Media Relations

How I Heard

My cell phone rang at 3:09 that morning. It was Carlos Carrasco, the chief operating officer (COO) of Orlando Health Orlando Regional Medical Center (ORMC), asking if I had heard about the shooting. I was a bit confused because two days earlier, on Friday, June 10, 2016, Christina Grimmie — a contestant on the TV show “The Voice” — was shot and killed in Orlando. She had just completed a performance at a local venue and was signing autographs when a crazed fan approached her table and shot her at close range. She was rushed to ORMC’s Level One Trauma Center. Unfortunately, she didn’t make it. So when Carlos called and woke me from a sound sleep, I wasn’t quite “all there.” It wasn’t until he told me about a shooting down the street from the hospital and said, “This time I think it’s real,” that I knew something very bad was happening. I immediately jumped up, started scanning social media channels, phoned my media relations manager who was on call that weekend, and we both headed into the hospital where we immediately went into Incident Command.

Synopsis

My department consists of six people — four managers, an administrative assistant and me, the director. We basically perform four functions:  1) proactive outreach to the press, 2) responding to press inquiries, 3) managing issues and 4) managing the press in times of crises. On an average day, we pitch three to four proactive stories to reporters, field four to five press inquiries and manage two to three issues. In the first week after the Pulse tragedy, those numbers dramatically increased to where we were interacting with around 100 reporters each day.

Preparation

Our crisis plan consists of approximately 150 pages divided into 15 sections. The sections include Hospital Incident Command (HICS) roles and responsibilities, a few prepared statements, guidelines for more than 20 emergency scenarios, media staging-area instructions with photos, sample media alerts and press releases, policies that are relevant to crises situations, and (what would become the most important page that day) the names and cell phone numbers of our crisis communication committee (CCC). At the time, the CCC consisted of approximately 30 individuals with whom the media relations team on a typical work-day has infrequent interactions — people such as our director of patient experience, our director of government relations and our web master.

The crisis plan is a “working” document, meaning that it does not sit on a shelf collecting dust. Each media relations team member has an electronic version of the plan as well as a hard copy that is contained in a four-inch, bright red binder. We try to always have the red binder with us -- either in the car, in our computer case, at home or somewhere that makes it easily accessible.

We refer to the plan almost on a daily basis for various purposes, but certainly during crisis drills. When drills occur, everyone in the department has a role as either the HICS Public Information Officer (PIO) or media relations support for the PIO.  Following normal Incident Command procedures, the team member who is serving as the PIO will craft and distribute information to the “pretend press.” The rest of the media relations team will serve as 1) members of the “pretend press” pummeling the PIO with questions and requests expected of the news media or 2) follow “pretend” directives given by the PIO, which could be anything from scheduling a press conference to escorting a reporter to a specific location. Once drills are complete and while they’re still fresh in our minds, we return to our office to conduct a debrief specific to media relations to help us identify what went well and areas of opportunities.

Other crisis preparation tools in our portfolio include a video studio that is located directly across the street from ORMC’s main entrance and adjacent to the media relations office building. The studio is outfitted with a lighting grid that can illuminate one or all six permanent sets, which include a logoed backdrop for use during press conferences.

Another element we had established prior to the Pulse tragedy, and one that would become invaluable during the weeks and months that followed, was a single email address that reaches the entire media relations department. We received hundreds, maybe even thousands, of email inquiries related to Pulse through that address during the weeks and months that followed.

In addition to these elements, our social media (SM) channels and website also were critically important. We have several SM channels that were created since 2010, but the most important ones during the Pulse response were Twitter and Facebook. All SM channels are managed by a local vendor with whom we’ve developed extremely close relationships. The vendor works with multiple Orlando Health departments and facilities to create and distribute information, including messages during crises. The morning of Pulse, two vendor representatives were in HICS sitting with me and our internal communication director/co-PIO. This three-legged stool of communication — internal, external and social — is the foundation of all Orlando Health crisis communications.

Response

After receiving the call and gathering my thoughts, I turned on the lights and the television, and started scrolling through emails and social media sites to see if there was any press interest or coverage at that point. There wasn’t. I phoned my manager who was on-call that weekend to see what he knew. A light sleeper, he had been awakened by the “bings” on his cell phone of incoming emails from our security team. We spoke a few minutes, and then both of us got dressed and headed toward the hospital.

It takes about 15 minutes to drive from my house to ORMC when traffic is light. Since it was 3:45 in the morning, traffic was particularly light. When I got about three blocks from ORMC, I noticed a few people pacing on the sidewalk in front of a 7-Eleven. There were two men and a woman wearing a short dress or skirt and holding in one hand a pair of high-heeled shoes, which was odd. Almost immediately, I looked in the direction I was driving and could only see flashing police lights. The most I had ever seen. They stretched from one side of the four-lane street to the other. I managed to get to the valet circle at ORMC, where I parked, put my business card on the dash so the valet runners would see it and went into the hospital to Incident Command.

