Socialmedia driving Quality Improvement!

12/8/2013

A CRASH COURSE IN SOCIAL MEDIA FOR IMPROVEMENT
Christina Krause | Executive Director, BCPSQC | @ck4q
Kevin Smith | Communications Specialist, BCPSQC | @kevin4quality
IHI National Forum on Quality Improvement in Health Care | Dec 2013

Minicourse Pre-work
Before the minicourse, please complete this quick
pre-work so that you can get the most out of our
session.

http://ow.ly/rahOv
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@ck4q | @kevin4quality

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Before we get started …
Share what you are learning, ask questions
or chat with others on Twitter!

#m3

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Don’t forget to “hatch your egg”!

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Don’t forget to “hatch your egg”!

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Ground Rules
How do we want to work
together in this room today?

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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?
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Overview of the Day
Two Parts:

1. Social media as a strategy for health care
improvement
2. Getting your hands dirty with Twitter

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Our Vision

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

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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.

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Pew Internet Surveys (Generations 2010)

Pew Internet

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Pew Internet

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The Engagement Pyramid

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Gideon Rosenblatt, Former Groundwire Executive Director

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TRIZ

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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

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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?
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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 AT ALL
— Circle the ones that you resemble something
you are currently doing
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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?

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Why use online tools?

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#quality4 | #quality2013
@ck4q | @ajay4quality

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— Largest social network in the world with 1 billion+ users
— In Canada, 18 million people have accounts (52%)
— In the US, 128 million people have accounts (41%)
— 67% of us log-in daily
— Of people who are online, 4 out of 5 have an account
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Adapted from Josh Bernoff's POST (2007)

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#smIHI | @ck4q | @ajay4quality

Adapted from Josh Bernoff's POST (2007)
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Poll
My organization has a clear social media engagement
strategy:
a. SOS
b. Not so much
c. Pretty good
d. Absolutely!

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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
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BCPSQC
Communications
& Engagement
Strategy


Social Media Guidelines
Typically include:
-

Information about the context and benefits of using social media.
What to be aware of.
The process to follow when using social media.
Principles to guide the use of social media tools in your
professional capacity.
- Useful links.

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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
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Email Marketing
— Email newsletter using
• Targeted, personal emails
• Partner emails

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Newsletters ~ The Digital Way
1.
2.
3.
4.

The Look
Database Management
Two-way Dialogue (Engagement Pyramid)
Statistics

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#quality4@ck4q | @ajay4quality
#smIHI | | #quality2013
@kevin4quality

Things we consider when sending emails:
•
•
•
•

Email client
Open rate
Click rate
Time of day

•
•
•
•

Day of week
Subject line
Frequency of newsletters
Content

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Things we consider when sending emails:
• Engaging the subscribers
• Number of calls to action in
the email
• Growth of the subscriber base
• Subscriber & field analysis

• Segmentation
• Top forwarders strategy
(champions)
• Template & format
• Measuring End Outcomes

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@kevin4quality

98% receive your email
2% soft or hard bounce.

18-26% open
a few mark as junk.

2-5% click
0.2-0.5% unsubscribe.

1-3% take action
Courtesy of @mrbenjohnson


How many people do you think read your entire email?

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Storytelling
Finding stories
― from staff, partners, call outs/campaigns
Documenting stories
― written/blog, video, photo, audio
Sharing stories
― via social media, web, email, partners
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An Example: Tools & Products
1.
2.
3.
4.
5.
6.
7.

Email Blasts
Sharing presentations
Blog Posts
Videos
Photos
Unique website and analytics
Twitter

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Slides via
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
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Video
—
—
—
—
—

Promotion
Storytelling
Documentation
Education
vs

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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
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BCPSQC Approach
 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

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

The Conversation

@BCPSQC
@BCSepsis

@BCQualityForum

@sharimck

@tweetvandijk

@Kevin4Quality @Kanneprocter
@SeniorsQuality @DrMarsBar
@CHochfilzer

Initiatives

@BCSQAN

@CLeARBC
@ck4q

Organization

@crecsky

@Meher4Q

Staff

@DrDavSweet
@KimberMcKinley


Power of Collective Twitter Following
Started
BCPSQC
Jun 13 2011
ck4q
Mar 15 2011
Sharimck
Jul 28 2009
BCSQAN
Apr 27 2012
BCSepsis
Apr 27 2012
CLeARBC
Jun 7 2013
BCQualityForum May 1 2012
Kanneprocter
Mar 11 2011
Tweetvandijk
Oct 28 2010
Kevin4Quality
Feb 20 2012
Chochfilzer
Feb 23 2012
Total

