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Page 1: Social Media in Health Care: International Forum on Quality & Safety 2014

Social media in health care: A crash course in how to use Twitter and how to develop a social media

strategy for quality

Ros Gray, Scottish Government @Rosgray Jo-Inge Myhre, MD, F2 in Family Medicine University of Oslo Medical School @joinge_

Christina Krause, British Columbia Patient Safety & Quality Council @ck4q Kevin Smith, British Columbia Patient Safety & Quality Council @Kevin4Quality

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Before we get started …

Share what you are learning, ask questions

or chat with others on Twitter!

#M9

#quality2014

#M9 | #quality2014

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@doctavic

@MetisAudit

@AnthonyStaines

@nicholda

@ltkalmar

@kinanmuha

@mathieulouiset

@profroland

@grangerkate

@sonjakersten

Who’s in the room on Twitter?

@LAS-QI

@ce_ikas

@MAVR_1

@Priv8hospitals

@ncollinsmd

@joinge_

@rosgray

@ck4q

@Kevin4Quality

#M9 | #quality2014

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What we heard from you …

How would you rate your experience with social media?

a. I know nothing

b. Some experience

c. Lots of experience

d. I’m a superstar

#M9 | #quality2014

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0 5 10 15 20 25

I'm a superstar

Lots of experience

Some experience

I know nothing

How would you rate your familiarity with social media?

#M9 | #quality2014

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Impromptu Networking

Two minutes per person in pairs

Speak with 3 people you don’t know

Ask 2 questions:

- What are you passionate about in your work?

- How do you think social media can help you in your role?

#M9 | #quality2014

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Overview of the Day

1. Driver Diagrams

2. Social media as a strategy for improvement

3. Case Studies – cool examples to inspire!

4. Getting started on your own social media strategy

#M9 | #quality2014

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Driver Diagrams for Social Media

#M9 | #quality2014

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What is a theory?

• A description of our best understanding about why things are the way they are

• Theories/beliefs in other contexts?

– Economics – game theory

– Biology - theory of evolution

– Physics – string theory

– Metereology – chaos theory

– Social media - ?

#M9 | #quality2014

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How is a theory different from a belief?

• A theory can be tested scientifically

• Theories are predictions of the outcome of future events

• Theory is the starting place for generating new knowledge

#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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do

study act

plan

do

study act

plan

#M9 | #quality2014

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do

study act

plan

do

study act

plan

#M9 | #quality2014

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What do we believe about why things are the way they are?

• Evidence – what objective evidence have we collected locally or is available to us through the relevant literature?

• Local subject matter experts – people who work at the frontline who experience the system day to day and have strong experiential beliefs about where change is needed

#M9 | #quality2014

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Some guidance on creating a driver diagram

• Start with the outcome in mind – develop an aim statement that reflects the desired future state

• Primary drivers should be nouns that reflect the key leverage points in the system of interest from three areas: 1. Structures – physical, financial, administrative,

management and improvement, delegation and accountability

2. Processes – workflow of the system, how things are accomplished

3. Operating norms – written and unwritten rules that govern behaviour

#M9 | #quality2014

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Some guidance on creating a driver diagram

• Secondary drivers must be tangible things where action can be taken on the system

• Change ideas should link directly to secondary drivers and should exhibit these characteristics: 1. Specific - each change idea needs to be clear

and concise and it must be obvious how its introduction is different from the status quo

2. How to - each change idea must include a statement about how and where it will be put into practice within the system

#M9 | #quality2014

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SO CAN WE USE THIS APPROACH FOR OUR SOCIAL MEDIA STRATEGY?

#M9 | #quality2014

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Communication

and engagement To provide country-

wide access to

insights and

information re early

years through virtual

collaboration with

children, families and

staff in pursuit of

system improvement

by December 2015

Developing social

content

Aim Primary Drivers Secondary Drivers

Finding and capturing stories, Video, PPT, Photos

Newsletters

Email

Website development

Twitter strategy

Accessibility issues

Facebook strategy

Branding

Measurement of performance

Infrastructure

#M9 | #quality2014

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Social Media Strategy for Improvement

#M9 | #quality2014

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BCPSQC Vision

A sustainable health care system built on a foundation of quality.

