Two case studies of U.S. hospital emergency department marketing campaigns that have increased awareness about when it's appropriate to visit an emergency department for treatment come from BayCare health system and Lincoln Hospital. Hospitals educating people about when emergency department treatment is necessary is important considering that approximately 50% of medical care in the U.S. is provided within emergency departments, according to a 2017 article published by the University of Maryland School of Medicine. Furthermore, among patients that have insurance provided by their employers, 71% of visits they made to emergency departments "were for non-emergency causes."
Case Study 1: BayCare's ER Vs. Urgent Care Campaign
1. Campaign Description
BayCare health system (Florida) launched an untitled marketing campaign in Spring 2018 that has since gone viral and received considerable media attention.
The campaign "used simple, tongue-in-cheek imagery to educate patients about when to use the emergency room, urgent care, primary care and telehealth."
As part of the campaign, one of the billboards included a picture of a beehive and bee. The words on the billboard stated "stepped on a bee" and instructs people to go to urgent care for that, while they should go to the ER if a beehive had been stepped on.
This link shows a few billboard examples from the campaign.
According to BayCare's Chief Strategy and Marketing Officer, Ed Rafalski, the campaign "may have already begun to effect changes in patient behavior" between the time of its spring 2018 debut and August 2019.
A driving force behind the campaign was specifically to lower the number of improper emergency room (ER) visits for issues that should be treated in other settings, which are described as low-acuity matters.
The campaign was designed to be easy to understand and memorable, to bolster the odds of people remembering where to go for different healthcare needs.
The billboards used for the campaign mainly focused on the difference of when to seek ER and urgent care treatment.
After having launched the campaign, one of BayCare's emergency department locations observed fewer flu-related visits. Upon further research by BayCare's analytics team, it was determined "that most of the decline was in low-acuity upper respiratory activity."
The analytics team further determined that there were four times as many urgent care visits for low-acuity matters "compared to the decline in the ER."
The analytics team also found that there was a major increase in the number of walk-in, low-acuity visits for telehealth, which is located on the opposite side of the street as that ER.
According to Dr. Rafalski (Chief Strategy and Marketing Officer), the aforementioned findings provide an early demonstration that BayCare has started to successfully educate consumers about the right place to seek medical treatment, including when it's appropriate to visit the ER and when it's not.
Dr. Rafalski further explained that an underlying goal of the campaign was to simplify healthcare navigationinacreativeway that's easy for people to understand.
Case Study 2: Lincoln Hospital's Why Wait Campaign
1. Campaign Description
Lincoln Hospital (Bronx, New York) launched a campaign focused on increasing awareness about when it's proper to visit an emergency department for treatment titled "Why Wait."
Each year, more than 160,000 patients are seen for medical attention in the hospital's emergency department. Of those more than 160,000 visits in 2018, 45,000 involved illnesses that were not urgent.
The Why Wait campaign was launched in conjunction with the opening of its clinic called Express Care, where patients with illnesses that are not urgent can be seen. Those patients were the target audience for the campaign.
The campaign title (Why Wait) appears to send a message to people that they can be seen much faster at the clinic compared to at the emergency room for those with conditions for which the clinic is the proper location.
A Lincoln Hospital patient said that she waited five hours in the emergency room to be seen by a doctor. As she stated, "The wait in the emergency room is just too long, and there’s too many people."
In stark contrast to the aforementioned emergency room wait time, a Lincoln Express Care patient said she was seen within approximately 10 minutes at the clinic.
Lincoln's Express Care clinic opened in August 2018 and since, then, the number of patients who have visited the clinic for treatment has increased.
As an example, in September 2018, 360 patients were seen at the clinic. Just a few months later in January 2019, that monthly patient count increased to 750.
Conversely, Lincoln's emergency department has experienced a five-percent decrease in non-emergency-illness visits year-over-year.
We were able to find two examples of marketing campaigns from U.S. hospitals seeking to increase awareness about when it's proper to visit the emergency room for treatment and when it's not. These were actually the only two such examples we could find that were run directly by a hospital. A likely reason for that is because there were campaigns focused on that same message run by state and national health industry organizations, such as the Washington State Medical Association's initiative called "The ER is for Emergencies." We didn't use those organizational campaigns because the requested focus for our research involved hospital campaigns. More information was available about BayCare's campaign, which is likely a result of the fact that it went viral and received media attention due to its creativity.