Following
2265
1006
439
372
199
83
100
386
134
225
146

Followers # of Tweets Klout Score
2601
1316
439
277
417
51
222
179
227
228
92
8064

5002
2907
677
409
395
133
168
501
565
604
157

56
49
43
43
41
34
40
30
34
46
25

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BCPSQC Strategy
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
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BCPSQC Strategy
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

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An Example!

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So What Happened?

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And How’d it Grow?

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BCPSQC Strategy
1.
2.
3.
4.
5.
6.

# of followers
# of clicks
# of retweets
# of replies/mentions
# of lists featuring @BCPSQC
Top tweets (content) + review of layout

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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

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Let's Take an Issue.

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Engage the community

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Take an action

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Take an action

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Your
Media!


Your
Media!


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Our


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1. Ownership

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2. Measuring Success

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3. Changing Behaviour

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What did the Canadian Patient Safety Institute try?

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A Hand Hygiene
Video Contest!

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CPSI Campaign
— It’s all about the people –
“viewers choice”
— Videos posted to
Facebook & YouTube
— Votes = Likes on Facebook

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Hand Hygiene Across Canada
Housekeeping Staff
Maimonides Geriatric
Center, Quebec

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“Mrs. A”, Winner, Viewers Choice
Chatham-Kent
Health Alliance, Ontario

Outcome of HH Video Competition
•
•
•
•

1025 votes cast
54,000 post views on Facebook (up 154%)
Doubled their Facebook followers
1300 comments on the hand hygiene videos
(compared to almost no comments on posts
previously)
• ~3500 views of the videos
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Outcome of HH Video Competition
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
• Sustainability (e.g., 2012
Med Rec Video Contest)

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All time watched Hand Hygiene videos
University of Geneva Hospital
170,000 hits
Nov 17, 2009

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All time watched Hand Hygiene videos
University of Geneva Hospitals

Jefferson University Hospitals

~170,000 hits
(Nov 17, 2009)

~115,000 hits
(Jan 31, 2011)

What is the all-time most
watched video online?

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Most all-time
watched video
PSY – Gangnam Style
~1.8 Billion hits!
(Nov 13, 2013)

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The Next Sensation?!
PSY – Gangnam Style
~1.8 Billion hits! (Nov 13, 2013)

Global Handwashing Day
~127K hits (Nov 13, 2013)

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Another example!

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How NHS used social media to 'go viral' for
Change Day
— 9 million Twitter impressions for a dedicated #nhschangeday
hashtag
— 1, 600+ visits in 19 days to Change Day YouTube channel
— 33, 000 visits to Change Day Facebook Page
— 2, 000 visits to Change Day podcast channels, not including
downloads and subscriptions on a dedicated podcast channel
on iTunes

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How NHS used social media to 'go viral' for
Change Day
— 9 million Twitter impressions for a dedicated #nhschangeday
hashtag
— 1, 600+ visits in 19 days to Change Day YouTube channel
— 33, 000 visits to Change Day Facebook Page
— 2, 000 visits to Change Day podcast channels, not including
downloads and subscriptions on a dedicated podcast channel
on iTunes
— With a pledge target of 65,000, they achieved 182,000
pledges via online website
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What’s Next for NHS Change Day?

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Creating Your Own Social Media Strategy
Turn to Your Neighbour:
What are you working on?
What strategies might you use?

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Twitter 101:
Learn How Twitter Can Revolutionize the
Way We Engage Others to Improve Care

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Newbie? Amateur? That’s okay.
230 million users….
….40% don’t tweet.

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What Will We Do?
First Half:
1. Learn how to use Twitter
2. Why should we use Twitter?

