Emergency marketing: The ED is best choice for PR campaign
In today’s competitive environment, an effective marketing campaign can provide a much-needed boost to the ED’s bottom line. While some managers have substantial public relations budgets, smaller rural EDs may need to be more creative with limited resources.
The ED has excellent potential as a marketing tool, say experts. "Since all of our hospitals have EDs, we could do advertising across the board for all of our hospitals," says Andrew Mills, media relations manager of Columbia Healthcare Corporation’s Georgia division, which recently started a new marketing campaign for its EDs. "Not all of our facilities have cardiology or obstetrics The ED is the common denominator."
Newspaper and radio advertisements focused on specific selling points of several EDs in the 20-hospital network. "Some had a fast track, while others had a chest pain emergency center," Mills notes. "The look and logo is the same for all the ads, but the ads were tailored for each facility."
Boosting the image of the ED can have long-term benefits for the hospital. "We look at our ER as a window of opportunity to get people into our hospital and see what quality service we provide," says Mills. "If they have a good experience there, they’re likely to come back to us in the future."
Planning is required
Numerous surveys have shown that the most common complaint about the ED is long waits. Some EDs have confronted that negative perception with service guarantees stating that unless care is provided in a specific amount of time, it’s free. However, whether these guarantees are successful depends largely on the amount of planning done.
When seven Columbia/HCA facilities in Kentucky decided to focus their marketing campaign on the ED, service guarantees seemed like an attractive possibility, but administrators researched the idea thoroughly before proceeding.
"I wanted to get input from the experiences of other EDs, so at a marketing council meeting, I put up a big sign on the information board, If you’ve ever done a service guarantee, please put your business card here,’" says Michelle Bowe, marketing director of Columbia Healthcare of Central Kentucky. "I got eight or 10 cards, and that’s how I got started."
Bowe spoke with other marketing directors who had tried service guarantees. "I got a lot of ominous warnings. People would say, You really don’t want to do this; our nurses hated this campaign; it’s a bigger animal than you realize,’" she says. "If I hadn’t heard all that, we probably would have tried to throw it together like everybody else did, instead of going through a process improvement."
She also ordered customized research from the Health Care Advisory Board in Washington, DC. "I told them I was interested in service guarantees, and they supplied detailed information about the results of other hospitals which had looked at the concept," says Bowe.
There were some encouraging findings, but also some negative news. "When I talked to other facilities that had done this, I found it did drive volume, but I also found out that almost everybody had discontinued their service guarantee because they started to run into tremendous problems," says Bowe.
Address operational issues
When she dug deeper during follow-up interviews, Bowe soon realized the root of those problems. "I discovered that people approached it as a marketing campaign and didn’t address operational issues," she explains. "In some cases, ED managers told me they barely knew about the campaign before it came out."
Instead of giving up on the idea of a service guarantee, administrators opted to improve the ED’s operations first and focus on the marketing campaign second.
"The marketing campaign took a back seat," Mike Graue, division president, recalls. "We realized we had six months of operational issues to iron out." The promotional campaign was put on hold until things improved. "We decided to do time studies and make sure we improved continuously and only come out with the campaign when we felt truly comfortable with our progress."
Another problem with existing programs was poor communication with the public. "A lot of people used the word triage in their campaigns, mostly with 15-minute triage guarantees," Bowe says. "My research indicated that the general public doesn’t understand what that means. What they care about is seeing the doctor," Bowe says. As a result, the "ERgency" campaign’s guarantee promised the public they’d "be seen by an ER physician within 30 minutes of registration or you won’t be charged."
A major concern was that people would think 30 minutes was too long for a real emergency, so this sentence was added to advertisements: "Of course, in a life-threatening emergency, a physician will see you within seconds."
Patient feedback has been good. "Our angle was people’s time is valuable," says Bowe. "We tried to change our whole philosophy, which included thinking of our patients as customers." As a result of the campaign, patient volume has increased an average of 10%.
When patients enter the ED, they are given a card explaining the terms of the guarantee. "We wanted to be very clear that the time starts after the registration process is complete," she says. "We didn’t want people to walk in the door and say, The clock’s on.’" The registration clerk tells patients their time as they sign in.
Refund requests low
Administrators were pleasantly surprised by the few requests for refunds. "We’ve refunded less than $2,000 collectively between all our hospitals," says Graue. "We were hoping to meet the guarantee 90% of the time and wound up averaging 97%. The key was that this wasn’t just a marketing campaign It was a total process improvement."
When the guarantee isn’t met, patients can request a refund by calling the hospital’s business office within two days. Charts for patients who aren’t seen within 30 minutes are held in the business office.