Emergency Department (ED) Marketing Case Study (Non-US)
Two case studies of non-U.S. hospital emergency department marketing campaigns that increased awareness about when it's proper to visit the emergency department come from Fraser Health Authority/Peace Arch Hospital and Children's Hospital of Eastern Ontario. As an example of why non-U.S. hospitals are working to lower unnecessary emergency department visits, "[m]ore than 70 percent of all lower-urgency visits to Emergency Departments at Victorian hospitals between 2002 and 2013 could have been appropriately treated at GP [general practitioner] clinics."
Case Study 1: Fraser Health Authority/Peace Arch Hospital
The campaign's goal was to educate people about when it's appropriate to seek emergency department treatment compared to other treatment centers such as clinics.
Within year one of the campaign, Fraser's Peace Arch Hospital saw the number of non-emergency patient visits within its emergency department decrease by 1,100 visits.
As part of the campaign, signs and posters were spread across South Surrey and White Rock so that people would be reminded of the options outside of the emergency department that they have when it comes to receiving medical attention, such as clinics and traditional doctors' offices.
Beyond just reducing emergency department patient volumes, Dr. Grace Park explained another benefit for patients receiving care in the proper setting in stating the following: “Delivering the right care to our patients in the right place is important because we know the treatment of non-emergency health concerns in a community setting helps strengthen the relationship between a person and their physician.”
Within year one of the campaign, Peace Arch Hospital experienced "a decrease in low-acuity, the least sick emergency department patients, between three and eight percent every month.”
For reference, approximately 50,000 patients are seen at Peace Arch's emergency department each year and across Fraser Health Authority's ER locations, 40% of visits to those emergency rooms are not emergencies.
The campaign was deemed very successful and was thus "being expanded to the whole health region, starting with Chilliwack and Mission...with plans to start up in more communities later in the year."
Case Study 2: Children's Hospital of Eastern Ontario's Choosing Wisely Initiative
Children's Hospital of Eastern Ontario implemented an in-person marketing initiative titled Choosing Wisely to increase awareness about when it's appropriate to visit an emergency department for treatment.
The Choosing Wisely title referenced that caregivers need to choose wisely in determining whether kids actually need to be brought to the pediatric emergency department or not.
The hospital launched the initiative in May 2015, as a result of increasing pediatric emergency department visits and the increasing proportion of those visits deemed low-acuity (non-emergency).
The hospital implemented this initiative to influence how caregivers would make future decisions about the proper place to seek medical attention through educational content.
The educational information was "included [in] a two-page pamphlet...that consisted of four sections." Section one discussed why it's important to seek pediatric emergency department treatment for certain conditions. Section two was about assessing how serious a condition is.
Section three provided examples of non-emergency and emergency conditions. Lastly, section four provided information about alternative treatment centers for non-emergency conditions.
Physicians were actually the ones who gave the caregivers the pamphlet and followed that up with a brief conversation on that topic.
Within the 10-week period before the initiative started, there was a consistent time frame with significant pediatric emergency department visits, which exceeded the level from each of the previous two years.
Once the initiative started, there was a decrease in the number of pediatric emergency department visits.
When the initiative stopped, the number of pediatric emergency department visits "returned to the levels typical of previous years."
Based on the data, it was noted that the aforementioned fluctuating levels of pediatric emergency department visits "suggested that the initiative may have had an effect in reducing low-acuity...visits."
We were able to find two examples of successful marketing campaigns from non-U.S. hospitals seeking to increase awareness about when it's proper to visit the emergency room for treatment and when it's not. The only other non-U.S. hospital we found that launched such an initiative was Moncton Hospital (Canada), but we didn’t include it because the campaign wasn’t entirely unsuccessful. The unsuccessful part of the campaign was that it didn’t reduce the number of emergency department visits. However, the successful part of the campaign was that its website generated significant traffic (6,000 visits), which was deemed a success. We just wanted to mention briefly mention that campaign because it was partially successful.
The two case studies plus the Moncton Hospital campaign were actually the only three examples we could find of campaigns from non-U.S. hospitals that increased awareness about when it’s appropriate to seek treatment at an emergency department. A likely reason for that is because there were campaigns focused on that same message run by countries’ health industry organizations, such as Queensland, Australia’s “Keep Emergency for Emergencies.” We didn't use those country-wide campaigns because the requested focus for our research involved hospital campaigns.