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What Will We Do?
First Half:
1. Learn how to use Twitter
2. Why should we use Twitter?
Second Half:
1. Get our hands dirty through a live experiment!
2. Questions
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What to Expect
1. Learn how Twitter can compliment your work

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What to Expect
1. Learn how Twitter can compliment your work.
2. Learn practical skills on how to use Twitter to
help you and your organization succeed.

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What to Expect
• We won’t be able to delve into all the topics
but we will try to cover as much as we can!

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What to Expect
• We won’t be able to delve into all the topics
but we will try to cover as much as we can!
• Target audience = newbie to amateur user
(not superstar)
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Download it from
www.bcpsqc.ca
(we’ll be referring to it
throughout the session)

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@

RT # DM

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What’s a handle?
It’s how people know who you are on Twitter
(it’s your username or Twitter ID).

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Creating a handle
—
—
—
—

Create a Twitter ID that reflects who you are
Be concise and memorable
Keep it under 15 characters if possible
Avoid underscores

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Creating a handle
—
—
—
—

Create a Twitter ID that reflects who you are.
Be concise and memorable.
Keep it under 15 characters if possible.
Avoid underscores.
Bad Twitter ID
@Kevin__Smith76301

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Creating a handle
—
—
—
—

Create a Twitter ID that reflects who you are.
Be concise and memorable.
Keep it under 15 characters if possible.
Avoid underscores.

Good Twitter ID

Bad Twitter ID

@Kevin4Quality

@Kevin__Smith76301

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What’s the “@” symbol used for?
The @ is used before a handle to identify
accounts.
(just like an email address, if you write the
handle wrong or forget the @, the person will
not receive your message)

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What is the “@” symbol used for?
The @ is used before a handle to identify accounts.
(just like an email address, if you write the handle
wrong or forget the @, the person will not receive your
message)
In Real Life
Hi Kevin! How are you?

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What is the “@” symbol used for?
The @ is used before a handle to identify accounts.
(just like an email address, if you write the handle
wrong or forget the @, the person will not receive your
message)
In Real Life

On Twitter

Hi Kevin! How are you?

Hi @Kevin4Quality! How are you?
or
@Kevin4Quality Hi Kevin! How are
you?

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What is a tweet?
A post on Twitter
(similar to an email or text message, just shorter!)

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What is a RT or Re-tweet?
When you share what someone else has tweeted
(like forwarding an email).

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A Re-Tweet (RT)
RT @VCHhealthcare Clean up – Gangnam style! [video]
bit.ly/UQJouz #handhygiene via @NHSNorthants
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What is a hashtag or the “#” symbol?
The # is used to organize information so
that it is easy to find.

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Normally you’d say…
I’d like to learn how to
prevent stroke, any ideas
on where to go?

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Normally you’d say…
prevent stroke, any ideas
on where to go?

With a hashtag
prevent #stroke, any ideas
on where to go?

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What else are hashtags important for?

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What else are hashtags important for?
TRENDING
This occurs when a hashtag is used so often that
it becomes one of the most popular
conversations in the world or a specific region.

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Hashtags
Commonly used hashtags:
#hcsm
#healthcare

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Hashtags
#hcsm
#healthcare

Organic hashtags:
#handhygiene
#dementia
#nhschange

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Hashtags
#hcsm
#healthcare

Organic hashtags:
#handhygiene
#dementia
#nhschange

What about fun hashtags?
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Hashtags
• Commonly used hashtags: #bchc #healthcare
• Organic hashtags: #quality4 #handhygiene
• Fun hashtags
Normal Tweet via @simonwmedic
Have account, am tweeting but
photo upload not available - bonus
point unjustly denied! #quality2013
#quality4
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Fun Hashtags

Normal Tweet via @simonwmedic
Have account, am tweeting but photo
upload not available - bonus point
unjustly denied! #quality2013
#quality4

Normal Tweet, Funny hashtags

Have account, am tweeting
but photo upload not available
- bonus point unjustly denied!
#technologysucks
#stillanegg

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Does everything on Twitter have to be
public?

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public?
No!
Direct Message (DM): send a private message
(like a text message)

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public?
No!
Normal Tweet

Hi @Kevin4Quality! How
are you?
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public?
No!
Normal Tweet

Direct Message

Hi @Kevin4Quality! How
are you?

d Kevin4Quality Hi
Kevin! How are you?

