socialmedia driving quality improvement!

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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

#ihi25forum @ck4q | @kevin4quality

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

http://ow.ly/rahOv

http://ow.ly/rahOv

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Before we get started …

Share what you are learning, ask questions

or chat with others on Twitter!

#m3 #IHI25forum


Don’t forget to “hatch your egg”!

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Don’t forget to “hatch your egg”!


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


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


The Engagement Pyramid

Gideon Rosenblatt, Former Groundwire Executive Director

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TRIZ


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?


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?


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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#smIHI | @ck4q | @ajay4quality

Adapted from Josh Bernoff's POST (2007)



Adapted from Josh Bernoff's POST (2007)


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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



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


— Email newsletter using

• Targeted, personal emails

• Partner emails

Email Marketing


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

Newsletters ~ The Digital Way

#quality4 | #quality2013 @ck4q | @ajay4quality #ihi25forum @ck4q | @kevin4quality


• Email client

• Open rate

• Click rate

• Time of day

• Day of week

• Subject line

• Frequency of newsletters

• Content

Things we consider when sending emails:


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• 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

Things we consider when sending emails:



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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Finding stories

― from staff, partners, call outs/campaigns

Documenting stories

― written/blog, video, photo, audio

Sharing stories

― via social media, web, email, partners

Storytelling



1. Email Blasts

2. Sharing presentations

3. Blog Posts

4. Videos

5. Photos

6. Unique website and analytics

7. Twitter

An Example: Tools & Products


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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


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— Promotion

— Storytelling

— Documentation

— Education

— vs

Video


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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



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


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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 FA 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

Power of Collective Twitter Following Started Following Followers # of Tweets Klout Score

BCPSQC Jun 13 2011 2265 2601 5002 56

ck4q Mar 15 2011 1006 1316 2907 49

Sharimck Jul 28 2009 439 439 677 43

BCSQAN Apr 27 2012 372 277 409 43

BCSepsis Apr 27 2012 199 417 395 41

CLeARBC Jun 7 2013 83 51 133 34

BCQualityForum May 1 2012 100 222 168 40

Kanneprocter Mar 11 2011 386 179 501 30

Tweetvandijk Oct 28 2010 134 227 565 34

Kevin4Quality Feb 20 2012 225 228 604 46

Chochfilzer Feb 23 2012 146 92 157 25

Total 8064


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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



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


BCPSQC Strategy

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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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1. # of followers

2. # of clicks

3. # of retweets

4. # of replies/mentions

5. # of lists featuring @BCPSQC

6. Top tweets (content) + review of layout

BCPSQC Strategy


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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



Take an action


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Your

Media!


Your

Media!

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Our



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1. Ownership



2. Measuring Success


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3. Changing Behaviour



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What did the Canadian Patient Safety Institute try?


A Hand Hygiene Video Contest!


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

— Videos posted to Facebook & YouTube

— Votes = Likes on Facebook

CPSI Campaign


Housekeeping Staff Maimonides Geriatric Center, Quebec

Hand Hygiene Across Canada

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Chatham-Kent Health Alliance, Ontario

“Mrs. A”, Winner, Viewers Choice

• 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

Outcome of HH Video Competition


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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)

Outcome of HH Video Competition


All time watched Hand Hygiene videos

University of Geneva Hospital 170,000 hits Nov 17, 2009


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University of Geneva Hospitals ~170,000 hits (Nov 17, 2009)

All time watched Hand Hygiene videos

Jefferson University Hospitals ~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)


PSY – Gangnam Style ~1.8 Billion hits! (Nov 13, 2013)

The Next Sensation?!

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


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?


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?


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


1. Learn how Twitter can compliment your work.

2. Learn practical skills on how to use Twitter to help you and your organization succeed.

What to Expect


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

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)

What to Expect


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Download it from www.bcpsqc.ca (we’ll be referring to it throughout the session)

http://www.bcpsqc.ca/

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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).


— Create a Twitter ID that reflects who you are

— Be concise and memorable

— Keep it under 15 characters if possible

— Avoid underscores

Creating a handle


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Bad Twitter ID

@Kevin__Smith76301

— Create a Twitter ID that reflects who you are.

— Be concise and memorable.

— Keep it under 15 characters if possible.

— Avoid underscores.

Creating a handle


Good Twitter ID Bad Twitter ID

@Kevin4Quality @Kevin__Smith76301

— Create a Twitter ID that reflects who you are.

— Be concise and memorable.

— Keep it under 15 characters if possible.

— Avoid underscores.

Creating a handle


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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)


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?

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


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?




Normally you’d say… With a hashtag

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

I’d like to learn how to 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


Organic hashtags: #handhygiene #dementia #nhschange


Hashtags


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


Fun Hashtags


Normal Tweet via @simonwmedic Normal Tweet, Funny hashtags

Have account, am tweeting but photo upload not available - bonus point unjustly denied! #quality2013 #quality4

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

http://hootsuite.com/dashboard




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Does everything on Twitter have to be public?


