of both danger and opportunity are in a crisis

7. • Danger:- can exist when a crisis overwhelms the
person, bringing them to a point of suicide.
1. A crisis is danger when occur lower level of
coping function.
2. Person can develop:-
- Inability to recognized reality
- Poor interpersonal, occupational functioning
- Emotional instability
- Personality disorder

8. • Opportunity:- is possible because of the chance.
1. Crisis is a time limited for few days to few weeks because
person cannot tolerate level of extreme tension&
psychological disequilibrium
2.Person experiencing help through skills & knowledge
3. Person become productive and acquire adaptive coping
for self-growth and self-realization while the person
receives help.

9. Five Types of Crisis
• Facilities Crisis. This includes damage such as that caused by an
explosion, fire, leakage, or natural disaster.
• Community Crisis. This is an adverse condition created by the
organization or outside organizations hostile to the agency or its
mission.
• Employee Crisis. This includes loss of life, sabotage, or a reduction
in force.
• Consumer Crisis. This includes defective products, contracts that
can't be met, or an allegation against your agency.

10. Cont..
• Image Crisis:-
This includes unlawful or ill-perceived activities, such as
sexual misconduct, drug use, or the indictment or arrest of a
senior agency official.
This is the most difficult crisis to counteract.

11. DEVELOPMENTAL/ MATURATIONAL CRISIS
SITUATIONAL CRISIS
ADVENTITIOUS /SOCIAL CRISIS

12. DEVELOPMENTAL/MATURATIONAL
CRISIS:-
• Predictable events in the normal course of life and
formerly used coping mechanisms no longer work.
• Examples:-
O Passing from school-age to adolescence.
O Passing from adolescent to adult.
O Leaving home
O Getting married
O Having a baby
O Beginning a career

13. Maturational Crisis
• New coping mechanisms yet to be developed.
• While individual is without effective coping methods
they have anxiety which may affect behavior.
• The way these crisis are resolved affects the ability to
pass through subsequent stages.
• Alcohol and drug addiction can interrupt passage thru
these stages.

14. SITUATIONAL CRISIS
• A situational crisis is one that is precipitated by an un
anticipated stressful event that creates disequilibrium by
threatening one’s sense of biological, social or
psychological integrity.
• Unanticipated or sudden events arising from an external
source that threaten the individual’s integrity.
• Examples: Job Loss, Death Of Loved One, Abortion, Job
Change, Financial Change, Divorce, Pregnancy, Severe
Illness.

15. • Other examples of events that can precipitate
situational crisis are premature birth status and role
changes, death of a love dons, physical or mental
illness ,change in geographic location and poor
performance in school

16. Phases of crisis

17. Phases of a crisis
• Phase I - The person has an increase in anxiety in response to a
traumatic event à if the coping mechanisms work, there’s no
crisis à if coping mechanisms do not work (are ineffective) a
crisis occurs.
• Phase II – In the second phase anxiety continues to increase.
• Phase III – Anxiety continues to increase & the person asks for
help.
• (If the person has been emotionally isolated before the trauma
they probably will not have adequate support & a crisis will
surely occur).

18. • Phase IV – Is the active crisis – here the persons
inner resources & supports are inadequate.
• The person has a short attention span, ruminates
(goes on about it), & wonders what they did or
how they could have avoided the trauma.
• Their behavior is impulsive & unproductive.
• Relationships with others suffer à they view
others in terms of how can they help to solve the
problem.

19. SIGN AND SYMPTOMS OF CRISIS:-
– The major feeling in a crisis situation is anxiety .the individual
experiences a heavy burden of free floating anxiety.
– The anxiety may be manifested through depression ,anger and
guilt .the victim will attempt to get rid of the anxiety using
various coping mechanism ,healthy or unhealthy .

20. – The individual may become incapable of even taking care
of his daily needs and may neglect his responsibilities.
– The individual may become irrational and blame others for
what has happened to him.