Other HICS officers started to filter in and Carlos, the hospital COO, briefed us on what had happened. The room went silent while we all contemplated what we had just heard. I remember thinking, This can’t be real. This is Orlando! But there was no time for grief. We had work to do. I took the PIO seat and my manager grabbed our crisis plan and started calling members of the CCC.  

We distributed the first press message around 5:00 am to our local news outlets. The initial message simply provided information about our hospitals and for team members. It read: “ORMC was placed on lockdown around 2:00 a.m. after receiving several gunshot victims. Only essential workers allowed access. Arnold Palmer Hospital and Winnie Palmer Hospital [two other hospitals on the downtown campus] also placed on lock down.”

The volume of press inquiries that came into Orlando Health was initially very light but increased throughout the morning as details of the tragedy spread across the country. Reporters’ early focus, as expected, was on first responders and law enforcement, who staged the first press conference of the day at around 7:30 am. Participants included the FBI, the City of Orlando, the Orlando Police Department (OPD), the Orange County Sheriff’s Office and other emergency responders. The presser took place in the parking lot of a fast food restaurant, located about two blocks south of Pulse, where reporters had gathered spontaneously.

Inside ORMC’s Incident Command center, we watched the press conference on television monitors. As it concluded, the chief of staff for the City of Orlando, announced that a second press update would occur later that morning. She and I had communicated several times that morning about the number of patients being treated and their condition, so it was only natural that we participate in the next presser, which occurred just before 11:00 am. Along with David Strong, president and CEO of Orlando Health, and Dr. Michael Cheatham,  trauma surgeon/chief surgical quality officer for ORMC, I drove to OPD’s mobile command center where we met city officials. The street was teeming with every level of law enforcement. It was a bizarre scene.

I found myself standing in the middle of a blockaded major street next to an officer dressed in body armor and carrying an automatic rifle. Several other officers, dressed the same and armed with similar weapons, roamed the street. One of them turned to where I was standing under a canopy with a small group of people and told us there was going to be an explosion and not to be afraid. Easier said than done, I thought. Soon after, we heard a muffled blast. I don’t know what caused it, but surmised from the officer’s warning that it was the result of some event that was planned by law enforcement.

Our CEO, trauma surgeon and I joined the group of officials walking from the mobile command center to the press conference site. The group included federal, state and local law enforcement officers as well as several elected officials. All of them addressed the press. I don’t remember who spoke first or who said what, but I do recall the words of Orlando Mayor Buddy Dyer. It was at this press conference where Mayor Dyer announced there were more fatalities than originally thought. There were 50. With that announcement, I heard an audible gasp from members of the press.  

Dr. Cheatham provided patient statistics and conditions, including the fact that of the 44 victims who had come to ORMC, all 35 who made it to surgery had survived. He also provided additional patient information such as the number of surgeries performed that morning, surgeries still to be performed that day and the number of patients who were discharged. These facts formed the basis of the content of daily updates we provided to the press and posted on our social media sites. These updates continued until the last patient was discharged from inpatient status on September 6, nearly three months after the tragedy.

The rest of that Sunday was a blur as our team crafted messages for our various audiences, responded to press inquiries and in a few instances, scheduled press interviews via phone with our surgeons and executives. It became evident very early on that this event was international in scope and that there was no way my small team of six was going to be able to respond to every inquiry. Our goal then became to provide as much information as possible to the widest audience possible while maintaining positive working relationships with members of the press. To that end, I made the decision to actively service two groups of reporters — locals and domestic nationals.

Working with local reporters was important to us and to them. We didn’t want them to feel slighted or ignored because of the deluge of national reporters and celebrity personalities who had flooded into Orlando. Like most media relations teams, we work with local reporters every day and have good relationships with most of them. We wanted to keep it that way, so we tried to provide them with interesting human interest stories or let them break news locally before it went national. On the other hand, we knew the world was clamoring for information, and that national press would be able to distribute the news globally. My goal became to secure at least one story on each of the main national broadcast and cable news outlets — ABC, CBS, NBC, FOX, CNN and MSNBC — as well as in the nation’s largest daily/digital news outlets, including USA Today, New York Times, Washington Post, Wall Street Journal, Yahoo News, US News & World Report and Huffington Post. We succeeded.

After the 11:00 am press conference, we returned to Incident Command and resumed normal HICS operations. By 4:00 pm, those of us who had arrived in HICS at 3:45 am reached the 12-hour maximum on-duty time allowed. I relinquished my role as PIO to one of my media relations managers and then walked across the street to the media relations office where I made a few calls and completed some paperwork. I returned home in the early evening. My teenage son and husband, whom I had said goodbye to hours earlier, had been following the news all day. They knew what had happened inside Pulse but wanted to hear from me what was happening at ORMC. Talking it through not only confirmed for them some of what they had seen and heard on the news, but it also helped me process the day’s events.

On Monday, the onslaught of press began in earnest. Without saying anything, my team and I knew we were in an all-hands-on-deck situation. Getting to our office each morning required careful navigation through a maze of satellite trucks and other news vehicles. Four CNN vehicles lined the south side of the street, directly in front of ORMC’s main entrance. ABC, NBC and FOX vehicles lined the north side of the street. It was organized chaos both outside and inside our building. My team and I communicated with each other through texts, emails, face-to-face conversations and sometimes by simply shouting questions, requests or updates down the hallway.