#M9 | #quality2014

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Our Mission

Provide system-wide leadership through collaboration with patients, the public and those working within the health system in a relentless pursuit of quality.

#M9 | #quality2014

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#M9 | #quality2014

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Pew Internet

#M9 | #quality2014

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Pew Internet

#M9 | #quality2014

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The Engagement Pyramid

Gideon Rosenblatt, Former Groundwire Executive Director #M9 | #quality2014

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TRIZ

#M9 | #quality2014

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TRIZ – First Step

In groups, make a list of “to do’s” in answer to your assigned question on a flip chart.

There is no wrong answer – GO WILD! 5 minutes

#M9 | #quality2014

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Questions

1. How can we ensure privacy is breached on social media tools such as Twitter/Facebook?

2. How do we make sure no one is on Twitter?

3. How can ensure NO dialogue, learning or sharing occurs on online community of practice websites?

4. What could we do to ensure we do NOT succeed in using social media as a health care improvement tool?

#M9 | #quality2014

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TRIZ – Second Step

Go down the list and ask:

“Is there anything on this list that we currently practice, even remotely?”

— Cross out the ones that you aren’t doing EVER — Circle the ones that you resemble something

you are currently doing

#M9 | #quality2014

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TRIZ – Third Step Take one item at a time and ask: — How am I and how are we going to stop it? — What would be the first move? — What could I personally commit to stopping right now. — What could we do in the next few days? Next week? — Do we need leadership help? Organizational support?”

#M9 | #quality2014

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Why use online tools?

#M9 | #quality2014

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0 5 10 15 20 25 30

Other

Pinterest

Instagram

LinkedIn

Tumblr

SlideShare

Storify

Flickr

YouTube

Facebook

Twitter

What social media tools do you use now?

#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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Adapted from Josh Bernoff's POST (2007)

#M9 | #quality2014

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Adapted from Josh Bernoff's POST (2007)

#M9 | #quality2014

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My organization has a clear social media engagement strategy:

a. SOS

b. Not so much

c. Pretty good

d. Absolutely!

Poll

#M9 | #quality2014

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0 5 10 15 20 25

I don't

Entertainment

To share information

To connect with colleagues

To learn about developments in my field

Why do you use social media?

#M9 | #quality2014

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BCPSQC Journey…just beginning!

Communications & engagement to …

1. Support efforts to improve quality of care

2. Build social movement thinking into quality

3. Engage at a wide scale – strong ties/weak ties

Through …

Engagement | Storytelling | Digital Strategy

#M9 | #quality2014

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BCPSQC Communications & Engagement Strategy

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Social Media Guidelines

Typically include:

- Information about the context and benefits of using social media.

- What to be aware of and a bit about the process to follow in using social media.

- Principles to guide the use of social media tools in your professional capacity.

- Useful links.

#M9 | #quality2014

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Social Media Guidelines

Typically include:

- Information about the context and benefits of using social media.

- What to be aware of and a bit about the process to follow in using social media.

- Principles to guide the use of social media tools in your professional capacity.

- Useful links.

- CONSULT BOTH YOUR ORGANIZATIONAL & PROFESSIONAL GUIDELINES

#M9 | #quality2014

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— Email newsletter using

— Targeted, personal emails

— Partner emails

Email Marketing

#M9 | #quality2014

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1. The Look 2. Database Management 3. Two-way Dialogue (Engagement Pyramid) 4. Statistics

Newsletters ~ The Digital Way

#M9 | #quality2014

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• Email client

• Open rate

• Click rate

• Time of day

• Day of week

• Subject line

• Engaging the subscribers

• Number of calls to action in the email

• Growth of the subscriber base

• Frequency of newsletters

• Content

• Subscriber & field analysis

• Segmentation

• Top forwarders strategy (champions)

• Template & format

• Measuring End Outcomes

Things we consider when sending emails:

#M9 | #quality2014

Page 47: Social Media in Health Care: International Forum on Quality & Safety 2014

18-26% open

2-5% click

98% receive your email

2% soft or hard bounce.

a few mark as junk.

0.2-0.5% unsubscribe.

1-3% take action

How many people do you think read your entire email?