Administrators braced for a deluge of refund requests were in for a surprise: patients entitled to refunds didn’t usually request them. "There are a lot of charts we don’t meet the 30 minute guarantee on, but people don’t call because they’re satisfied with the service overall and know we’ve done everything we can to be efficient," says Bowe.
In an effort to enhance patient satisfaction, staff take time to explain delays to patients. "They’ll tell them, There was a motor vehicle accident so we’re really backed up. We’re not going to be able to see you within 30 minutes, but we wanted you to know why,’" she explains. "People are usually pretty reasonable, they just want an explanation. The staff figured that out really quickly, so that’s one way we’re keeping our numbers up."
A consultant was brought in to train all ED staff in customer service. "The registration person is the first person you meet, which sets the tone for the whole visit," says Bowe. "That person may be one of the lowest-paid people in the hospital, but [he or she] is key to the overall ED experience, so we also did customer service training with those people."
Some EDs in the network hired extra technicians to draw blood for lab tests to improve times. In other cases, procedures were changed. During a walk-through visit in one ED, Graue discovered it took an extra four minutes to print a patient’s registration forms because the printer had to warm up. As a result, the printers were reprogrammed.
Because of the Kentucky EDs’ successes, other Columbia facilities are considering a service guarantee campaign. "We have calls from them asking how we did it," says Bowe. "As long as it’s not a competitive situation, we’re glad to share some basic information."
Maximize press coverage
Once Columbia made the decision to go ahead with the service guarantee, the media were alerted. The campaign’s name, "ERgency" and tagline "urgency in any emergency guaranteed," were appealing to the press and public. "We wanted something catchy and clever," says Bowe. "It has really caught on."
The ED made specially printed "ERgency" T-shirts with the slogan and made stopwatches for staff to wear. A mailing was sent to the community with brochures and refrigerator magnets. When everything was up and running, the media were invited to a press conference. "We had great attendance," says Bowe. "Associated Press picked the story up, and we were in 40 newspapers. All the TV stations picked it up, and we got significant radio coverage too."
The ED’s campaign became a popular topic of conversation in the community. "A comic appeared in the paper with a pizza guy in the ED holding a pizza, saying, The doctor will see you now,’ and he looked at his watch and said, ’Twenty-eight minutes Rats.’" says Graue. "It became a fun thing to talk about for people."
In addition to television and newspaper ads that supplemented the press coverage, payroll stuffers were put in employee paychecks with information about the service guarantee. "The local industries really liked the idea because the faster someone’s in and out of the ED, the faster they’ll be back on the job." says Graue.
Some EDs are tapping into the public’s fascination with the hit TV show "ER." Columbia’s 20 hospitals in Georgia tapped into that consumer awareness with their "ER" campaign, which includes bright red billboards with "ER" in bold white letters. "The concept was to play off the success of ER,’ since people are so in tune with the show," says Mills.
The show’s tremendous appeal is a boon for ED marketers. "You have to consider what the consumers are being exposed to, whether in the industry or popular culture, to make sure you can communicate with them and get a response," says Jessica Hart, a senior account executive with T.G. Madison, the Atlanta-based advertising agency that created the campaign. "We used ER’ because, with a billboard, you need to get the message across really quickly. Everyone knows what ER means, and that’s certainly been heightened by the show," says Hart.
"Our key objectives were to get people to think ahead for emergencies and also think of our facilities," says Hart. Radio and print ads work in tandem in a "stories" campaign, including chest pain, a minor emergency, and sports medicine scenarios. Each ad features a real-life but not life-threatening situation for people to identify with.
"We weren’t going for a scare tactic, a scenario like you’re driving down the road and get hit by a semi," says Hart. "Instead we chose a child falling off a swing at a park who needs stitches. Even a chest pain ad showed [the ER] prevented a heart attack from happening, not that they brought him back from the jaws of death. We wanted to tug at the heart strings, but we didn’t want to do it in a pandering way."
To prepare the campaign, questionnaires were sent out to the ED department heads to ask what their strengths were, such as new triage system, a fast track, or new equipment. "We wanted to make sure the campaign was a practical approach for all the facilities," says Hart.
[Editor’s note: ED managers looking for information on marketing campaigns can contact the Health Care Advisory Board in Washington DC. The organization provides research to administrators on marketing, managed care, quality, and patient care. Members can access its custom research and database library, direct research questions to the staff, and receive reports on issues affecting the ED. For more information, contact Deborah Cunningham, managing director, Health Care Member Services. Telephone: (202) 672-5653.]
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