Adding a human touch

Editor’s note: Robin Segbers is manager of planning services at Marcus Thomas LLC, a Cleveland advertising and public relations firm.

To increase its volume of high-acuity and long-term patients, Northeast Ohio-based Akron Children’s Hospital needed to understand parents’ reasons for sending their children to one hospital over another. The hospital enlisted Marcus Thomas LLC, a Cleveland advertising and public relations firm, to help determine the thought process involved in such health care decisions by targeting several key service areas in which high-acuity patients could most often be found - namely, cardiology/cardiac surgery, neurology/neurosurgery, orthopedics/orthopedic surgery, hematology/oncology and pulmonary/asthma.

Focus groups served as the basis for a subsequent telephone survey. From observing the one-on-one interaction of the focus groups, hospital executives learned which issues were most important to the target audience and uncovered the terms respondents used when referring to their experiences. Therefore, the focus group helped the hospital determine the most appropriate questions to ask in the quantitative portion. The quantitative research provided the necessary measurable results needed to develop an overall communication plan for the hospital.

Marcus Thomas first conducted three focus groups, with an average of eight respondents per group, in which participants were asked to discuss their experiences while at a hospital. Participants were required to be the primary decision makers for health care decisions within the family and have a child - one month to 18 years old - with an acute condition and who had spent at least three consecutive days in a hospital.

As expected, most focus group participants were female since the health care decision makers within a family tend to be women. Participants were most often between 25 and 54 years old and had two or more children, ranging from toddlers to 18 years old.

Understand the process

Marcus Thomas developed discussion topics that would allow focus group facilitators to understand the hospital selection process and criteria for acute care, including:

  • identifying influencers throughout the process of diagnosis and treatment;
  • ascertaining reasons for selecting a hospital for treatment versus diagnosis;
  • understanding the criteria or factors used by parents in determining quality of care, how they know and what makes them believe a hospital offers excellent quality;
  • understanding common situations and circumstances in which a more expert, second opinion is sought; and
  • understanding the role insurance coverage plays in a parent’s selection of a physician or hospital for her child’s serious illness.

With regard to hospital selection, focus group respondents placed greater value on the following criteria: proximity; recommended by pediatrician/general practitioner; insurance; reputation of quality; previous experience with hospital.

Respondents felt proximity was critical for emergency and long-term treatment situations but was less of a factor when parents did not know their child’s diagnosis. Instead, parents were willing to travel far to seek a diagnosis.

When asked about physician referrals, many respondents said they contacted their pediatrician when their child became sick or at the time of an emergency. And when their pediatrician recommended a specific hospital, parents usually followed their pediatrician’s advice.

“With a broken bone, a close place is fine for treating a child. But if it’s for something that is life-threatening, you are not very versed on the hospitals that are farther away and you are putting your trust in your doctor to choose a hospital,” said one respondent.

A majority of respondents reported selecting hospitals where they knew they had insurance. Many parents reported calling their insurance company to ask for a referral.

When parents selected a hospital on their own, the hospital’s reputation for high quality was critical. Participants defined high quality as having the best doctors, being world-renowned and having the newest treatments available. Compassion followed as the second-most crucial criterion and included such attributes as being responsive to patients’ needs, having respect for the patient and family, communicating with patients and families, and creating family-friendly facilities with meeting and activity rooms, single rooms and places for parents to stay overnight.

In situations in which respondents had to select from two equally competent hospitals, respondents - especially the parents of chronically-ill children - placed greater importance on the dedication/caring exhibited by hospital staff.

“It’s a bigger picture when you have a chronic condition. You want a little more. I want doctors to relate to my son and to us better,” said one respondent.

When asked about their perception of Akron Children’s Hospital, respondents perceived the hospital to offer a personal approach and greater communication, respect and caring than other hospitals who treated patients as “numbers.”

Telephone interviews

For the quantitative portion of the study, Marcus Thomas conducted 1,000 telephone interviews with parents who lived in hospital growth areas. Of the respondents, 15 percent, or 154 individuals, were parents of high-acuity children defined as having had a hospital stay of three consecutive nights or more. Respondents were primarily white, married moms in their 30s and 40s.

For telephone respondents, Akron Children’s Hospital received the highest top-of-mind, unaided and aided awareness, with 33 percent of respondents mentioning the hospital without prompting and 52 percent with prompting.

Akron Children’s Hospital ranked first in patient preference for orthopedics and orthopedic surgery, with respondents overwhelmingly preferring the hospital (46 percent) to its primary competitors. The hospital was also widely preferred for treatment of lung or respiratory problems (41 percent) compared to its competitors.

