Marketing Patient Safety & Hand Hygiene


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These are the slides from a presentation by Dr. David Fairchild, CMO of Tufts Medical Center, and Dan Dunlop, president of Jennings, a healthcare marketing agency. To visit Dan's blog go to

Published in: Health & Medicine

Marketing Patient Safety & Hand Hygiene

  1. 1. Marketing Patient Safety Within Your Hospital David Fairchild, MD, MPH, Tufts Medical Center Dan Dunlop, Jennings Healthcare Marketing October 1, 2009
  2. 2. Bert Jacobs, Life Is Good!
  3. 3. In the Spotlight: Hand Hygiene & Hospital Acquired Infections <ul><li>Statistics </li></ul><ul><ul><li>90,000 people die each year of hospital acquired infections </li></ul></ul><ul><ul><li>$4.5 billion in excess costs </li></ul></ul><ul><ul><li>1 in every 22 patients gets a hospital acquired infection; approximately 1.7 million patients/year </li></ul></ul><ul><ul><li>Medicare and private insurers no longer reimbursing hospital acquired infections </li></ul></ul><ul><ul><li>By eliminating one case of hospital acquired infection, you can save enough money to pay for a hand hygiene campaign </li></ul></ul>
  4. 4. In the Spotlight: Hand Hygiene & Hospital Acquired Infections
  5. 5. In the Spotlight: Hand Hygiene & Hospital Acquired Infections
  6. 6. Tufts Medical Center <ul><li>Two full-service hospitals </li></ul><ul><ul><li>Tufts Medical Center, academic medical center; 451 licensed beds </li></ul></ul><ul><ul><li>Floating Hospital for Children, renowned children’s hospital </li></ul></ul><ul><li>Urban setting - downtown Boston </li></ul><ul><li>Roughly 5,000 employees </li></ul>
  7. 7. Tufts Medical Center: Context for the Patient Safety Campaign <ul><li>Lackluster, inconsistent results on hand hygiene </li></ul><ul><li>Various campaigns on different floors </li></ul><ul><li>No consistent monitoring </li></ul><ul><li>Need to develop a patient safety culture </li></ul><ul><li>Joint Commission coming </li></ul><ul><li>Market watching </li></ul>
  8. 8. Pre-Campaign Hand Hygiene Compliance Numbers <ul><li>Baseline pre-campaign compliance of 71% for January and February 2008 </li></ul><ul><li>Compliance averaged 73% in 2007 </li></ul><ul><li>Poor ‘Before Care’ compliance relative to ‘After Care’ </li></ul>
  9. 9. Existing Campaigns Within Tufts Medical Center
  10. 10. Existing Campaigns Within Tufts Medical Center
  11. 11. Existing Campaigns Within Tufts Medical Center
  12. 12. Existing Campaigns Within Tufts Medical Center
  13. 13. The Cluttered Environment Within Tufts Medical Center
  14. 14. Our Assessment Pointed to the Need to Drive The Message Home <ul><li>Doctors and nurses know they need to wash their hands </li></ul><ul><li>Not an educational issue, but rather a forefront of mind issue </li></ul><ul><li>We needed to hammer this message home </li></ul><ul><li>The revelation: “This is about me!” </li></ul>
  15. 15. Challenges of a Culture Change <ul><li>Seeking behavior change – most difficult “marketing ask” </li></ul><ul><li>Need to communicate washing before and after patient care, and any time in the room </li></ul><ul><li>Many different audiences in many different places with many different opinions </li></ul><ul><li>Few places to communicate to just employees – patients and families exposed to almost all messages; hospital a “serious” place, have to be sensitive </li></ul>
  16. 16. A Comprehensive Campaign Required <ul><li>Monitoring </li></ul><ul><li>Competition and accountability </li></ul><ul><li>Breakthrough, consistent creative </li></ul><ul><li>Advocates on the floors </li></ul><ul><li>A commitment from the top </li></ul><ul><li>A willingness to “do something different” </li></ul>
  17. 17. The Campaign Development Process <ul><li>Research </li></ul><ul><li>Creative brief </li></ul><ul><li>Spec campaigns </li></ul><ul><li>Presentation to Safety Leadership Council </li></ul><ul><li>Development of winning campaign </li></ul><ul><li>Campaign rollout </li></ul>