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@

RT # DM

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RT # DM

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Three Main Things to Keep in Mind
1. Tweet short (<120 characters) and include links.
2. Use hashtags (but don’t overuse them).
3. Mention people.

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What Happens if You Make a Mistake?

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What Happens if You Make a Mistake?
Not to worry!
You can delete tweets.
Or, if it’s a honest mistake, you can correct
yourself. (Like an email – if you forgot to
attach a file, you would follow up with a
secondary email with the file)
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10 Things to Keep in Mind While Tweeting

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Be Two-Way. Ask Questions.
1. Make tweets engaging and informative.
2. Feel free to crowd-source for
information or feedback.
3. The point is to be engaging.

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When Should I Tweet?

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It’s up to you!

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It’s up to you!
— When you have time to tweet.
— When you have something to share: a quote, an
article, a toolkit, a model, a job posting, etc.
— When you’re at an event.

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You can also schedule tweets to provide
framework for discussion throughout the day and
avoid sending multiple tweets all at once.

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You can also schedule tweets to provide framework
for discussion throughout the day and avoid
sending multiple tweets all at once.
HootSuite is a great tool that can help you do this easily.

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Scheduling Tweets

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Provide Links

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Provide Links
Use a tool that shortens links

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Provide Links
Use a tool that shortens links.
Actual Link
http://www.changemodel.nhs.uk/pg/dashboard

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Provide Links
Use a tool that shortens links.
Actual Link
http://www.changemodel.nhs.uk/pg/dashboard
Shortened Link
ow.ly/cenYS

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via @danzarrella

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Follow & tweet organisations and/or individuals
that interest you

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Follow & tweet organizations and/or individuals
that interest you
via hashtag search:
1. Search #ihi25forum
2. See who else is tweeting
3. Then you can follow those people that interest you.

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that interest you
Follow these relevant accounts:
@TheIHI
@BMJ_Group
@NHSIQ
@helenbevan

@KoAwatea
@bcpsqc
@maureenbis
@jasonleitch

And don’t forget your own organization and colleagues!
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that interest you
Don’t worry you can follow as many groups as you
like, there’s no limit.
Need help on how to follow others?

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Building a Strong Twitter Following
1. Follow others, look to see who they are following:
—
—
—

e.g., @maureenbis or @TheIHI
Accounts with shared interests
And check out their lists. Speaking of which…

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—
—
—

e.g., @maureenbis or @TheIHI

2. Look at lists – that you and similar accounts belong to

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—
—
—

e.g., @berci or @TheIHI

3. Search for hashtags – who is using them?

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—
—
—

e.g., @berci or @TheIHI

4. Tweet!
—
—

Great content (we’ll get into that)
Schedule tweets

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—
—
—

e.g., @berci or @qualityforum

4. Tweet!
—

Great content (we’ll get into that)

5. Engage with others!
–

Conversations, Twitters chats, thanks for following

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6 Things to Consider:
1. Who is this person?
2. What does this person tweet about?
3. How many followers?
4. What is the following/follower ratio?
5. When was the last tweet?
6. How often are tweets sent?
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Some additional points to consider:
1. You’ll need to purge at some point
2. Review your following / follower ratio

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HTTP://NJIMEDIA.COM/PROJECT/BESTTWITTERPRACTICESINFOGRAPHIC/

Three Main Things to Keep in Mind
1. Tweet short (<120 characters) and include links.
2. Use hashtags (but don’t overuse them).
3. Mention people.

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Seriously?
Let your personality shine

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Seriously?
It’s okay to have fun

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Seriously?
Being casual works, too

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What Could We Tweet About?

#ihi25forum

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12/8/2013

What Could We Tweet About?
How about Live Brain Surgery?!

#ihi25forum

103

12/8/2013

#ihi25forum

104

12/8/2013

LET’S GET OUR HANDS DIRTY!

#ihi25forum

Who is Your Audience?
Method

Audience

Flipchart
Twitter

#ihi25forum

105

12/8/2013

Method

Audience

Flipchart
Twitter

Only Us

#ihi25forum

Method

Audience

Flipchart
Twitter

Only Us
The World!

