So in my years of gaming I have had 2 hostage standoffs. The first was a disaster of inaction the second worked itself out in action economy.
The classic "take another step and I'll kill her" is a heroic story trope but in the universe of game mechanics it tends to break down. Generally heroes don't have the means of 1-shotting the baddie with hostages but the hostages often are squishy.
How do you all handle these situations?
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It depends upon the specifics. If it is done during combat in order to secure a truce, etc, the hostage taker readies an action to attack or cast a spell on the hostage and tells the PCs to back off. For this situation I use the standard readied action rules.
There are some challenges here since hostages aren't all squishy but if it's a planned situation the standard action coup de Grace feat can help. However for the most part hostages are squishy enough (or have become squishy enough-a downed but not dead PC is a common target)
Called Shot rules for Heart (could flavour as Head if you want) is good for this, tough shot.
For Hostage Takers, Throat Slicer is a great feat that allows for devastating takes.
Can't say I've run one in PF, but I'm interested for future.
Here's someone's house rule on it. More complicated than I'd use, but it I'd seen it recently enough to do a double-take when I saw your post.
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Had a browser error leave my post half finished. I think the rules do have the equipment for a reasonably satisfactory resolution.
Taking a hostage: move to appropriately vulnerable hostage, ready action to make lethal attack, say, "move and your friend gets it!"
If the PCs ignore the threat and take overtly hostile action the ready triggers and the held NPC or PC at -3 hp takes a greatsword or a slay living or whatever to the face.
If the PCs try to be subtle, they can make the appropriate skill check to avoid triggering the ready. Usually it's going to be bluff, stealth, or sleight of hand. Succeed and the bad guy doesn't notice until it's too late. (And he acts after the PC's action). Fail and the bad guy does notice and the readied action is triggered.
If the negotiations have gone on several rounds and active combat has ceased, I will drop out of combat. At that point if the PCs try to restart combat (or if they arrived at a hostage scene without being in combat) they can use their skills (usually the previously listed ones) to try and get themselves a surprise round. After the surprise round or if the bad guy wasn't fooled, the question is who was quickest on the draw so I just roll initiative and go with that. That's what initiative is for.
That PCs may have difficulty taking down a full health hostage taker in one round is not necessarily a problem. There are a lot of useful things they can do to render the hostage taker ineffective from combat manuevers to grapple, reposition, or bull rush the hostage or hostage taker out of reach of each other to spells (which can instantly kill or incapacitate the hostage taker or render the hostage immune to the attack (vanish, invisibilty, resilient sphere, dimension door, wall of force, counterspells, etc).
It's not a situation that should be common, but the rules do handle most of it in a reasonably satisfactory manner.
The bad guy can't pin a target himself and ready an attack which does preclude some classic schemes but as long as he has an accomplice or has the victim tied up, held, unconscious, etc it works fine.
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Other notes on scenarios.
In a spur of the moment hostage situation where a bad guy (for example) uses an unconscious pc as a hostage, the bad guy will often be seriously wounded, weak, or both, making the one-shot attack a possibility even if it normally would not be practical to one-shot him from full hp. The BBEG may not try it until he's desperate and the minion is weak to begin with.
In the pre-planned hostage scenario, you have the freedom to use a villain who is not actually up to taking on the PCs--the whole point of the encounter is resolving the hostage crisis so you can make him weak enough to be one-shottable without removing the challenge of the scenario. Like in real life, the challenge is not defeating the bad guy, it's defeating the bad guy without getting the hostages killed. That is one of the scenarios where for example a 2nd or 3rd level bad guy could actually be a legit challenge for level 6+ PCs. Depending on the usual spell layouts, it might not even be a layup for 16th level PCs.
Story from a campaign my partner ran:
One of the baddies was really wounded, grabbed one of the party's NPC allies, and did the "Drop your weapons or I'll kill him!" thing.
They all dropped their weapons. The spellslinger wizard dropped his gun, looked the guy right in the eye, rolled Bluff...and activated his ring of the ram.
It didn't actually bull rush the enemy away from the NPC, but it did enough hp damage to kill him since he was so hurt already.
The only hostage situation that will work, in my mind, is that when the hostage taker can deliver damage to vide area as a free action. Or has someone help, in form of a partner who is watching how the situation will resolve and can do it for him if it goes bad. Or maybe when party is low-level.
Had two hostage situations at my table. One resulted in the hostage taker being dead before she could act in her round. The second - party just let the hostage be killed, so they could take down the bad guy and then "raise dead" the victim.
My group had to rescue a kidnapped woman. They were level 10 or so, so they decided they wanted to fireball everything they saw and then raise their target. I said something about alignment, so they instead had a wonderful three round battle against a much weaker thieves' guild, wiping out every enemy. Then they came to the boss thief holding her as a hostage. They attacked, the thief acted before they could kill him, and killed the unconscious hostage. They raised her, just as planned.
If the hostage is weak, then the hostage-taker has the advantage: They just need a readied action to kill the hostage if attacked. So if there's a PC on negative HP (but stable), any intelligent NPC has a lot of power.
As for what happens after that - I'd suggest coming out of initiative and handling it with Diplomacy / Intimidate / Bluff, or negotiating a solution. (Unless you have a PC who can stealthily take out the hostage-taker in a single surprise action.)