Meeting the moment

During the initial tumultuous months of 2020, as communities around the country—and the world—retreated into quarantine due to the pandemic, the Veterans Health Administration (VHA) tackled unforeseen challenges almost daily, including national personal protective equipment (PPE) supply strain; the infection, and in some cases, deaths of frontline clinicians; and a presidential mandate to support the national response to COVID-19.¹

This was all in almost real time, in addition to suddenly providing care to the millions of Veterans they already served via telemedicine. Department of Veteran Affairs (VA) employees, as with the rest of the nation, were flooded with emotions—fear, uncertainty, loneliness, anger, grief, and conversely, at times, hope and pride.

Eventually, it became clear to the VHA leadership: Success was all about trust. Specifically, VHA’s actions and communication needed to assure VA employees that PPE supplies were arriving, that it was safe for Veterans and their families to come to VA’s medical facilities for care, and that all Veterans—regardless of race, ethnicity, or socioeconomic background, could get the best care anywhere at VA.

More practically speaking, the response required sharing the information people needed most quickly and transparently in an ever-changing and often politically charged environment. It was about demonstrating empathy. Within weeks, communication and trust became the single integral element that powered VA’s response to the pandemic both internally and externally.

And these were challenging times not just because of the pandemic. Trust in government was at historic lows.² Communicating in such a trust-deficit environment can be extremely challenging.

With the focus now on building trust, the VHA team designed a communications strategy focused on three elements: competency, humanity, and integrity.

• Competency: Internal and external stakeholders needed to know that VHA was good at health care delivery—an authority in the field—and that its operations and staff were capable, logical, and of high quality.
• Humanity: Veterans, employees, and their families wanted to know that leaders saw them and understood them beyond a job title or a statistic. It was important to demonstrate that the leadership’s decisions were made with genuine empathy, care, and concern, even when the decisions were not welcomed, such as limiting family visits to those in in-patient and community living center units.
• Integrity: It had been over 100 years since the nation faced such a massive health crisis so no organization was prepared, and more information was being discovered about the disease daily. Stakeholders wanted VHA to be agile and fully transparent in its approach, especially as guidance shifted. Leaders could not be seen as clinging to previous decisions or policies that were overcome by events.

The VHA’s 360,000 employees went on to not only save lives within the VA health care system, but also complete more than 150 missions with Federal Emergency Management Agency as part of the national response, administering millions of vaccinations, and opening doors to non-enrolled Veterans, spouses, caregivers, and communities across the nation.

This study explores how leaders can tap into the three elements of trust—competence, humanity, and integrity—to effectively break through in today’s trust-deficit environment.³ To meet these needs organizations should design small, agile, cross-functional “rapid response” teams to specifically address the important intersection of communication and trust.

These rapid response communication teams should engage not only in the business of facts and messaging but also the areas of psychology, mental health, and social awareness. By focusing on establishing empathy and trust from both leaders and institutions, taking advantage of the skills of a behavioral health specialist, and combining their expertise with effective social listening and graphic design, organizations can structure not just the words used but also the nonverbal and emotional communication that invites and builds trust and gives a message sticking power.

From crisis communication to “rapid response”

The foundational redesign of VHA’s communication strategy started before the pandemic in 2020. In the fall of 2019, the VHA decided to reimagine its communication strategy and engaged a team to augment its existing capabilities. The team worked on moving away from traditional crisis communications to a “rapid response” approach, signaling a shift from the old respond-and-defend mode to being proactive and strategic. Specifically, the team provided forward-looking surge support to internal leaders and their communication teams by anticipating bad news and formulating a communication plan.

Because the team’s emphasis was on building trust through agility and responsiveness, it was designed to be kept to a core group of three: an executive strategist, a senior executive writer, and a behavioral health communication specialist. The team also consisted of visual design specialists, misinformation experts, and video production specialists. These teams addressed trust by understanding the practices outside of the communication wheelhouse, including conflict resolution, online information patterns, social media networks, mental health, sociology, linguistics, and beyond (figure 1). Professionals in many of these disciplines have been examining and designing for trust for decades and offered meaningful insights to communicators about navigating the realities of the communication environment quickly and effectively.

