“Nightmare” in Healthcare: Using Vital Signs to Reach Clinicians and Patients

Background: One family of bacteria, Enterobacteriaceae, has become increasingly resistant to last-resort antibiotics, and more hospitalized patients are getting lethal infections that are impossible to cure. 

Program background: To bring carbapenem-resistant Enterobacteriaceae (CRE) prevention to the forefront of the U.S. medical and public health fields, CDC's Division of Healthcare Quality Promotion (DHQP) assigned CRE as its annual Vital Signs report topic.  The Vital Signsprogram translates critical public health data into recommended actions using plain language. In addition to a scientific article, Vital Signs teams produce more than 30 communications pieces to amplify the message among key audiences. 

Evaluation Methods and Results:  DHQP identified key audiences as administrators and health care providers in hospitals, long-term acute care hospitals, and nursing homes.  Because CRE is best prevented using a multi-facility approach, state health departments were also a primary audience.  Patients/caregivers were considered a secondary audience.  Objectives were to raise awareness of and drive CRE prevention steps.  Materials were written to inform audiences about concrete actions to prevent CRE infections and spread.  Key messages and sound bites were developed to help draw urgent action. Two months before the report, DHQP informed key medical, health department, and consumer partners about the report’s content, giving them time to prepare and to identify opportunities for collaboration. Upon release, CDC distributed a materials suite including a fact sheet written in plain language and featuring easy-to-understand graphics; a digital press kit;  a press release; social media posts; supplementary graphics;  prevention success stories; and online advertisements.  Key partner engagement strategies were also used. Coinciding with the release, CDC held a press conference attended by members of the media, state health departments, and partners.  Within one week, DHQP fielded numerous media requests that drove stories in outlets including the New York Times, Washington Post, Wall Street Journal, major broadcast networks and top medical sites including Medscape. Within four weeks, the CRE Vital signs CRE home page was viewed about 60,000 times, and the prevention toolkit was downloaded 11,000 times. More than 65,000 clinicians viewed a CDC CRE slideshow on Medscape.  Twitter impressions reached 48 million. CDC continues to field clinician inquires about CRE. Several organizations sent alerts to their members, one placed a national op-ed, and CDC partnered with CMS to craft a letter for U.S. hospitals.  Several facilities and health departments sent alerts urging action within and between facilities. Two weeks after launch, CDC held a webinar for state health departments.  Attendance hit an all-time high, with 447 participants.

Conclusions:  The CRE Vital Signs effort was one of the most accessed Vital Signs reports in CDC’s history.  Using key partner networks, pointed key messages, and materials created specifically for and delivered directly to key audiences, DHQP was able to penetrate a traditionally difficult audience with critical key messages.

Implications for research and/or practice:  This campaign demonstrated that audience definition, careful message crafting, and partner recruitment are important factors in the success of large-scale campaigns expected to make an impact.