波士顿马拉松爆炸案给危机管理的启示

    在我们供职的布莱根妇女医院（Brigham & Women's），特定的医生、护士、医疗助理团队并肩而立，随时准备救治伤者，而文书、诊断和运输人员为他们提供支持服务，共同应对这场危机。内科医生和护士帮助清理急诊室，从而为转入医院的幸存者提供了充足的治疗空间。在我们的急诊科，外科、骨科、麻醉、急诊医师和护士长携手努力，以确保病人及时转至手术室。这就是哈佛商学院（Harvard Business School）领导力教授艾米•埃德蒙森所称的“团队协作”。

    穿上一件明亮的黄色背心

    爆炸刚发生时，斯顿街陷于一片混乱之中。但波士顿的爱国者日正是这座城市一直在规划并准备应对的灾难时刻；因此，每个人都有一个预先确定的角色，都穿上了可见标识。马拉松比赛开始前，为这场赛事服务的每一位医生、护士和其他志愿者都领到一件带有颜色编码的背心。医疗急救队、警察和消防员身着正规制服，其中一些人也穿上了背心。爆炸发生时，应急者和旁观者通过背心就能识别应急行动的指挥者。

    一旦你的公司面临紧急事件，谁将“穿上”象征领导者的背心？在危机期间，普通的命令和控制措施往往过于迟缓，采用委员会之类的管理方式是不恰当的。作为HICS系统的组成部分，领导者穿上特定背心，这样他们就可以很容易被识别。为你的企业建立类似的准备机制：无论爆发的一场物理事故、公关过失、股东惨败，还是其他任何事件，人们应该向谁报告？谁说了算？你的团队如何识别领导者？

    一等于无，而二等于一

    超过50万观众参加这场新英格兰地区最大的年度体育盛会。波士顿每年都做足了万全准备。各种组织提前进行协调演练，其中包括附近的创伤中心和三家儿童医院，这些医疗机构全部位于终点线的2.5公里半径内。

    但其他的灾难往往不会发生在这样的环境之中。最近的例子是：今年4月17日发生的西德克萨斯州西化肥厂（West Fertilizer Plant）爆炸事件；5月20日那场席卷俄克拉荷马州摩尔市的龙卷风，以及7月6日韩亚航空公司（the Asiana Airlines）班机在旧金山国际机场（San Francisco International Airport）的坠毁事故。

    为了应对这些事件，医院频繁地进行各种严苛的演练。我们必须根据墨菲定律（Murphy's Law，即认为会出错的，终将出错的论断）制定计划。灾难可能发生在公司CEO不在本州之际，或者夜半时分。在这种情况下，一位中层管理者必须挺身而出，根据最低限度的信息肩负起责任。每一个人都必须是可替换的，所有相关方务必紧密合作。一个人能够做的事情少之又少，但并肩作战的两个人则拥有巨大的力量。

    沟通再沟通

    爆炸当天，整个城市的医院面临巨大的不确定性，这种状况持续了多日。是否还将发生爆炸？是否将出现更多的伤者？整体反应处于什么状态？应对行动是否正在产生效果？

    在多次发布简报期间，沟通提供了一个持续改善的机会。临床医生需要准确和及时的信息以优化病人的护理方案，但灾难严重破坏了我们日常收集和传递信息的流程。你是否预先制定了应对这种状况的沟通计划？有没有一项后备计划，以及这项后备计划的替换方案？

    你需要悉心管理你的团队和信息，唯如此，面临危机时，你才能获得掌控权。

    本文作者埃里克•格罗尔尼克是布莱根妇女医院应急准备科医疗主任，急诊医学部临床副主任。罗恩•沃尔斯是布莱根妇女医院急诊医学部主管。两人均任教于哈佛医学院。（财富中文网）

    译者：任文科  

    At the hospital we work for, Brigham & Women's, designated teams of physicians, nurses, and medical assistants stood side by side, at the ready, supported by clerical, diagnostic, and transport personnel to respond to the crisis. Internal-medicine physicians and nurses helped clear emergency departments of patients to create space for incoming survivors. In our emergency department, surgeons, orthopedists, anesthesiologists, emergency physicians, and nursing leaders collaborated to ensure patients were sent to operating rooms without delay. It's what Amy Edmonson, a leadership professor at Harvard Business School, refers to as "teaming."

    Wear a bright yellow vest

    The initial scene on Boylston Street was chaos. But Patriots Day in Boston is an occasion on which the city plans and prepares for disaster; thus everyone has a predetermined role and wears visible identification. Prior to the start of the race, color-coded vests were issued to physicians, nurses, and others slated to volunteer at the event. Emergency medical services, police, and firefighters wore their regular uniforms, and some of them also donned the vests. When the explosions went off, responders and bystanders used the vests to identify responding leaders.

    At your company, who would wear the (figurative) leadership vest during emergencies? Ordinary command and control is slow, and management by committee is not appropriate during crises. As part of HICS, leaders wear specific vests so they can be easily identified. Establish the same prep for your business: Whether it's a physical accident, PR gaffe, shareholder fiasco, or anything else, to whom do people report? Who is in charge? How does your team identify that leader?

    One is none and two is one

    Over 500,000 spectators attend New England's largest sporting event every year, and Boston is more than ready for it. Various organizations coordinate exercises in advance, including the nearby trauma centers and three children's hospitals, all within a 2.5-mile radius of the finish line.

    But other disasters don't occur in such an environment. For recent examples, look no further than the West Fertilizer Plant facility explosion on April 17 in West Texas, the tornado in Moore, Okla. on May 20 or the Asiana Airlines flight crash at San Francisco International Airport on July 6.

    Hospitals train for these events -- rigorously and frequently. You must plan for Murphy's Law, the idea that what can go wrong will. Your disaster may strike when your CEO is out of state, or in the middle of the night, and a middle manager must step up to take charge based on minimal information. Everyone must be replaceable, and collaboration is essential. Alone, one person can do little, but two people acting together are powerful.

    Communicate; then communicate again

    In hospitals across the city on day one, there was a great deal of uncertainty, and it continued for days. Would there be more explosions? More patients? What was the status of the overall response? Was it working?

    During multiple debriefs, communication offered a consistent opportunity for improvement. Clinicians rely on accurate and timely information to optimize patient care, but disasters wreak havoc on our usual process of collecting and transferring information. Do you have predetermined communication plans for such a scenario? And is there a backup plan, and a backup for that backup?