The creation of the rapid response communication team was an important decision in hindsight. As the pandemic hit American shores in early 2020, the VHA communication team was ready to respond to the incoming crisis. Within days, the team mapped the three elements of trust into an agile and responsive content strategy for regular communication with employees and external stakeholders. The new communication strategy was centered on a recently launched daily video message delivered by the executive in charge of VHA, retired Army Major General Dr. Richard Stone, who was responsible for answering myriad questions for his 360,000+ employees.

Some videos were operational, sharing information, and building on competency. Others were a behind-the-scenes look at decision-making filmed in locations most employees would never see, demonstrating integrity. Stone also shared stories that viewers could relate with, including his time serving in Afghanistan as a combat doctor, his childhood growing up in Michigan, his children, and his concern for his aging father. The employees now saw the “human” side of their spokesperson and leader facing many of the same emotions and challenges that they were facing.

These videos were just two to three minutes long, with Stone speaking directly into a cellphone camera without notes. They were filmed in the early morning in his office and released to employees later that same day. Almost instantaneously, VA’s large workforce had a direct line to communication with its leader.

In addition to seeing and hearing their leaders in their own words, the communication strategy called for employees to also receive written guidance and encouragement in close to real time. Speaking with one voice, Dr. Stone and his team didn’t deny the uncertainty about the future and fear that the pandemic would endanger loved ones. Instead, they stood in the moment with their employees, honoring their experiences, being empathetic to their challenges, and giving assurance through connection and commitment.

The response from VHA employees was overwhelmingly positive and quickly created a feedback loop. Tens of thousands viewed the videos every day and wrote back about how the messages “reminded them that they are not alone in this fight,” “inspired them,” “provided them strength,” “were a fine balance between encouragement and acknowledgment of fear,” and “provided them a peek into leadership decision-making.” Some of the feedback informed the communication strategy with key messages and personal stories from the field.

Importantly, the trust-based communication strategy was backed by concrete actions that showed agility and competence in tackling the health crisis. This was important to ensure that the leadership “walked the walk”—that their actions matched their words. For instance, the agency’s investments in cloud technology allowed it to scale quickly to address the demand for telehealth, telework, veteran communications, and later for vaccination scheduling and tracking. Remote connections capacity tripled from 59,000 to 127,000 unique daily users between February and June 2020.⁴

The story of VHA during the pandemic shows the importance and impact of honest, empathetic, transparent communication from leaders during times of crisis. Government leaders today can face cumbersome processes to get information to their networks and challenging tensions when delivering complex messages. It is not just in crisis communication, however, that trust communication strategies are necessary. Trust is important for successful missions across the US government at all levels.

Leveraging the three elements of trust

As traditional and social media become more deeply connected and woven into the fabric of our lives, government communication needs to move beyond just traditional press releases. News moves at the speed of light in today’s media. A new public policy draft sent to leadership for feedback before its scheduled release will be forwarded, posted, and discussed on the local or national evening news by the end of the day. Confidentiality may not always be guaranteed.

As governments explore ways to communicate in this complex and ever-evolving environment, they can be supported by communication strategies and teams that tap into and leverage the three elements of trust (figure 2). However, communication needs to accurately reflect the reality on the ground and be followed by transparent and logical actions that drive the three elements of trust.

Competency

Competency refers to the capacity and resources required to successfully achieve current and future actions—the ability to do what you say you will do. In the VHA’s case, it was visible in Dr. Stone’s focus on operational capabilities, reducing administrative barriers, frontline response, and providing information on therapeutics which underlined the agency’s competence in battling the pandemic.

His confidence in the competency of his employees was also a constant refrain. And this confidence was supported by data; Veterans’ trust in VA had consistently improved since 2016 and their regularly measured trust score was between 70% and 75% when the pandemic hit in early 2020.⁵ He consistently reiterated his belief that those closest to the bedside knew best, and demonstrated his unwavering trust and respect for his employees.

Taiwan offers another example of the role of competency in building trust. The Taiwan Central Epidemic Command Center (CECC) played a critical part in not only communicating effectively during the pandemic but also taking actions to reassure residents.⁶ The CECC’s daily live-streamed press conferences provided residents with important information on health screenings, city restrictions, mask stockpiles in pharmacies, and other public health protocols.⁷ These communications were accompanied by actions on the ground.

