NEWS MEDIA FRAMING OF PREVENTABLE CRISIS CLUSTERS. CASE STUDY: NEWBORN BABIES KILLED IN THE FIRE AT A ROMANIAN HOSPITAL.

• Author: Cmeciu, Camelia

1. Introduction

   On August 16, 2010, around 6.00 PM, a blast followed by a fire took place at a Romanian maternity hospital (Panait Sarbu Clinical Hospital of Obstetrics and Gynecology, also known as Giulesti Maternity Hospital in Bucharest). It killed four premature newborns, two more babies dying after several days. Caused by an electrical fault in the air conditioning system, the fire burned the Intensive Care Ward of Giulesti Maternity Hospital completely, killing four newborns on the spot and causing serious burns to other eight babies. The pictures of the firefighters holding the babies, of the burned incubators, the blackened room and the melted equipment had a profound emotional appeal, thus drawing considerable press attention. The questions raised by the Romanian news media immediately were: (1) How could a fire spread so quickly without being noticed by the staff of the IC Unit of Giulesti Maternity? (2) Where were the medical nurses who were supposed to take care of the newborn babies in the IC Unit? These questions reflect the fact that 'crises and disasters are, by definition, abnormal, dynamic, and unpredictable events' (Seeger, 2006, p. 241) and that 'a crisis can violate the expectations that stakeholders hold about how organizations should act' (Coombs, 2007, p. 3). Maternity hospitals, as all organization, should have a proper crisis communication system (Coman, 2009a, p. 152) in order to keep stakeholders permanently informed, to avoid silence responses, and to maintain regular media relations. The scarce number of statements provided by the Giulesti Maternity representatives showed that it did not have a crisis management plan.

   The research on the Romanian health system has mainly focused on medical organizations: studies on the organizational diagnosis in hospitals (Baba et al., 2009), on leadership within the healthcare reform (Hintea et al., 2009) or analyses of improper crisis management in hospitals (Coman, 2009b).

   Besides the organization which goes through a crisis situation, the local and/or national authorities or rescue organizations, journalists constitute one important actor. Timothy W. Coombs (2007, pp. 119-120) considers that news media should be included within the external stakeholder network of the organizations' crisis knowledge map. The journalists' framing of the crisis in the news may have significant implications for the public understanding and for the moral evaluations of the issues, organizations, and social actors involved in the (un)predictable event.

   Our comparative analysis of the sober and sensationalist news coverage of the crisis situation at the Giulesti Maternity provides a new strand of research into the Romanian health system. Our study of the media coverage of the Giulesti Maternity crisis situation is meant as a practical insight for Romanian hospital managers who should become aware of the types of frames and crisis issues used in the Romanian daily and sensationalist news media.

2. The Giulesti Maternity fire--preventable crisis cluster

   The Giulesti Maternity has the reputation of being one of the best hospitals in Bucharest. It is also known as the hospital where many Romanian celebrities gave birth to their children. Despite this, the death of six babies revealed the organization did not have a pre-event planning, an aspect which M.W. Seeger (2006, p. 237) considers of vital importance in crisis situations. At the same time, the opacity of the hospital officials, who preferred not to provide sufficient information to their stakeholders, showed that the hospital representatives did not use two practices which are mentioned in the literature: (1) to be truthful, honest, frank, and open (Covello, 2003, p. 6) and (2) 'to deliver on the promise to be the first and best source of information' (Heath, 2006, p. 248). During the crisis, no press releases or official statements were posted on the Giulesti Maternity website.

   Attila Cseke, the Romanian Health Minister, described the fire at the Giulesti Maternity as 'one of the darkest tragedies in the history of the Romanian healthcare system' (Adevarul, August 17, 2010). The fire at the Giulesti Maternity may be included in what Timothy W. Coombs (2007, p. 142) defines as the preventable crisis cluster since it was provoked by a twofold human-error accident and organizational mismanagement: (1) the improper maintenance system: the fire was caused by the improper isolation of an electrical cable in the air-conditioning system; and (2) the absence of a nurse in the IC unit. When the fire started, the nurse was not in the room because she needed to go to the toilet and her colleague, who was supposed to replace her, was in a surgery, as she stated during the hearings.

   The Giulesti Maternity management should have considered that a preventable crisis cluster produces very strong attributions of organizational crisis responsibility and that a silence response will trigger a lack of control and credibility. Within this information void created by the Giulesti Maternity, the Romanian news media were the main source of information for the key stakeholders and the Romanian public.

   The lack of transparency determined us to analyze the Romanian media coverage of this crisis situation. A media content analysis, in terms of crisis issues and news frames, may have a threefold practical rationale for hospital communication departments:

1. It provides an evaluation of the reputational threat provoked by the hospital's silence response;

2. It reveals the types of frames used by different types of mass media (daily versus tabloid newspapers) during crisis situations;

3. It makes hospital management departments become aware that news media are important stakeholders and that constant media relations have a beneficial outcome upon the organizational reputation.

3. Theoretical background: framing theory

   News media shape public opinion by selecting and making certain news stories more salient. Besides the setting of the public agenda, news media also provide assessment of the published content. Frames are used to make sense of information or an occurrence (Goffman, 1974, p. 21), providing 'principles for the organization of social reality' (Hertog and McLeod, 2001, p. 140). News frames are 'conceptual tools which media and individuals rely on to convey, interpret and evaluate information' (Neuman et al., 1992, p. 60). Frames rely on the selection of 'some aspects of a perceived reality' which are made 'more salient in a communicating text, in such a way as to promote a particular problem definition, causal interpretation, moral evaluation, and/or treatment recommendation for the item described' (emphasis by R.M. Entman, 1993, p. 52). The news frames provided by media during crisis situations serve as interpretation guidelines for different stakeholders, especially when the organization involved in the respective crisis adopts the silence strategy. At the same time, organizations should take into account two aspects:

1. Media frames may emphasize some aspects of a certain issue above others (Valentini and Romenti, 2011, p. 361) and thus may introduce bias by omitting essential information about the crisis;

2. Media frames may influence the public's evaluation of organizational responsibility for the crisis event (Cho and Gower, 2006, p. 420).

   We consider that the framing model is relevant and useful for two reasons: (1) It helps audiences 'locate, perceive, identify, and label' the flow of information around them (Goffman, 1972, p. 21); and (2) The organization, the selection of content and thematic structure of a news message may 'render particular thoughts applicable, resulting in their activation and use in evaluation' (Price et al., 1997, p. 286). Organizations should consider the types of frames that news media use in interpreting crisis situations so that they may adapt their future crisis response strategies to the information needs of different news practices. The literature (Connell, 1998; Sparks, 2000) shows that whereas the sensationalist discourse framed in tabloid media focuses plain and simple on credulity, the rationalist discourse framed in daily media is informative and insightful.

4. Method and research questions

   We used content analysis as a method for framing research (Wimmer and Dominick, 1997, p. 114), since it is seen as a 'reality check, in which the portrayal of a certain group, phenomenon, trait, or characteristic is assessed against a standard taken from real life'. The analysis of the media coverage of the crisis situation which took place at the Giulesti Maternity Hospital in 2010 had two reasons: on the one hand, the emotional impact of the tragic outcome (six dead newborn babies), and on the other hand, the extensive media coverage of this dreadful event (August 16, 2010--October 22, 2010).

   The study employs both a deductive and an inductive method. We used a deductive method by seeking to assess the differences in the use of the crisis news frames among the tabloid and daily media coverage of the fire at the Giulesti Maternity. In the existing literature (Semetko and Valkernburg, 2000; An and Gower, 2009; Valentini and Romenti, 2011), five...