Dilemmas and dynamics of
media management
An explorative study on media strategies of
health care inspectorates in Europe
Prof. Mark van Twist
Presentation at 20th EPSO Conference Helsinki, Finland
(September 30th 2015)
EPSO conference in Utrecht (2012)
Starting point: a personal puzzle
• Dutch Health Care Inspectorate closes down intensive
care units in hospitals, to end life threatening situations.
• (Former) Inspector General is asked to come and explain
this action on national television in the Netherlands.
• Expecting applause for showing decisiveness, instead he
is criticised severely: unexpected shift in ‘blame game’
Paradoxes of media management
• 1st paradox: The essence of inspection is making sure
everything is allright - by exposing what is wrong.
• 2nd paradox: Inspectorates are invisible in the media if
nothing is wrong - and (so) their work is successful.
• 3rd paradox: Inspectorates become visible when things
are wrong; then easily framed as ‘failing’ in ‘blame game’.
• 4th paradox: not only critical reports make Inspectorates
vulnerable, supportive reports do so even more.
Mediatization perspective
• Preliminary research on perceptions of media influence
by EPSO members, first presented in 2012 in Utrecht…
• Informational biases in the media (Bennett, 2009):
– Dramatization
– Personalization
– Authority disorder bias
– Fragmentation
• Media logic ‘invading’ and ‘colonizing’ other domains?
Conclusions of preliminary research
• Perceptions of media-attention by EPSO-members
(2012 EPSO conference in Utrecht)
– Increasing media attention for supervisory work
– Can be productive but also counterproductive for
the work of the health care inspectorates
– Media coverage and frames can be influenced by
the health care inspectorates
– Inspectorates should reflect on how they develop
effective media strategies
EPSO conference in Brussels (2013)
Theoretical perspectives on influence of media
Mediatization
perspective
Context
Agenda setting
perspective
Issues
Public relations
perspective
Management
Developments in the
media landscape
How is news created
and to what extent is
media logic taking over
other domains?
Agenda setting and
impact of the media
What factors influence
the issues on political
and administrative
agendas?
Selling messages and
using the media
How are messages
communicated
effectively through
media to an audience?
Interesting Signs of adaptation of
phenomena political-administrative
to look at
life to media logic.
Reporting in media on
governance processes
Dynamics of agenda
setting, windows of
opportunity in the
media to put issues on
relevant agendas.
Ways to communicate
ideas, closeness of
journalists with
politicians and how
journalists are 'used'.
Focus
Focal point
Research
questions
Mediatization
perspective:
bending with
the media:
Agenda
setting
perspective:
undergoing
the media:
Public
Relations
perspective:
Using the
media
View of media
Media as independent
negative force, highly
biased, that should
make more room for
balanced news
Media as 'natural
phenomenon‘, that
definitely show signs
of 'media logic' but
can be influenced
Media are just as
dependent on the
dynamics of the
governance process as
they can help shape it.
View of governance
Media disturb governance
and supervision, make
things complex, are a
disturbing, often annoying
factor for inspectorates
Media are an inherent
element of governance
and should be taken as it
comes and managed as
good as possible
In highly complex and
dynamic governance
processes the media can
be an instrument in the
hands of inspectorates
Policy prescription
Not much can be done.
Very difficult to cope
with media logic,
limited influence on
media
You cannot really
influence media. Be
pragmatic and think
about what you want
to communicate
Create strong images
and communicate
them, go along with
complex decisionmaking process.
Framework for research on media management
• Distinction between strategies for:
– Impact enhancement: attracting positive publicity
on the organization. For instance by publishing
information, press conferences, pre-arranged
interviews.
– Damage control: protecting the organization
against negative publicity. For instance by the
spinning of potentially damaging stories or the
suppressing of potentially damaging information.
Research on media management
• Study on relation between EPSO-members and media
(2013 EPSO conference in Brussels), first results:
– Ambivalent relationship between media and health
care inspectorates.
– Both serve as ‘watchdogs’ in the public domain, but
they do not so in a concerted effort.
– The media can create windows of opportunity and
provide a platform for sending messages to public.
– But the media can also interfere with inspectorates
efforts e.g. by holding them accountable for incidents
EPSO conference in Porto (2014)
Research approach
•
•
•
•
Step 1: Discussing experiences with the media
Step 2: Collecting cases
Step 3: Performing a vignette study (questionnaire)
Step 4: Discussing and interpreting results
21 Respondents from 11 countries
Country
Belgium
Denmark
Estonia
France
Netherlands
Northern Ireland
Norway
Republic of Ireland
Portugal
Sweden
United Kingdom
16 vignettes tested by EPSO contacts: most of them
relevant in different national contexts
Vignette: example
• Your supervisory organization is conducting its regular
periodic review of all major hospitals. There are no
specific complaints or negative sources of information.