As early as December 2019, Taiwan medical officers snapped into action based on early accounts of a potential virus spread in China. The country activated its public health protocols put in place during the 2003 SARS outbreak to put early travel restrictions, health screening for people traveling from China, and shoring up mask production by deploying military personnel.⁸ In addition to demonstrating their preparedness, clarity, and ability to respond, they also served as a central resource for up-to-date and trustworthy information for people through their ongoing, informative communications.

Humanity

Humanity describes the values and resolve that demonstrate commitment to others’ interests, well-being, and individuality. This is the need to show that the government genuinely cares for its constituents’ experiences and well-being by demonstrating empathy, connection, and kindness. For instance, Dr. Stone encouraged and facilitated employees getting to know him beyond their titles and degrees. His openness and authenticity allowed employees to show the same—sending him personal messages about what was happening in their lives. They shared a connection while never wavering from the agency’s mission to save lives.

Sometimes empathy and fairness in communication come from a leader’s or organization’s ability to accept and acknowledge wrongdoing from the past. In February 2019, the city of Edmonton in Canada got a new police chief—Dale McFee. The Edmonton Police Service (EPS) had a history of concerns from members of the lesbian, gay, bisexual, transsexual, queer, and two-spirit (LGBTQ2S+) community going back decades. In May 2019, Chief McFee, in front of a packed atrium of members of the LGBTQ2S+ community, police officers, politicians, and other dignitaries, made a public apology to the community.⁹ “To the members of the lesbian, gay, bisexual, trans, queer, and two-spirit community—both across the public and within the service,” said Chief Mcfee, “on behalf of the Edmonton Police Service, I am sorry and we are sorry.”¹⁰

The chief’s message was clear: The department cannot change the past, but it can acknowledge, apologize, empathize, and build pathways for a better future.¹¹ The message was direct, naming and acknowledging the emotional realities, not just changes to policies and processes.

Integrity

Integrity outlines the standards and norms that are consistently expected for relevant interactions. It signals that leaders will follow ethical standards when making decisions and openly share information, motives, and choices (wherever required and possible) related to policy, budget, and program decisions in a straightforward language. This was especially important because decisions and guidance shifted throughout the pandemic as more information was discovered. In some messages, Dr. Stone outlined the allocation model for vaccines or how a major decision was made. This allowed employees not just to see the end product but to understand the different implications and considerations that went into it. He was frank that these were hard choices that did not always make everyone, including him, happy.

In October–November 2020, El Paso, Texas, was in the middle of a brutal COVID-19 wave, with the city having the highest coronavirus infection rates in the country. With the arrival of a new mayor in January 2021, who himself had lost his mother and brother during the second wave, the administration decided to overhaul its communication strategy.¹²

The new mayor and his administration wanted cooperation from constituents to rein in the infection rate in the city. Beyond talking directly to residents, the city also created a COVID-19 dashboard, allowing the leadership team to be transparent and base its message on a single source of information. The dashboard was made public-facing to allow people to check information and build trust in the city’s COVID-19 response on the ground. The efforts paid off with El Paso becoming the first city with 81% of the population above five years of age fully vaccinated by May 2022.¹³

By baking in the three elements of trust in communication, governments can create and foster an environment in which organizations and leaders are trusted and messages are believed. However, government leaders also face the challenge of choosing the right tools, practices, and platforms to reach their constituents.

Bringing it to life

While both audiences and communicators may be more prepared for the pandemic today than two years ago, the next challenge for executives will be different. Strategies that focus on trust can be adapted to different situations and contexts. The work of a cross-functional communication team is to leverage approaches from multiple disciplines to address the trust deficit. One of the key advantages of trust is that it does not necessitate the agreement of all stakeholders. Trust doesn’t reflect confidence in an individual action, outcome, or response but the ability to navigate uncertainty because of a relationship.

Our perception of any content has emotional and neurochemical roots in our beliefs about the people and ideas surrounding or generating that content.¹⁴ In practice, this means that by understanding the psychology of trauma and stress, leaders can understand their stakeholder’s emotional landscape. Stress changes our perception at a chemical level and can impact our understanding of everything from words and images to team members and our environment.¹⁵ Several psychological approaches underline how the level of distress in our bodies can change how we hear and intake information even when it’s right in front of us.¹⁶ Adding behavioral health professionals to communication teams can change the tools and approaches they have at their disposal.