“Who’s available to talk to ‘Good Morning America’?”

“Book the studio for Scott Pelley’s interview with the surgeons.”

“What time does Dr. Gupta want to do his piece?”

“The New York Times wants to talk to Dr. Ibrahim.”

“Does anyone know anything about a Bloody Shoes post? Get social media on the line!”

“Am going to check with hospital administration and see about holding our big press event tomorrow.”

We did host the traditional physician press conference the following day, Tuesday. The event came together faster than any I have ever worked on. Location? Check. Production crew? Check. Still photographer? Check. Backdrop, microphones, media alert? Check. Check. Check. Patient? Check, with family members.

Our three key messages were simple and authentic: We were prepared. We are the experts. We are a team.

By 8:00 that morning, hundreds of reporters, producers, camera operators and technicians had lined up at the hospital entrance to gain entry into the press conference, which was scheduled for 10:00 am. As I was walking out of an administration conference room where I’d been briefing physicians, one of our media managers stopped me and said, “You gotta see this,” referring to the room where the presser was being held. When I looked in I saw a room so full of people there was virtually no visible floor space. Despite being as crowded as it was, it was about to get even more so.

About 20 doctors, nurses, residents, hospital administrators and the patient with his family members filed into the room and took their seats or stood behind the table in front of the Orlando Health backdrop. Dr. Cheatham, the trauma surgeon who had spoken at the press conference in the fast-food restaurant’s parking lot, opened the session. He walked the audience through the timeline of events that unfolded in ORMC’s emergency department and invited others seated or standing with him to share their experiences and thoughts as he spoke. The patient’s story followed. It was emotional and raw. He painted a picture of the horror he experienced inside the club, his fear of dying from his injuries and his gratitude to the clinical teams that saved his life.

The news crews seemed mesmerized. I think they would have stayed for hours listening to the stories of heroism and selflessness, if possible. But another group was scheduled to use the room at noon, so the press conference closed with reporters still clamoring for “just one more” interview. From that point forward, press inquiries were constant, but for the most part, manageable. There were a few producers we had to admonish for failing to comply with our policies, but I was pleasantly surprised at the courtesy and respect exhibited by the vast majority of news professionals. Their coverage, in both traditional and social media, was unparalleled.

In the first four days of the incident – June 12-15 – we received more than 2,800 print and online mentions reaching more than 7.5 million print subscribers and more than 5.8 billion unique online visitors. Over that same time period, we had more than 830 television news hits reaching an audience of more than 20.8 million. The reach on social media was just as dramatic.

 After about two weeks, we began to see a levelling off of press inquiries, but not an end. Each month from June 12, 2016, through June 12, 2017, we had at least one press request concerning the Pulse shooting.

Lessons Learned

We identified areas of opportunities by noting deficiencies or inefficiencies during the process of managing the situation. For example, we realized that we needed more people and sooner to handle various support functions such as creating a spreadsheet of all our press interactions, especially during the first few weeks. Our PR firm of record would have handled that task masterfully. But we were so busy we simply neglected to contact them.

Another area of opportunity was created as a result of the sheer volume of press. For example, the room in which we staged the Tuesday press conference was packed with people. In our crisis plan, although we have multiple press staging areas for all of our facilities, we never imagined needing a room to accommodate hundreds of people. That remains an opportunity that we are reviewing.

And finally, we failed to consider the possibility of some sort of sensational sidebar story the press latches onto that requires its own special media relations attention and thereby draws away already-strained resources.

What We Changed

We got our PR firm more involved in department operations. During our community-wide crisis drill in March 2017, the COO of the PR firm joined us in Incident Command. He also managed a few of the Pulse one-year-later stories for us and we added him to the email list, so the firm is always aware of what is happening in our department.

Conclusion

It’s been said that in times of crises, you either rise to the occasion or you crumble. I’m proud to say that my team rose to the occasion. When faced with the most demanding situation that any of us have encountered, or likely will encounter in our careers, we pulled together and successfully managed the largest press presence imaginable. The phrase “team work” so aptly applies to how we received, organized and responded to members of the press and how we collaborated with each other. There were hundreds of tasks to be met each day — securing patients, executives and physicians for press interviews, booking the studio, producing our own video news releases, ordering food, the list seemed endless. Each of us knew what needed to be done and we were empowered to do it.

The Pulse shooting affected each of us differently. Ultimately, I think it made us all more confident in our abilities. Unfortunately, it also made us realize just how vulnerable we are as individuals.

Key Takeaways

• You must be prepared! Have the processes and plans in place that you will need to handle a tragedy of this size.
• You must practice it! Don’t leave your plan on the shelf. Create crisis situations that require you to test it. In this way, you can identify what works and what doesn’t.
• You must work together as a team! A tragedy of this size requires many people managing many tasks. One person can’t do this alone.
• You must be empowered! Each team member must know that they were hired not only for their experience and expertise, but also for their resourcefulness in times of extreme stress.