Akron Children’s Hospital performed on par with its primary competitors in the other three service areas, including cancer care (32 percent), heart care (34 percent) and brain and spinal cord care (33 percent).

Filling patients’ emotional needs was rated highest when selecting a hospital without regard to a specific service line. The ideas that the hospital’s first and last priority is the patient and that doctors take the time to listen to their patients, answer their questions completely and respond to their needs quickly were rated most appealing by the majority of respondents (42 percent) (Figure 1). This characteristic was most often associated with Akron Children’s Hospital, with half of the respondents overwhelmingly believing that the hospital’s first and last priority is always the patient.

Sixty-one percent of respondents claimed the hospital knows how to make children and families comfortable and less afraid, while 59 percent believed the hospital had competent and caring nurses and also claimed that doctors take more time with patients, listen to them and respect them. Fifty-eight percent of respondents believed that the entire hospital focuses on the needs of children and families and that the hospital staff is responsive to their needs throughout their stay (Figure 2).

Parents of chronically-ill children placed more importance on private rooms and comfortable amenities and on making children and families less afraid and more comfortable.

Clinical excellence

Based on the research results, hospital officials decided to focus on Akron Children’s clinical excellence in three of the high-acuity service areas: cardiology, orthopedics and oncology. The hospital wanted to position itself as the preferred hospital for these service areas instead of just one of the preferred hospitals. At the same time, officials wanted to build upon the hospital’s competitive strength as a hospital in which doctors and nurses offer personal care and attention to families, which consumer research shows is the quality that parents selecting a hospital value most.

“The research showed us very clearly that when parents select a hospital, it is that emotional connection that they value most,” says Andrea Reynolds, manager of Web development and public relations at Akron Children’s Hospital. “Parents want to know that doctors will take the time to answer their questions fully and completely and make one of life’s most frightening experiences as comfortable as possible. This one-on-one interaction between the families we serve and our staff has always been a hallmark of Akron Children’s care, and we wanted to relay that to viewers.”

The hospital worked with Marcus Thomas to develop an ad campaign that would best portray this personal care and attention while showcasing the hospital’s clinical excellence in these areas. “We wanted the ads to demonstrate our high-quality and high-tech medical care, but at the same time we wanted viewers to receive an inside look at our unique child friendly care,” Reynolds says.

Untraditional approach

Since the abundance of hospital advertising uses actors, Marcus Thomas opted for an untraditional approach to the advertisements to overcome skepticism and build trust among its target audience. “The hospital staff is truly focused on the needs of children and families,” says Joanne Kim, partner of Marcus Thomas LLC, who created the ads. “We felt the best way we could capture and communicate this was through a documentary-style format. Real doctors, real patients, real families living through each stage of care at the hospital.”

“From pre-surgery to post-surgery, the footage was totally unscripted,” says Kim. “It was a risky approach because hospital administrators and staff obviously couldn’t guarantee the outcome of the surgeries.”

A director and crew chronicled the real-life stories of two families facing serious surgeries. The first series focused on a two-year-old girl who was born with a hole in her heart between the left and right ventricles. She also developed additional complications with her aortic valve. The leak was allowing blood to flow backwards into the left ventricle, threatening to enlarge the heart and lead to congenital heart failure. In another series, an eight-year-old was suffering from a hip dysplasia in which the ball on top of the thighbone does not properly rest within the hip’s socket.

Each family’s story was developed into a series of 30-second commercials, each of which builds upon the other as the story unfolds. Each commercial recounts a particular stage, from admission to post-op and release.

Viewers received a firsthand look at the personal care and attention that the hospital is known for with the footage showing each step of a child’s care. In one scene, a nurse rocks and comforts the crying two-year-old after surgery. In another an Akron Children’s doctor kneels down to be on the same level as the eight-year-old as he explains to the child and her parents what will happen in the surgery.

Positive response

The television spots run daily Monday through Friday during peak viewership times of the hospital’s target demographic - women ages 25-49. Spots air during popular programs such as the Oprah Winfrey Show, Good Morning America, Today Show and local morning newscasts. One spot airs per week. Regular viewers will see the stories unfold over the course of several weeks.

Each spot ends by directing viewers to the hospital’s Web site so they can learn more about the families and hospital and see future spots in the series. A series on the hospital’s oncology services is planned for later in the year.

Thus far, the response to the commercials has been overwhelmingly positive. “The advertisements are wonderful,” says Reynolds. “We have received a lot of attention from people talking about the spots and how powerful they are.”