21. Crisis Management:-
• An organized effort to identify , assess and reduce
the risk of patients, visitors, staff and organizational
asset.
• Another definition : the optimal achievement of
therapeutics benefit and avoidance of risk and
minimization harm

22. Importance of Crisis
Management:
• Attempt to control liability ‫مسؤولية‬
• Prevent financial loss
• Protect the financial assets of the organization
• It reduction or elimination of financial loss due to
damage, misplacement of property or patient injury
• It’s the main goal to create and maintain a safe and
effective healthcare environment for patient , visitor
and employee

23. Crisis Manager should be Aware of All
of the following:
– Clinical area:- He must review care and provide guidance
to clinical providers of care.
– Insurance industry:- Since the risk manager help in making
decisions regarding various insurance covering as hospital
professional liability and workers compensation

24. Crisis Management Team

25. What is a Crisis Management Team?
• A Crisis Management Team is formed to protect an
organization against the adverse effects of crisis.
• Crisis Management team prepares an organization
for inevitable threats.

26. Roles of crisis management team
• Establish has happened
• Assess the impact
• Resolve any conflicts of interest
• Identify and priorities action required
• Retain control

27. Crisis Management Team includes:
1) Head of department‘s
2) Chief executive officer and people closely
associated with him
3) Board of directors
4) Media Advisors
5) Human Resource Representatives

28. Role of Crisis Management Team
members
1. Crisis Manager (CMT Team Leader) - Approve the Crisis Management Plan and
provide overall leadership.
• CNO influence—The chief nursing officer (CNO) is a member of the senior
leadership team who advocates for the nursing staff, patients, and families
through his or her experience as a clinical nurse or nurse leader, education,
and advanced leadership training. Because they are highly visible and
accessible throughout an institution, CNOs are well positioned to provide
strategic insight and influence during crises and organizational challenges.
• They display a combination of situational, transformational, and crisis
leadership styles suited for a critical situation.
2. Security Manager - Provide review and revision input regarding security related
procedures contained in the CMP during scheduled plan reviews.

29. 3. Public Affairs Advisor - Provide input and participate on all
aspects of Crisis Communications.
4. Medical Advisor - Assess and assist in human health impacts of
events
5. Human Resource Advisor - Maintain a current, accessible contact
list of all employees, contract employees, and responders
6. Health, Safety, Security, and Environmental Advisor (HSSE) -
Coordinate direct implementation, and training and updating of
Incident Response Plans
7. Legal Advisor - Ensure a Legal representative is available at all
times in case of a crisis.

30. 8. Crisis Management Advisor - Supervise and coordinate necessary
support roles. However, individual Aides may be assigned to work
directly under any core CMT position to fill a specific need. Also
responsible for the readiness of a Crisis Management Center, if
necessary.
9. Aide(s) - Administrative resource(s)
10. Business Unit Advisor(s) - Anticipate Business Unit issues, develop
strategic plans to proactively address these issues, and adjust
staffing of Business Unit Group and to suit evolving incident needs.
11. Subject Matter Expert(s) (SME) - Be available to assist crisis
manager on as ―as needed‖ basis.

31. STRATEGIES RESPONSE
1- Triage Assessment System
• rapid, but systematic technique for the crisis worker's
use in adjudicating the severity of a client's
presenting crisis situation and gaining some sense of
direction in helping the client cope with the dilemma

32. Six step counseling Model
1. Defining the problem
2. Ensuring client safety
3. Providing support
4. Examining alternatives
5. Making plans
6. Obtaining commitment to positive action

33. crisis Management process
• It is the process that requires guidelines resources
analysis communication and decision making that go
beyond a single organization function.
• Condition that produce a crisis are normally
uncontrolled and spontaneous, however steps can be
taken to mitigate the effect of the crisis by:
- Anticipating areas of concern
- Establishing response guidelines to these perceived
concerned
- Responding in a timely and organized manner

35. PLANNING
In planning the previously collected data is analyzed and specific
interventions are proposed .
during this phase the nurse will undertake the following activities:
• Dynamics underlying the present crisis are formulated
• Alternative solutions to the problem are explored .
• Steps for achieving the solutions are identified .
• Environment support needed to help the patient is decided upon
,coping mechanisms that need to be developed and those which
need to be strengthen are identified.