No! Direct Message (DM): send a private message

(like a text message)



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Normal Tweet

Hi @Kevin4Quality! How are you?





Normal Tweet Direct Message

Hi @Kevin4Quality! How are you?

d Kevin4Quality Hi Kevin! How are you?


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@ RT # DM


@ 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?


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)

What Happens if You Make a Mistake?


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10 Things to Keep in Mind While Tweeting


http://www.changemodel.nhs.uk/pg/dashboard

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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?


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.




via @danzarrella

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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.



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


Provide Links


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Use a tool that shortens links

Provide Links


Use a tool that shortens links.

Actual Link http://www.changemodel.nhs.uk/pg/dashboard

Provide Links


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Use a tool that shortens links.

Actual Link http://www.changemodel.nhs.uk/pg/dashboard Shortened Link ow.ly/cenYS

Provide Links


via @danzarrella


http://t.co/vlRjqF4Q

http://t.co/vlRjqF4Q

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Follow & tweet organisations 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.

Follow & tweet organizations and/or individuals that interest you


https://twitter.com/search?q=%23quality2013&src=typd

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Follow these relevant accounts:

@TheIHI @KoAwatea

@BMJ_Group @bcpsqc

@NHSIQ @maureenbis

@helenbevan @jasonleitch

And don’t forget your own organization and colleagues!



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…



1. Follow others, look to see who they are following: — e.g., @maureenbis or @TheIHI



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


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1. Follow others, look to see who they are following: — e.g., @berci or @TheIHI




3. Search for hashtags – who is using them?



1. Follow others, look to see who they are following: — e.g., @berci or @TheIHI





4. Tweet! — Great content (we’ll get into that)

— Schedule tweets


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1. Follow others, look to see who they are following: — e.g., @berci or @qualityforum





4. Tweet! — Great content (we’ll get into that)

5. Engage with others! – Conversations, Twitters chats, thanks for following


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


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?


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How about Live Brain Surgery?!


What Could We Tweet About?

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LET’S GET OUR HANDS DIRTY!


Who is Your Audience?

Method Audience Flipchart

Twitter


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Method Audience



Flipchart Only Us

Twitter


Method Audience



Flipchart Only Us

Twitter The World!


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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

Tweet short (<120 characters) and include links

Use hashtags (but don’t overuse them)

Mention people

Three Main Things to Keep in Mind (checklist)



Tweet short (<120 characters) and include links

Use hashtags (but don’t overuse them)

Mention people

Three Main Things to Keep in Mind (checklist)


Exercise #1: Send out this tweet:

What’s you’re favourite ah-ha moment from an @TheIHI Forum? Tell us! #ihi25forum #AhHa

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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”

(278 characters)


Exercise #3: Let’s try a campaign

The Art of Tweeting


http://www.youtube.com/watch?v=TGddyTW5eMc




http://www.bcpsqc.ca/events/events-qualitycafe.html

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Exercise #3: Let’s try a campaign

People Organizations @helenbevan @The IHI

@jasonleitch @BMJ

@Jo_Inge @BCPSQC

@maureenbis @NHSIQ

@paulplsek @WHO

@LynneMaher1 @KoAwatea

The Art of Tweeting



Exercise #3: Re-Tweet

Let’s go see what’s happening on #ihi25forum


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Tweetdeck

OpenBreak Echofon

Other cool tools

Storify Twitterfall

Social Media Dashboards Twitter apps for Mobiles


1. Capacity

2. Managing even more sources of information

3. Staff - personal vs professional use

4. Privacy Concerns

5. Untapped potential

Reflections so far ...


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+ +

Current Practice


+ +

Compliment it with...

Future Practice


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1. More connections, less isolation

The future...



2. Compelling stories through video

The future...


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3. Power of the crowds

– Mobile Apps

The future...


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– Mobile Apps

– Gamification

The future...


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– Mobile Apps

– Gamification

– Hackathons #hackinghealth

The future...


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- 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

Join us for our next #QualityChat!



January 29, 2014

Pat Rich (@cmaer)

Managing Editor, Member Communications, Canadian Medical Association

Join us for our next #QualityChat!


March 26, 2014

Helen Bevan (@HelenBevan)

Chief Transformation Officer with the NHS Horizons Team

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


http://bcpsqc.ca/events/events-qualitychat.html



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Final Thoughts

1. Download our “Twitter for Health Care Professionals” Guide .

2. Attend a Twitter Chat!

#qualitychat #twitJC

#hcsmca #hcsmeu

#nhschange #hcldr

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

#ihi25forum

www.bcpsqc.ca

What were your ah-ha moments?


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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


Fidelma Fitzpatrick

Ireland

@ffitzp

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Abhishek Bhartia

India

@abhishek4q

Grete Kistrup

Denmark

@Gkistrup

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Thank you!


socialmedia driving quality improvement!

Health & Medicine