Courtesy of @mrbenjohnson

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#M9 | #quality2014

UCL

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#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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Jun

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July

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Au

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Newsletter Open Rates Percent

#M9 | #quality2014

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Finding stories

― from staff, partners, call outs/campaigns

Documenting stories

― written/blog, video, photo, audio

Sharing stories

― via social media, web, email, partners

Storytelling

#M9 | #quality2014

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1. Email Blasts

2. Sharing presentations

3. Blog Posts

4. Videos

5. Photos

6. Unique website and analytics

7. Twitter

An Example: Tools & Products

#M9 | #quality2014

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286 presentations uploaded Example from Quality Forum 2013 — 4 plenary presentations — 102 breakout session presentations — 11 academic and quality pre-forum presentations — 7 patient & family centered care pre-forum presentation — 8 Heath Talks presentations

Slides via

#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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Email Marketing, Blogs & Photo Strategy

Driver Diagram Work Time!

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Unique opportunity to:

1. Engage with colleagues (strong & weak tie)

2. Disseminate ‘calls to action’ to large audiences

3. Increase awareness of issues

4. Build and strengthen communities

5. Promote learning from events

#M9 | #quality2014

Page 67: Social Media in Health Care: International Forum on Quality & Safety 2014

Trusted voice on health quality

Support the work of our partners

Empower staff and those interested to use Twitter to grow interest and involvement in the health quality agenda

BCPSQC Approach

#M9 | #quality2014

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@BCPSQC

@BCSQAN

@BCSepsis

@CLeARBC

@BCQualityForum

The

Co

nve

rsat

ion

Organization

Initiatives

Our Strategy on Twitter ( T H E J O U R N E Y S O F A R )

Staff

T W I T T E R S T R AT E G Y

@ck4q @sharimck @tweetvandijk

@Kevin4Quality @Kanneprocter @Meher4Q @SeniorsQuality @DrMarsBar @DrDavSweet

@CHochfilzer @crecsky @KimberMcKinley

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Power of Collective Twitter Following

Following Followers

BCPSQC 2619 2927

ck4q 1066 1552

Sharimck 439 457

BCSQAN 372 296

BCSepsis 198 485

CLeARBC 82 60

BCQualityForum 131 310

Kanneprocter 385 186

Tweetvandijk 157 263

Kevin4Quality 311 332

Crecsky 364 120

Chochfilzer 167 107

Total 7094

#M9 | #quality2014

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1. Follow organizations/individuals that align with our work

Helps build followers (~ 15-25% of those you follow, follow you back)

2. Engage with those who interact with us

RTing our partners, thanking for RTs, #FF

Active dialogue on relevant topics

BCPSQC Strategy

#M9 | #quality2014

Page 71: Social Media in Health Care: International Forum on Quality & Safety 2014

3. Disseminate content in a way that is fresh and engaging

– Live tweet from events

– Keeping tweets short and witty

– Provide links to Council and partner events, documents or interesting information

#M9 | #quality2014

BCPSQC Strategy

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Seriously?

It’s okay to have fun

#M9 | #quality2014

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Being casual works, too

#M9 | #quality2014

Seriously?

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#quality4 | #quality2013 @ck4q | @ajay4quality

via @danzarrella

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Scheduling Tweets

#quality4 | #quality2013 @ck4q | @ajay4quality

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via @danzarrella

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— Leverage social networks to build social stories

— Based upon social media networks

Twitter, Facebook, YouTube, Flickr, Instagram, etc

— Provides opportunity to make sense of what you've pulled together

#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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About #QualityChat…

#M9 | #quality2014

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About #QualityChat…

#M9 | #quality2014

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#M9 | #quality2014

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So What Happened?

#M9 | #quality2014

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And How’d it Grow?

#M9 | #quality2014

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Objective:

• To increase the adoption and

compliance of sepsis protocols

Plan: • Every five protocols = 1 life

saved*

• Across BC: 750 patients treated = 150 Lives saved in 150 days!

• Encourage best practice and teamwork

*For cases of severe sepsis and septic shock

#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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LET’S GET OUR HANDS DIRTY!