36. Implementation
Managing the crisis:-
- Initial response to a crisis phase 1
• What happened?
• Has a cause been identified e.g., accidental or intentional?
• Who is affected and what is known about those affected?
• What response is underway and who is involved in the response?
- Managing the response – phase 2
• It has two purposes
• To develop and maintain awareness of the crisis or emergency
situation for critical decision makers
• To coordinate support and assistance for crisis and emergency
responders

37. - Crisis management team process – phase 3
• If there is a critical aspect to the management of a
crisis for both immediate support of the site or
incident scene team and long –term recovery for
the company, it is communication.

38. Your audience may be one or all of the following:-
• Employee and their families
• Customers/ clients
• Contractors/ vendors
• Board of directors
• Media
• Government and regulatory agencies
• Local law enforcement
• Emergency responders
• Insurance companies

39. Training& Maintenance
Training :-
• The crisis management teams should be educated
about their responsibilities and duties, checklists of
critical actions and information to be gathered are
valuable tools in the education and response
processes

40. Maintenance:-
• A plan is only effective if it is current and practiced keeping a plan
current is anon going task that needs constant attention, obviously
phone numbers require the most vigilance and could be tied to
database for easier maintenance, but there is other information
that must be tracked, contact information for external contacts and
procedures are likely to change.

41. • A plan is only effective if it is current and practiced keeping a
plan current is anon going task that needs constant attention,
obviously phone numbers require the most vigilance and could
be tied to database for easier maintenance , but there is other
information that must be tracked, contact information for
external contacts and procedures are likely to change.

42. ROLE OF THE NURSE IN CRISIS INTERVENTION:-
• Nurses responds to crisis situations on a daily basis .
• crisis can occur in any unit for example in general hospitals, home
settings ,community health centers ,schools ,offices and in
private practice .
• indeed nurses may be called upon to function as crisis helpers in
any situation.
• Knowledge of crisis intervention techniques is thus an important
clinical skill of all regardless of the setting or practice specialty.

43. NURSING ASSESSMENT:-
• The first step of crisis intervention is assessment ,during
this phase the nurse collects data regarding following
factors :-
• Precipitating event or stressors
• Patients perception of the event or stressor
• Nature and strength of the patients support systems.
• Coping resources

44. • Level of psychological stress patient is suffering from and
degree of impairment he is experiencing.
• Patients previous strengths and coping mechanisms
• During this phase, the nurse begins to establish positive
working relationship with the patient. In a disaster or mass
casualty situation, different systems for triage
• Have been developed

45. • One system is known as START (Simple, Triage and, Rapid Treatment).
• In START, victims are grouped into four categories,
• depending on the urgency of their need for high level of training.
• The categories in START are:
• The deceased, who are beyond help
• The injured who could be helped by immediate transportation
• The injured with less severe injuries whose transport can be delayed

46. • Those with minor injuries not requiring urgent care.
• Another system that has been used in mass casualty
situations is an example of advanced triage
implemented by nurses or other skilled personnel.

47. • This advanced triage system involves a color-coding
scheme using red, yellow, green, white, and black tags:-
• Red tags:-
• - (immediate) are used to label those who cannot survive without
immediate treatment but who have a chance of survival.
• Yellow tags:-
• - (observation) for those who require observation(and possible later
re-triage). Their condition is stable for the moment and, they are
not in immediate danger of death. These victims will still need
hospital care and would be treated immediately under normal
circumstances.
• Green tags:-
• - (wait) are reserved for the "walking wounded "who will need
medical care at some point, after more critical injuries have been
treated.

48. • White tags
• - (dismiss) are given to those with minor injuries for whom a
doctor's care is not required.
• Black tags
• - (expectant) are used for the deceased and for those whose
injuries are so extensive that they will not be able.

49. Thank you…..