#ihi25forum

106

12/8/2013

LET’S GET OUR HANDS DIRTY
Exercise #1: Send out this tweet:
What’s you’re favourite ah-ha moment from an @TheIHI Forum?
Tell us! #ihi25forum #AhHa

Three Main Things to Keep in Mind (checklist)
Tweet short (<120 characters) and include links
Use hashtags (but don’t overuse them)
Mention people
#ihi25forum

Exercise #1: Send out this tweet:
What’s you’re favourite ah-ha moment from an @TheIHI Forum?
Tell us! #ihi25forum #AhHa

Three Main Things to Keep in Mind (checklist)
Tweet short (<120 characters) and include links
Use hashtags (but don’t overuse them)
Mention people
#ihi25forum

107

12/8/2013

The Art of Tweeting
Exercise #2: Create a great tweet out of this!
“Cleaning your hands is important. Have a look at this
really interesting video that uses Gangnam Style as a
way to engage health care providers to improve hand
hygiene. Here is the link:
http://www.youtube.com/watch?v=TGddyTW5eMc”
#ihi25forum

(278 characters)

The Art of Tweeting
Exercise #3: Let’s try a campaign

#ihi25forum

108

12/8/2013

The Art of Tweeting
Exercise #3: Let’s try a campaign
People
@helenbevan
@jasonleitch
@Jo_Inge
@maureenbis
@paulplsek
@LynneMaher1

Organizations
@The IHI
@BMJ
@BCPSQC
@NHSIQ
@WHO
@KoAwatea

#ihi25forum

Exercise #3: Re-Tweet
Let’s go see what’s happening on #ihi25forum

#ihi25forum

109

12/8/2013

Social Media Dashboards

Twitter apps for Mobiles

OpenBreak

Echofon

Tweetdeck

Other cool tools

Storify
Twitterfall

Reflections so far ...
1.
2.
3.
4.
5.

Capacity
Managing even more sources of information
Staff - personal vs professional use
Privacy Concerns
Untapped potential

#ihi25forum

110

12/8/2013

Current Practice

+

+

#ihi25forum

Future Practice

+

+

Compliment it
with...

#ihi25forum

111

12/8/2013

The future...
1. More connections, less isolation

#ihi25forum

The future...
2. Compelling stories through video

#ihi25forum

112

12/8/2013

The future...
3. Power of the crowds
– Mobile Apps

#ihi25forum

113

12/8/2013

The future...
– Mobile Apps
– Gamification

#ihi25forum

114

12/8/2013

The future...
– Mobile Apps
– Gamification
– Hackathons #hackinghealth

#ihi25forum

116

12/8/2013

Join us for our next #QualityChat!
- One hour “Twitter chat” on topic related to
improving quality of care
- New guest host each month (it can be you!)
- Last Wednesday of each month

#ihi25forum

Join us for our next #QualityChat!
January 29, 2014
Pat Rich (@cmaer)
Managing Editor, Member Communications, Canadian Medical Association
March 26, 2014
Helen Bevan (@HelenBevan)
Chief Transformation Officer with the NHS Horizons Team
#QualityChat
www.bcpsqc.ca/events/events-qualitychat.html
#ihi25forum

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12/8/2013

Final Thoughts
1. Download our “Twitter for Health Care
Professionals” Guide .
2. Attend a Twitter Chat!
#qualitychat #twitJC
#hcsmca
#hcsmeu
#nhschange #hcldr

www.bcpsqc.ca

3. No better way to learn, than to practice!
#ihi25forum

What were your ah-ha moments?

#ihi25forum

119

12/8/2013

Tweet out your commitment!
Table Exercise:
1. What will you do after this session?
2. Write it down on a piece of paper with a
marker, take a picture and tweet it out
OR
Write out your commitment as a Tweet

#ihi25forum

Fidelma Fitzpatrick
Ireland

@ffitzp

120

12/8/2013

Abhishek Bhartia
India

@abhishek4q

Grete Kistrup
Denmark

@Gkistrup

121

12/8/2013

Thank you!

#ihi25forum

122

Socialmedia driving Quality Improvement!

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Socialmedia driving Quality Improvement!