Friday 1 April 2011

#oceanward – tweeting a day in the life of a children’s heart unit

This blog post was first published on the NHSSM (NHS social media) blog.

Inspiration struck only an hour after we first became aware of #Walsall24, during a team brainstorm about raising Southampton’s profile in the Safe and Sustainable national children’s heart surgery review. Walsall Council had followed in the footsteps of Greater Manchester Police’s 24-hour tweet, but so far, we 
weren’t aware of an NHS tweetathon.

Tweeting the activities of an entire hospital would have been a logistical nightmare but following a single specialist service seemed a more manageable proposition, and the campaign to differentiate the Trust from our rivals seemed an opportune moment for a social media experiment.

It would be partly a gimmick – doing a UK first in order to gain press attention. But we had a less cynical purpose. #oceanward would aim to highlight the wealth of specialist knowledge, the volume of work, the complexity of procedures and depth of ongoing care on our specialist children’s heart ward. It would also give a human face to the patients and families whose lives would be fundamentally affected by the loss of the second highest quality service in the country.

We moved quickly in case any of the other at-risk cardiac centres had the same idea. #Walsall24 happened on Thursday 3 March and we tweeted #oceanward on Friday 11, deliberately coinciding with the visit of local councillors (among them the social-media-savvy Leader).

Telling a story

In order to control the message (specialist, professional centre of excellence) and draw our audience into the human stories before we punched through with the calls to action, we wanted to produce an overall narrative that followed patients through their day. We therefore decided to write the tweets as observers rather than handing over to the staff as first person tweeters. Given the tight timescales this was a pragmatic approach that also solved the problems of providing training or setting up multiple accounts and meant the nurses and doctors could go on with their daily business with minimal distraction. But I’d certainly like to experiment further and have the staff themselves tweeting a service.

Although the whole communications team supported the effort, coordinating the press coverage, taking photos and helping keep conversation flowing while we had our noses in our iPods, most of the tweeting was carried out by just two of us. Michelle Harris, communications manager, and I both regularly tweet as @SUHT so our conversational register was already established. As the day progressed, we read each other’s tweets to cement the tone and ensure continuity in the patients’ stories. One keen follower told us that the Tweets read “almost like the script of a TV programme”.

Live and unedited

Aside from a handful of scheduled tweets containing long URLs and a cheat-sheet of staff names (we gave up and called Dr James Gnanapragasam just ‘Dr James’) we didn’t plan or plant anything; it was a genuine live action tweet-along of activities as they unfolded. We first met the patients and families on the morning and although the staff had been primed about our visit, we introduced ourselves to them as we introduced them to our audience.

Staff and families alike were welcoming, tolerant and selfless in allowing us access to almost all areas. This was at least partly because everyone is aware of the threat of closure and is passionate to do everything they can to save the unit.

We did back off a few times to preserve privacy and dignity, and some patients were not named because their families were not available to consent. Even though we only used first names and ages (“Evan, 11 days”), consent was vital because these patients could be readily identified by family and friends reading our tweets at home. One follower used an @ to SUHT to wish good luck to her friend who was waiting for her son to go down to surgery, and NHS Plymouth sent best wishes to a patient who had been transferred to us.

Practical considerations

We’d aimed to tweet at least every 5 minutes and in the end managed around 200 updates during our 12 hour shift.  We did have the option of tweeting from desktop computers but roving the ward with iPod Touches was much more convenient and flexible, and produced more immediate results; we were thankful for flawless cooperation from IT, giving us temporary access to the secure wireless network.

We had no budget so used personal iPods and made do with our existing digital camera. Colleagues uploaded the pictures back at the office, which is why the Twitpics in our timeline are out of sync with events on the ward. The photos did get some of the greatest numbers of re-tweets so not doing more of those or having a mobile device with a camera are among our regrets.

Spreading the word

Our press release was picked up on the BBC website and local press and commercial radioIndia Knight and the Department of Health retweeted us, and the council and leading Southampton twitterers also boosted our reach. The emotive nature of the campaign meant we also got some great online interaction with families of patients and other supporters. Overall they issued more than 50 impassioned retweets and sent us over 90 @ messages, including personal requests for us to pass on thanks to particular doctors, to which we happily acquiesced and responded.

At one point around lunchtime gave us an audience of nearly 50,000, and we gained 103 new followers for @SUHT over the course of the day, a more than 10% increase.

We didn’t get quite the amount of coverage we might have done (one national broadcaster was lined up to air the story but pulled it) because naturally a lot of air time and news pages went to the Japanese earthquake, but that was rightly so and of course outside our control.

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