• You receive a request from a television broadcaster
wanting to make a program about the work of your
inspectors.
– Strategic option: Do you collaborate with the makers
of the television program, who will show the work of
the inspectors inside the hospitals?
EPSO conference in Helsinki (2015)
Media management: dilemmas (1)
• An Inspectorate should always actively inform the
public on incidents through the news media even when
this greatly damages the trust in the health care sector.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Dynamic
Negative news: You want to inform
passive
the public about
communication or problems, but
active informing? prevent mediaattention to be
disproportionally
damaging to the
health care sector
Paradox / effects
Snowball effect:
enlargement and
hyping of negative
messages
Intervention options
Consider the longerterm dynamics of
negative news
Example:
Negative news is often - Some issues can be
amplified and hyped, solved ‘behind the
which can cause extra scenes’
damage to the
- Meet frequently with
reputation of the
journalists to
sector
accomplish moreinformed publications
Media management: dilemmas (2)
• An Inspectorate should always actively inform the
public on incidents through the news media, even if
there is the risk of ‘backfiring’ in the blame game.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Dynamic
Paradox / effects
Intervention options
Negative news: You want
Unintended
Consider the frames
better to
transparency and
consequences:
and the weaknesses
emphasize or
need publicity to
backfiring efforts to for the image of the
downplay the role exercise influence on send critical messages supervisory
of the
the sector, but
organization
inspectorate?
negative news is
Supervision in media
often interpreted as reports is often ‘failing Example:
‘failing supervision,’ supervision’
- Discuss talking points
which diminishes the
before the broadcast
image and
effectiveness of the
supervisory
organization
Media management: dilemmas (3)
• An Inspectorate should always publish reassuring news
about health care organizations, even when it makes the
public sceptical about the inspectorates independence.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Reassuring news:
better to send
reassuring
messages, or no?
Dynamic
You want to publish
reassuring news, but
the more positive
the news, the more
sceptical it could be
received
Paradox / effects
Media can reframe a
message from a
different perspective:
‘hitting the target,
missing the point’
Intervention options
Consider the broader
context and history in
which the message
will be interpreted
Example:
Reassuring messages Link news to other
from supervision are positive events from
suspicious
the past to show a
positive pattern
Media management: dilemmas (4)
• An Inspectorate should always publish reassuring (good)
news about health care organizations, even if this makes
the sector & Inspectorate vulnerable in a later stage.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Positive news;
remain on the
background or
publicly celebrate
successes?
Dynamic
You want your
positive message to
make the proper
impact, but media
attention is always
contested by other
issues
Paradox / effects
Variability of media
attention: media
attention depends on
the density of issues
Intervention options
Consider attractiveness
and timing of the
message
Examples:
Good supervision is - Generate media
usually invisible; the attention: create event
amount of mediawith famous guests?
attention is
- Prevent media
dependent on other attention: reschedule
issues on the agenda press conference to
coincide with other
media event?
Media management: dilemmas (5)
• An Inspectorate should collaborate with television
broadcasters if they propose to make a ‘real life’
program on the work of inspectors.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Permit journalists
close proximity to
the inspectorate’s
work, or keep
them at a
distance?
Dynamic
You want to
moderate which
(sensitive or
personal)
information
becomes public,
but also show
journalists a real
impression of the
work
Paradox / effects
Quickness of story
building
Intervention options
Consider involving
journalists in real-time
aspects of inspectorate
Media construe their work
storylines and only
use small bits and
Examples:
pieces of the
- Let journalists tag along
information from the with an inspector for a day
supervisory
- Give selected journalists
organization
a scoop before the event,
so they include it in their
coverage
Media management: dilemmas (6)
• An Inspectorate should inform the media on findings in
their reports even before the work is complete, to help
create the ‘right’ story lines.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Dynamic
Paradox / effects
Discuss early
You don’t want to
Self-reinforcing
findings with the prematurely share storylines
media, or share information, but also
conclusions after can’t afford to be
Once a storyline is
work is complete? overtaken by events established, it is
self-reinforcing and
the option to send
another message
decreases
substantially
Intervention options
Consider the timing of
public messages during
the start of storybuilding
Examples:
- Be proactive in
creating storylines
- Publish parts of
research before media
coverage
- Add to a story-line,
instead of contradicting
Media management: dilemmas (7)
• If the Inspectorate is being criticized in the media it is
best to wait for attention to ebb, not to start defending
the Inspectorate by bringing out new information.
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Counter media
hype by waiting
for attention to
ebb, or persist at
the media’s
tempo?
Dynamic
Paradox / effects
You want to defend Vicious cycles
yourself when there
is criticism, but don’t Defensive messages
want to strengthen often elicit negative
the negative cycle by responses, but staying
firing up the debate silent can reinforce
that as well
Intervention options
Consider the depth
and length of criticism
and the reaction on a
defensive tone
Media management: dilemmas (8)
• An Inspectorate should stick to the facts and never
engage in ‘framing contests’ or make use of biases in
the media logic (e.g. dramatization, personalization).
