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By ELLEN F. HARRIS

Josiah S. "Sy" Johnson was settling into his new position as chief executive of the PeaceHealth Columbia Network, in Longview, Wash., when a major crisis unfolded: a caregiver at a network hospital was suspected of diverting narcotics in ways that could have exposed a number of patients over two years to Hepatitis C infection.

"It was very scary," Johnson said. He learned, in February 2014, that a caregiver in direct patient care at a network hospital might be working under the influence of drugs. Fourteen months earlier, one of the caregiver's patients at PeaceHealth Southwest Medical Center in Vancouver, Wash., had tested positive for Hepatitis C.

"A wave of worry" descended on Johnson. Johnson left PeaceHealth in April, but as the crisis was unfolding, he wore two hats in its Columbia Network. In addition to being the top executive, he was chief mission officer. As such, he determined to stay true to the core value that every person is a treasure.

"We were dealing with people's lives. We help people when they're at the most vulnerable time of their lives," he said. "If we believe there is a chance that a patient may have been exposed to Hepatitis C at PeaceHealth, we have an obligation to take whatever steps (are) necessary to investigate and correct the situation," he said.

Johnson and Tim M. Strickland, senior director of communications at PeaceHealth's corporate office in Vancouver, will explain how they managed the crisis in an Innovation Forum at the Catholic Health Assembly. Their presentation is entitled "Doing the Right Things for the Right Reasons: The Four Pillars of Crisis Communications." The assembly runs June 7-9, in Washington, D.C.

Covering all bases
Johnson said he saw the crisis as a chance to prove PeaceHealth's mission mettle. "How an organization behaves and the choices it makes in navigating a crisis offer a lot of evidence about the core values of the organization," he explained.

PeaceHealth had multiple responsibilities: it had to determine whether past patients had been infected by the caregiver; it had to address the concerns of the community served by the hospital; it had to answer questions from the media; and it had to protect the caregiver's identity, since there was no direct evidence the caregiver had committed a crime.

The first intimations of a problem that would mushroom into a crisis began in 2012. That December, PeaceHealth Southwest Medical Center in Vancouver received notice from a local, infectious disease physician that a patient had tested positive for Hepatitis C. The patient's only known risk factor for the virus was having been hospitalized six months earlier at PeaceHealth Southwest Medical Center.

Investigators at PeaceHealth Southwest and Clark County Public Health checked the medical center's infection controls. They were found to be sound. "We were at a dead end," Strickland said.

Connecting the dots
In February 2014, an incident occurred that would tie back into the infection control investigation. Hospital caregivers alerted management that one of their colleagues was behaving as if under the influence of an inappropriate substance and might be diverting narcotics.

That caregiver had direct contact with the Hepatitis C index patient when the patient was hospitalized at PeaceHealth Southwest in June of 2012.

In April 2014, the caregiver tested positive for Hepatitis C. (Johnson and Strickland decline to identify the employee by name or occupation and will only say the person is no longer employed by PeaceHealth. The employee was not prosecuted because the hospital found no evidence of drug theft.)

Researchers from the Centers for Disease Control and Prevention, Clark County Public Health and PeaceHealth tested whether the Hepatitis strain of the caregiver matched that of the index patient. The tests were inconclusive: they could not determine whether the caregiver infected the patient. Strickland said the hospital had been prepared to take responsibility for the patient's care in the event there was evidence that the patient had contracted the virus at the hospital. No such evidence was found.

Hospital staffers began culling patient lists for those with direct contact with the infected employee over the term of his or her two-year employment.

Integrity, justice and mission
In May 2014, Johnson announced to the media that PeaceHealth was conducting an investigation into whether any patients of the caregiver who'd tested positive for Hepatitis C had contracted the disease. He said the hospital had identified 936 former patients who had come in contact with the former caregiver and would urge them to come in for testing.

Strickland said in response to a "media breach" the hospital had called this first news conference to speak about the potential patient exposure to the Hepatitis C virus before it was ready to send letters of notification to the list of potentially at-risk patients.

The hospital sent certified letters to the former patients a few weeks after the initial news conference, urging them to come in for testing at PeaceHealth's expense. It held a follow-up press conference. Throughout the crisis and its aftermath, "We were so intentional in the words we chose at the moment to be sure we didn't accidentally mislead anyone about the facts," Strickland said.

Johnson said: "We said publicly that if anyone had contracted the disease at our hospital we would take responsibility to care for that person and assume the cost of that care."

Staffers set up a website and a call center to keep the public informed.

PeaceHealth received hundreds of phone calls and thousands of visits to the website. More than 80 percent of the 936 patients came in for testing.

"We were trying to show the world that we are who we say we are," Johnson said. "If we made a mistake or have a problem, we'll take responsibility. We are here to help you. If it's something we've done, we'll make it right. It was about integrity, justice and living our mission," he said.

All clear
By September 2014, Johnson announced that after testing, no evidence of disease transmission at the hospital had been discovered.

PeaceHealth Southwest suffered no decline in patient volume. A community survey gave the facility an 88 percent favorable rating for the way Johnson and his staff handled the crisis. Strickland said that's the highest postcrisis favorable rating he'd seen in his 25-year-plus career.

"Everyone benefited and it all stemmed from our decision to honor the Catholic values of PeaceHealth," Strickland said.