  18. 18. Research <ul><li>Interviews with key stakeholders within Tufts Medical Center </li></ul><ul><ul><li>Dr. David Fairchild, Chief Medical Officer </li></ul></ul><ul><ul><li>Dyan Madrey, Development and Training Manager (HR) </li></ul></ul><ul><ul><li>Barbara Curley, RN, Director of Performance Improvement </li></ul></ul><ul><ul><li>Dr. Shira Doron, Professor of Medicine, Infectious Disease, Head of Anti-Microbial Management Team </li></ul></ul><ul><ul><li>Terri Hudson Jinks, RN, MSN, Clinical Director of Adult Nursing </li></ul></ul><ul><ul><li>Mary Sullivan Smith, Chief Nursing Officer & VP of Patient Care </li></ul></ul><ul><ul><li>Tricia Lemon, BSN, MPH, Infectious Control Practitioner </li></ul></ul>
  19. 19. Research: What We Heard <ul><li>Lots of clutter in the medical center - numerous initiatives and poster campaigns </li></ul><ul><li>Need to make patient safety part of the fabric of employees’ lives </li></ul><ul><li>Need to provide feedback to employees - data on compliance </li></ul><ul><li>Existing tension - Colleagues uncomfortable reminding one another </li></ul><ul><li>Patients and families intimidated by caregivers, don’t want to appear to be disrespectful </li></ul><ul><li>Campaign should feel home grown </li></ul>
  20. 20. Research: What We Heard <ul><li>Need to communicate accountability and expectations </li></ul><ul><li>Must be sustained over time; can’t be idea of the moment </li></ul><ul><li>A sense of humor would help </li></ul><ul><li>Must be highly visible graphically </li></ul><ul><li>Must empower patients, families and employees </li></ul>
  21. 21. A Sample of Programs Reviewed <ul><li>Stanford Hospital </li></ul><ul><li>Cedars-Sinai Medical Center </li></ul><ul><li>St. Mary’s Medical Center (PA) </li></ul><ul><li>Duke University Medical Center </li></ul><ul><li>University of Iowa Hospitals and Clinics </li></ul><ul><li>Beth Israel Deaconess </li></ul><ul><li>Brigham & Women’s </li></ul><ul><li>Johns Hopkins </li></ul><ul><li>Vanderbilt </li></ul><ul><li>UPMC </li></ul>
  22. 22. Research Existing Campaigns
  23. 23. Research Existing Campaigns
  24. 24. Research Existing Campaigns and Editorial Coverage
  25. 25. The Creative Brief <ul><li>Key Points: </li></ul><ul><ul><li>Campaign needs to accommodate a variety of patient safety messages, not just hand hygiene </li></ul></ul><ul><ul><li>Break through the clutter; impactful without frightening patients and family </li></ul></ul><ul><ul><li>“ Be with the employee” all day without blending into the woodwork </li></ul></ul><ul><ul><li>Audiences: </li></ul></ul><ul><ul><ul><li>Employees - broad, heterogeneous audience; create the environment where it is okay to speak up; change behavior </li></ul></ul></ul><ul><ul><ul><li>Patients & Family members - Overwhelmed with information; need to be given permission/empowered </li></ul></ul></ul>
  26. 26. The Creative Brief <ul><li>Key Points: </li></ul><ul><ul><li>Tonality: fun/positive, engaging and in your face </li></ul></ul><ul><ul><li>Should not feel like a generic, off-the-shelf campaign </li></ul></ul><ul><ul><li>Can’t become background </li></ul></ul><ul><ul><li>Must be sustained </li></ul></ul><ul><ul><li>Message: Hand hygiene is for everyone, every time; that means you! </li></ul></ul>
  27. 27. Spec Creative <ul><li>A variety of approaches: four options </li></ul><ul><li>Varying tonality </li></ul><ul><li>Some more flexible than others moving forward </li></ul><ul><li>Need to get approval of the Safety Leadership Council </li></ul>
  28. 28. Choices Campaign <ul><li>“ You’re making choices about hand hygiene and you want to make the right choice.” </li></ul><ul><li>“ By the way, the right choice is obvious!” </li></ul>
  29. 29. Choices Campaign
  30. 30. Choices Campaign
  31. 31. Choices Campaign
  32. 32. Choices Campaign
  33. 33. Choices Campaign
  34. 34. Choices Campaign
  35. 35. Nametag Campaign <ul><li>Gives germs a human face! </li></ul>
  36. 36. Nametag Campaign
  37. 37. Nametag Campaign
  38. 38. Nametag Campaign
  39. 39. Nametag Campaign
  40. 40. Nametag Campaign
  41. 41. Germs Campaign <ul><li>Links germs to your behavior </li></ul><ul><li>Conveys accountability </li></ul>
  42. 42. Germ Campaign
  43. 43. Germ Campaign
  44. 44. Germ Campaign
  45. 45. Germ Campaign
  46. 46. Germ Campaign
  47. 47. Germ Campaign
  48. 48. The Winning Campaign <ul><li>Speak Up. Wash Up. </li></ul>
  49. 49. Speak Up. Wash Up.
  50. 50. Speak Up. Wash Up.
  51. 51. Speak Up. Wash Up.
  52. 52. Speak Up. Wash Up.