The following examples are not exhaustive communications plans but they show how responses might change when viewed through the lens of building trust. While crises can exacerbate the need for trust, it is better to be building it constantly. If leaders maintain authenticity and connection in good times, stakeholders may be more prepared to trust you when challenges arise. A steady state communication team can engage in many of these practices today even without a dedicated rapid response capability, but when the headlines focus on you, and you have everyone from journalists to unions waiting for your statement, it takes a specialized team.

Meet the new communication team

Working in a trust-deficit communications environment is not a time for guesswork or panic. What used to be called crisis communications is becoming business as usual and governments can build teams now that are ready to respond. Although there are multiple ways a cross-functional communication team can be put together, based on the VHA, here are a few key roles to consider.

• An executive strategist and adviser who should be a senior executive, or peer-leader, with relevant expertise or experience and the ability to understand the environment to provide trusted counsel (in private, if necessary) to the most senior leaders on challenging issues as they materialize.
• A senior executive writer who brings a depth of experience in executive communication, can lead production, and review with agility and responsiveness. This person should have experience staffing senior leaders and be able to pull communication needs from leadership briefings, as well as recommend and execute public/media appearances, site visits, and third-party partnerships.
• A behavioral health communication specialist who offers expertise in both communication and psychology and is responsible for identifying, understanding, and navigating the different emotions and concerns of audiences and stakeholders while building messages for emotional intelligence including empathy and authenticity.
• A digital and visual specialist who can help translate messages into clear, accessible visuals which could be incorporated into social media posts, infographics, video outreach, posters, and many other physical products. 
• A social monitoring or misinformation specialist who brings tools necessary to monitor dialogue and sentiment on a variety of social media platforms to gauge the efficacy of communication and messages as well as identify what key audiences are saying. In an era replete with mis- and disinformation, following trending conversations and being able to insert effective messages into them to reach key audiences is essential to understanding what your audiences are being exposed to. This person works with the entire team to offer context on the prevalence of various misinformation trends and whether or not an agency or leader should respond. They offer the agency the ability to tell the difference between the “mountain” and the “molehill.”
• An embedded rotating subject matter specialist, whose role is a rotating one that simultaneously builds capacity while allowing the team to rely on experts without burdening existing resources. For example, when facing financial concerns this could be an accountant, a doctor or an epidemiologist during a pandemic, or a data security specialist during a cyberattack. It is critically important that content is both factual and culturally competent in order to resonate with both lay and expert audiences to build trust and identify third-party validators.

Agility and responsiveness are often key. Such a team can dive into an issue immediately, assess the messaging environment and audiences, provide a proposed plan within hours or days rather than weeks, and operate as a self-contained, product-creating capability. These teams need to be trained in not just communicating facts and policies but in building trust. Perhaps most importantly, they themselves must be trusted and enabled by the organization’s senior leadership.

Getting leaders ready

Today’s government leaders should be prepared to deal with and navigate a complex communication landscape. They need support to build this new skill that goes beyond the traditional communication specialist job requirements, and they need to be out in this challenging environment, not hiding behind a faceless press release or easily dismissed tweet.

Building a trusted reputation for a person or an organization by offering genuine connections with employees and external stakeholders requires a proactive and open-minded approach toward communication. Winning the communications battle one message at a time is much more labor-intensive and unpredictable than becoming a trusted source of information, especially as it is almost impossible to be consistently “correct” about complex topics in the eyes of all stakeholder groups. Building emotional resilience and developing a communication style that suits today’s times will be vital in driving trust. Only then can government itself be trusted to complete its mission of serving its citizens.

The Future of Trust

As we recover, reopen, and rebuild, it’s time to rethink the importance of Trust. At no time has it been more tested or more valued in our leaders and each other. Trust is the basis for connection.

Trust is all-encompassing. Physical. Emotional. Digital. Financial. Ethical. A nice-to-have is now a must-have; a principle is now a catalyst; a value is now invaluable. Trust distinguishes and elevates your business, connecting you with the common good. Put Trust at the forefront of your planning, strategy, and purpose, and your customers will put Trust in you. Deloitte can help you measure, enhance, and amplify Trust in your organization.