– Yes or no? Why?
– What are opportunities and threats of each option?
– What conditions would you set to either yes or no?
– Who should be involved in discussing, deciding and
reflecting on this particular media strategy?
Dilemmas and dynamics of media management
Dilemma
Adjust public
statements to
accommodate
dominant media
logics and biases,
or emphasize
organizational
and professional
logic?
Dynamic
You want to stick to
the facts and your
role, but also cover
the proper frame in
order to get the
message across
Paradox / effects
Parallel stories,
conflicting logics
Intervention options
Consider the personal
side of
communication
Formal, legal
- Express sympathy or
statements speak to other emotional
the facts, while moral involvement
statements speak to - Use facts besides
the emotions
emotions, but not to
contradict them
Research on media management: conclusions
• Study on dilemmas and dynamics of media management
(2015 EPSO conference in Helsinki):
– Important role for the inspectorate leadership
– A well-functioning organization
– Connecting media strategies with other actors
– Connecting internal and external media strategies
– Attention to facts and framing
– Establishing continuity during crisis
– Prevent disasters after the disaster
– Structural media management: toggling time horizons
EPSO conference in …. (2016)
Social Media & Inspectorate 2.0?
Social
Media
Inspection
1.0
Inspection
2.0
• Strategic challenge for health care inspectorates: to identify
a) the tension between organizational capacities and the
need to adapt to the nature of open and/or citizen
generated data and social media
b) the potential of big, open and/or citizen generated data
and social media to create public value through
inspection
Innovations in health care inspection?
• Looking for innovative media management practices
deemed relevant, appropriate and useful in the context
of being ‘watchdog in the public domain’:
– More interactive:
• e.g. Wheredoesmymoneygo.org, Zorgkaart.nl
– More citizend initiated:
• e.g. Mypolice.org, Patientslikeme.com
– More dynamic:
• e.g. Twitter day, Recovery.gov
Interactive Accountability
– User generated content on quality of health care
– Patient centered
– Personal experience
– Soft information
– Rating of doctors
– Number of likes…
– Comparing providers
– Potential harm
– New challenges: selection bias & social desirability bias
– ‘Crowd validation’ & important source for Inspectorate?
Citizen Initiated Accountability
– Online
– Local knowledge
– Crowdsourcing
– Interactive
– Using open data
– Prosumers
– Wiki wisdom
– GIS & Mash ups
– Self organization
Dynamic Accountability
– Information on quality of public service organizations
– Problem spotting
– Detect fraud/waste
– Visualization
– Predictive value
– Engage citizens
– Coproduction
– Opportunities to participate
– Upload/download information
– Developing new and innovative strategic options
• Process model of
communication in
traditional media:
Sender:
message
Reciever:
effect
• Network model of
communication in
social media:
Mass media
Social media
Characteristic Relevance for
Inspection (1.0)
Characteristic Relevance for
Inspection (2.0)
Model
Process
model
Only enable one-way
communication
Network
model
Enable many-directional
communications
System
Analog/
printed
High risk of information
manipulation
Digital
Near real time data sharing and
transportation
Direction
Vertical
/top-down
(In)formal account giving Horizontal
to superiors
Directly (in)formal account giving
to citizens and social movements
Interaction
One-way
Accountability institution Many-tointerrogates the actor
many-ways
Users can interrogate by engaging
in peer-to-peer interactions
Information Medium
created
content
Actor provide data and
User
institution question their generated
adequacy
content
Information is created, recreated
and monitored in a peer-to-peer
setting
Audience
Passive
consumers
No citizen participation / Active
few are consuming
consumers
Prosuming / Consumers, cocreators & co-producers
Access
Limited by
gatekeepers
Pre-selected tailor made Mostly
information
unlimited
Organizing their own institutions
and information channels
Inspectorates & Social media strategies:
disruptive innovation?
• Optimistic view: user generated state, cocreation
– Open innovation (Chesbrough, 2003)
– Wisdom crowds (Surowiecki, 2004)
– Wikinomics (Tapscott, 2006)
– Crowdsourcing (Howe 2008)
• Critical view: big brother, soft sister
– Cyberocracy (Ronfieldt, 1992)
– Monitory democracy (Kean, 2009)
– Armchair auditors (OPI, 2013)
Contact
Erasmus University Rotterdam
Departement of Public Administration
Prof. Dr. M. (Mark) van Twist
Postbus 1738
3000 DR Rotterdam
Telephone: +31 70 30 24 932
e-mail: [email protected]
or [email protected]
Netherlands School of Public Administration
J. (Jorren) Scherpenisse Msc
Lange Voorthout 17
2514 EB The Hague
Telephone: +31 70 30 24 933
e-mail: [email protected]
www.nsob.nl/en