Journey to High Reliability Healthcare: How Storytelling Fuels Engagement

Background:

In 2015, the Air Force Medical Service (AFMS) launched its journey toward becoming a high reliability organization (HRO), termed “Trusted Care.” Over the past four years, the AFMS has diligently striven to create a psychologically safe environment, promote safety/reliability behaviors, and equip “every Airman” to be a problem solver. Though new along its HRO journey, AFMS knew that it needed to change the behavior of its Airmen and provide them with the proper resources to become a learning and improving organization.

Program background:

AFMS Trusted Care created three campaigns:

What’s Your Why (WYW): Designed to raise awareness about Trusted Care and inspire Airmen to join the HRO journey by sharing their personal stories for committing to highly reliable healthcare.

How Do You C.A.R.E. (HDYC): Created C.A.R.E. tools (Clear Communication, Attention to Detail, Respectful Teamwork, Exercise a Questioning Attitude) based the Air Force Core Values, Trusted Care Principles, safety science and the Department of Defense’s TeamSTEPPS strategies and tools. AFMS used a multi-pronged approach including badge cards, toolkits, social media and video/essay contests to build awareness on how C.A.R.E tools reduce the number of medical errors, encourage Airmen to use C.A.R.E tools and embed safety into the AFMS culture.

Trusted Care Heroes: Established a recognition program to acknowledge Airmen who embody the desired Trusted Care behaviors. Any Airman can nominate peers and the Air Force Surgeon General selects one nomination to spotlight as the Trusted Care Hero of the Month.

Evaluation Methods and Results:

WYW: Tracked the number of video views (65,397) and Facebook engagements including likes, comments, and shares (5,915). Developed and disseminated a post campaign survey to measure behavioral impact reaching 14% of the campaign participants (n = 225). 71% of participants believed the campaign increased their knowledge of Trusted Care and 84% were willing to share their personal experience with others.

HDYC: Distributed 50,000 badge cards to 76 facilities across 50 states and around the world reaching 42,000 Airmen and trained 35,000 Airmen in safety behavior and error prevention tools as of July 2018. Facebook engagements: 2,322; Video views: 60,116. Received the “Success Story Award” and the “Best Demonstration of Reliability Tools in Action Award” from the Press Ganey National Client Conference.

Trusted Care Heroes: Received 750 submissions as of January 2019.

Conclusions:

Each campaign helped to reinforce Airmen’s commitment to Trusted Care and the use safety behavior and error prevention tools. These campaigns allowed Airmen to see the impact of storytelling and to understand the importance of how a medical error can lead to large implications and how each Airman plays a role in a safe culture. These campaigns led to fewer serious safety events (average decrease of 17 per year) and purpose-driven work, which is well-established as an effective means of increasing productivity and improving health of staff.

Implications for research and/or practice:

A multi-channel health communications and marketing approach, driven by social marketing tactics, can be applied to behavior change campaigns to keep audiences engaged and help them reach their desired end behavior.