• Healthcare Pledge Selfie! @QualityForum Campaign

• Tweet your “healthcare pledge” and include a selfie to #quality2014

Tweet short (<120 characters) and include links

Use hashtags (but don’t overuse them)

Mention people

Three Main Things to Keep in Mind (checklist)

#M9 | #quality2014

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Fidelma Fitzpatrick Ireland

@ffitzp

#M9 | #quality2014

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Abhishek Bhartia India

@abhishek4q

#M9 | #quality2014

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Grete Kistrup Denmark

@Gkistrup

#M9 | #quality2014

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Twitter

Driver Diagram Work Time!

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— Promotion

— Storytelling

— Documentation

— Education

— vs

Video

#M9 | #quality2014

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#M9 | #quality2014

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What did the Canadian Patient Safety Institute try?

#M9 | #quality2014

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A Hand Hygiene Video Contest!

#M9 | #quality2014

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— It’s all about the people – “viewers choice”

— Videos posted to Facebook & YouTube

— Votes = Likes on Facebook

CPSI Campaign

#M9 | #quality2014

Page 112: Social Media in Health Care: International Forum on Quality & Safety 2014

Hard Data

• 1025 votes cast

• 54,000 post views on Facebook (up 154%)

• Doubled Facebook followers

• 1300 comments (vs almost no comments on posts previously)

• ~3500 views

Overall

• Audience Engagement

• Social Spread

• Reward

Outcome of HH Video Competition

#M9 | #quality2014

Page 113: Social Media in Health Care: International Forum on Quality & Safety 2014

University of Geneva Hospitals 226,000 views (April 3, 2014)

All time watched Hand Hygiene videos

Jefferson University Hospitals 207,000 views (April 3, 2014)

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What is the all-time most watched video online?

#M9 | #quality2014

Page 115: Social Media in Health Care: International Forum on Quality & Safety 2014

Most all-time watched video

PSY – Gangnam Style ~1.9 Billion hits! (April 3, 2014)

#M9 | #quality2014

Page 116: Social Media in Health Care: International Forum on Quality & Safety 2014

PSY – Gangnam Style 1.9 billion views! (April 3, 2014)

The Next Sensation?!

Global Handwashing Day 138,000 views! (April 3, 2014)

#M9 | #quality2014

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Desktop & Mobile Website

Internet Radio Service

Mobile web application and Smartphone Apps

Twitter

Traffic Customer Care Line

VMS/Kiosks

Traffic Scotland Information

Hierarchy & Service Platforms Potential Audience Reach

Max delivered to date 115m page impressions in month of Dec 2010 equates to 1.1m distinct IP addresses Resilient to

spike demand.

At the peak can have over 100,000 contacts a month

Currently 286,843 downloads for iPhone/ Android/Blackberry/Windows 7 Stats feed through to TS website usage

Traffic Scotland Twitter has currently 32,000 followers and follows 542 partners

22,000 calls annually However dramatic seasonal and event driven spikes in demand

Automated messages includes Traffic Scotland Radio

203 VMS and currently 3 TS kiosks: Gretna Green (A74);

Ballinluig Services (A9) and Harthill Service (M8)

Pre-Trip/On trip

On-Trip

#M9 | #quality2014

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#bestplacetogrowup

#M9 | #quality2014

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Early Years Collaborative

-9 months to 1 year

1 year to 30

months

30 months

to

Primary school

Leadership 5 – 8 years

Scotland – the best place in

the world to grow up

#M9 | #quality2014

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0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

LS1 LS2 LS3 LS4

Nu

mb

er o

f Twe

ets N

um

be

r o

f Im

pre

ssio

ns

Learning Session

Number of Twitter Impressions and Tweets at Early Years Collaborative Learning Sessions

Impressions

Tweets

#M9 | #quality2014

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#M9 | #quality2014

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#M9 | #quality2014

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Overall Strategy

Driver Diagram Work Time!

Page 130: Social Media in Health Care: International Forum on Quality & Safety 2014

April 30, 2014 9 am PST/ 12 pm EST/ 6 pm GMT

Join us for our next #QualityChat!

May 28, 2014 9 am PST/ 12 pm EST/ 6 pm GMT

#QualityChat www.bcpsqc.ca/events/events-qualitychat.html

#M9 | #quality2014

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Post-it Note:

What were your ah-ha moments?

Evaluation Survey:

#M9 | #quality2014

Page 132: Social Media in Health Care: International Forum on Quality & Safety 2014

Thank you!

#M9 | #quality2014