  53. 53. A Local Campaign
  54. 54. The Winning Campaign <ul><li>Speak Up. Wash Up. </li></ul><ul><li>Messaging speaking directly to: </li></ul><ul><ul><li>Physicians </li></ul></ul><ul><ul><li>Patients & families </li></ul></ul><ul><ul><li>Patient care workers </li></ul></ul><ul><li>Tonality: </li></ul><ul><ul><li>Positive encouragement for providers (not negative/guilt) </li></ul></ul><ul><ul><li>Empowering for patients </li></ul></ul><ul><ul><li>Encouraging peer communication </li></ul></ul><ul><ul><li>Attention-getting </li></ul></ul><ul><ul><li>Friendly </li></ul></ul>
  55. 55. Speak Up. Wash Up. <ul><li>Location specific messaging: </li></ul><ul><ul><li>Patient rooms </li></ul></ul><ul><ul><li>Staff lounges & bathrooms </li></ul></ul><ul><ul><li>Public restrooms </li></ul></ul><ul><ul><li>Mirrors </li></ul></ul><ul><ul><li>Clinical areas </li></ul></ul>
  56. 56. Speak Up. Wash Up. <ul><li>A variety of delivery vehicles: </li></ul><ul><ul><li>Stickers of varying colors, size and shapes </li></ul></ul><ul><ul><li>Buttons </li></ul></ul><ul><ul><li>Posters </li></ul></ul><ul><ul><li>Monthly CMO email messages </li></ul></ul><ul><ul><li>Newsletter articles </li></ul></ul><ul><ul><li>Patient briefing sheets </li></ul></ul>
  57. 57. Before We Started <ul><li>Baseline monitoring data by unit (critical!) </li></ul><ul><li>Patient Safety Champions on every unit (physician and nurse) </li></ul><ul><li>Know all the rooms on the units </li></ul><ul><li>Hand Hygiene lecture for all employees with post test </li></ul><ul><li>Annual updated education for nursing staff </li></ul><ul><li>Educational lectures by staff in Infectious Disease </li></ul><ul><li>Enhanced distribution of gel dispensers </li></ul>
  58. 58. Speak Up. Wash Up. <ul><li>Launch e-mail blast to internal audience </li></ul>
  59. 59. Speak Up. Wash Up. Important patients and families understood what we were doing
  60. 60. Speak Up. Wash Up.
  61. 61. Speak Up. Wash Up.
  62. 62. Speak Up. Wash Up.
  63. 65. What Worked <ul><li>Localizing the campaign: Stickers with photos of Tufts Medical Center leadership were a hit </li></ul><ul><li>Campaign stood out graphically </li></ul><ul><li>Bold colors and short messages </li></ul><ul><li>Reporting compliance results/competition </li></ul><ul><li>Using existing communication vehicles </li></ul><ul><li>Variety of messaging for different audiences </li></ul><ul><li>Visible involvement of leadership </li></ul>
  64. 66. What Didn’t Work <ul><li>Some stickers did not adhere to all surfaces </li></ul><ul><li>The most edgy messaging was not well-received. Anything with slight sexual content or hard edge pulled. </li></ul><ul><ul><li>“ Take your dirty hands off me” </li></ul></ul><ul><ul><li>“ Chairman do it in 15 seconds” </li></ul></ul><ul><ul><li>“ Hellacious & Efficacious” </li></ul></ul><ul><li>Reception to campaign varied by department </li></ul><ul><li>Posters were too heavy </li></ul>
  65. 67. Results
  66. 68. Results
  67. 69. Results <ul><li>The day finally arrived… </li></ul><ul><li>Joint Commission visit in August 2008 </li></ul><ul><li>No violations </li></ul><ul><li>They left wearing our buttons! </li></ul>
  68. 70. Southern New Hampshire Medical Center <ul><li>Adopted Tufts’ Hand Hygiene Campaign </li></ul><ul><li>Started with favorite stickers contest (March ‘09) </li></ul><ul><li>May ‘09 campaign roll out </li></ul><ul><li>Compliance increase May to July: </li></ul><ul><ul><li>Nurses 80% to 92% </li></ul></ul><ul><ul><li>Physicians 71% to 87% </li></ul></ul><ul><ul><li>Others 54% to 80% </li></ul></ul><ul><li>Stickers keep disappearing </li></ul><ul><li>Now selling stickers in gift shop </li></ul>
  69. 71. The Ideal Hand Hygiene Campaign <ul><li>Employee education </li></ul><ul><li>Letter to employees’ homes </li></ul><ul><li>Presentation to department heads </li></ul><ul><li>Email blast to employees </li></ul><ul><li>Kick off parties - partner with vendor </li></ul><ul><li>Local champions at the unit level </li></ul><ul><li>Coverage in internal newsletter </li></ul>
  70. 72. The Ideal Hand Hygiene Campaign <ul><li>Celebrations on key dates: patient safety awareness week, handwashing awareness week, etc. </li></ul><ul><li>Refresh campaign every few months </li></ul><ul><li>Measure effectiveness; inspire competition </li></ul><ul><li>Report results regularly to employees </li></ul><ul><li>Signage everywhere: restrooms, break rooms, public areas, patient rooms, handwash dispensers, paper towel dispensers, etc. </li></ul>
  71. 73. Contact Information <ul><li>David Fairchild, MD, MPH, Tufts Medical Center </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><li>Dan Dunlop, Jennings (Healthcare Marketing) </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><li>Online Healthcare Marketing Community: </li></ul><ul><ul><li> </li></ul></ul><ul><li>Website: </li></ul><ul><li>Blog: </li></ul>