Everyone knows that a crisis is not an option. It is not a matter of "if," but of "when," "how big," and "how damaging."

Crises share four common characteristics:

1. No matter how prepared a hospital - or any organization - thinks it is, there is always a price to be paid: at best a chip, at worst a chunk of reputation is questioned or lost.
2. A crisis virtually never happens when we are best prepared for one.
3. As often as not, we create our own crisis.
4. A crisis generally lasts a lot longer than we think it should.

Crises come in many shapes and sizes, and increasingly they are issue-driven (i.e., changing legislation, new regulations, funding, community relations). However, still too many organizations, if they plan at all, tend to focus their crisis-management/communications plans and processes on event-driven incidents (i.e., fire, a missing patient, food poisoning). As a result, they neither expect nor know how to effectively manage and overcome issue-driven crises. Yet more and more, crises currently tend to be issue-driven.

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