Community Engagement Drives Service Line Success

This article, written by HealthLeaders Media Associate Editor Chelsea Rice, was originally published in Healthcare Marketing Advisor.

By 1 p.m. on December 15 and 16, 2012, the 6,100 spaces in the parking lot at The Mall at Short Hills in Short Hills, N.J., were filled to capacity. Approximately 1.3 million people visit the mall monthly, coming from New Jersey, New York, and Pennsylvania to shop for tax-free apparel 23 miles from Manhattan. Thousands of shoppers paused their holiday shopping for an exhibit just outside Macy's, and it wasn't for pictures with Santa.

Men, women, and children—ranging from as young as 4 years old to folks in their 80s and 90s—lined up to operate two da Vinci robots, put on display for the second consecutive year through a collaboration among Intuitive Surgical, which designs and builds the da Vinci robot surgical systems, the mall administration, and the nearby 597-bed Saint Barnabas Medical Center.

Physician-based community presentations and "Ask the Doctor" booths, which Saint Barnabas has offered in the past at the mall, provided a more personal connection with potential patients, but by letting patients interact with the robots and the surgeons, the hospital hoped to demystify a technology most patients don't ever see and in turn show them what is possible at Saint Barnabas.

By building an exhibit space at The Mall at Short Hills, Saint Barnabas created a setting for those connections at one of the largest malls in the country during the peak of the holiday shopping season.

One of the oldest nonprofit hospitals in New Jersey, Saint Barnabas is also the flagship hospital of Barnabas Health, one of the largest integrated health systems in the state. Its campus, which admits 33,114 patients annually, is located five miles from the mall.

Founded five years ago, the hospital's robotic surgery program has an international reputation. In 2009, the world's first robotic-assisted kidney transplant was performed at the hospital, and in 2007 two urologists and a general surgeon performed the state's first robotic bladder creation surgery, a procedure that involved removal of the bladder and prostate and then used the robotic system to create a new bladder from a section of the intestine.

Patients travel from states as far away as Florida and California, and even internationally, for the most advanced procedures from the hospital's surgeons, who operate using the da Vinci robotic surgery system.

Michael D. LaSalle, MD, is a urologist who specializes in impotence, infertility, and microsurgeries but has a passion for robotic surgery and educating the community about this technology.

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"We've done physician presentations before for community education, like question and answer sessions, but I thought although it's a pretty pricey piece of equipment, wouldn't it be great to put it on display—No. 1, so people could understand the technology; No. 2, so they know we offer this service at Saint Barnabas; but more importantly, to let the community interact with it," says LaSalle.

When he approached the marketing department, the hospital already had an ongoing promotional relationship with The Mall at Short Hills, the third most productive retail center in the United States, according to U.S. News & World Report. The average household income within three miles of the mall, which is also Saint Barnabas' local patient population, is $169,135.

"This relationship is a tremendous marketing opportunity for Saint Barnabas, and it raises a lot of awareness to a market of people that is extremely diverse," says Sally Malech, MPH, director of public relations and marketing. "You can't find all the stores there under one roof in many places in the world actually because it's a very high-end mall. It also draws a lot of people from Pennsylvania to New York City, so it's not a local mall that only pulls in the surrounding population."

Malech says she immediately saw the strength of LaSalle's idea to market robotic surgery at the mall and to this audience.

"Patients have all of these preconceptions about robotic surgery and this was an opportunity to really explain how it works, and they could see it," says Malech. "They could see what the instruments looked like and how small they were, but also it helped them understand the benefits of robotic surgery."

"Saint Barnabas is our flagship hospital for the system and commands a lot of visibility. And as a leader in the area for robotic surgery, I thought it would be a good idea to bring it to the community so they could put their hands on it," says LaSalle.

The first Saint Barnabas surgical robot interactive display was held in December 2011. Visitors tested the accuracy and efficiency of their movements on a simulator robot, which operated like a video game, allowing users to move jacks into colored bowls. A full-motion surgical robot was also on display for visitors to test drive by manipulating tiny rubber bands with the four surgical arms, horse-shoe style, over colorful, gumdrop shaped pegs.

The marketing department set a goal to have 250 people try each machine. The turnout and response to the display was tremendous. Around 500 visitors test drove the robots that day, and the hospital estimates the display attracted over 1,000 spectators. The mall says the robot display contributed to one of the busiest days it ever had. The display also generated a lot of local buzz, says Malech, in local online and print newspapers, at physicians' offices, and with the shoppers and retailers.

"The response the first time they showcased this equipment and the doctors was amazing," said Janet Cesario, the marketing and sponsorship director at The Mall at Short Hills. "I actually had calls from some of our customers telling me how impressed they were that we allowed a demonstration like this. They found it fascinating and loved being able to speak with the doctors."

LaSalle says the reaction to the event proved its importance.

The volume of surgeries performed by the 27 surgeons on the Saint Barnabas robotic surgery system increased 60% last year (2011–2012) from 250 to 400. Four hundred cases is the threshold one surgical robot system can handle in a year, according to LaSalle, because the robot is also used for training and instruction.

Based on the increasing demand, Saint Barnabas is planning to add another robot and expand its robotic surgery system into a multidisciplinary program for robotics.

The robotic display was coupled with advertisements in the local weekly papers regarding the display and the physicians involved. The event's information also ran in the hospital's e-newsletter, which is sent to about 15,000 people. The mall's email newsletter and website also featured the event. The summer 2012 issue of the hospital's magazine, Barnabas Today, which mailed to 100,000 households in late June, also featured robotic surgery and the mall display in an article about a professional opera singer's robotic prostate surgery and quick return to the stage.

"Although we can't attribute this growth exclusively to the mall display, our growth and expansion reflects the commitment of the system's administration to support the program and showcase what we provide," says Malech. "I would say that the growth is multifactorial. It includes increased public awareness, marketing, additional physicians being trained, and trained physicians increasing their usage of the robot."

The number of surgeons being trained on the da Vinci system has more than doubled from 2011 to 2012, according to LaSalle. Fourteen of those surgeons (gynecological, urological, and general surgeons) were on hand to rotate through the robotic exhibit as hosts in 2012. Their names and exhibit times were advertised on the print ads and posters about the display, in case patients were interested in speaking with a particular surgeon.

The synergy between the marketing department and the physicians is what's been really incredible about the robotic display, Malech says. More physicians volunteered in 2012 to work the two-day exhibit, donating an hour or two, but usually staying longer, says LaSalle.

In 2012, the marketing department upped its goal to 500 as the number of visitors who would test each robot. "A big part of this display was demystifying robotic surgery," says Malech. "Many observers had either already been operated on by the robot, they were about to have surgery, but most just wanted to understand how it worked."

In 2012, the robotic surgery display expanded to include other interactive exhibits showcasing different physicians and the services and procedures the hospital offered that were aligned with more consumer-based decisions, says Malech.

The promotion benefitted the mall and the hospital, but it's clear the robots were the star. The mall has already requested that Saint Barnabas bring them back for the 2013 holiday season.

Chelsea Rice is Associate Editor of HealthLeaders Media. This article was originally published in Healthcare Marketing Advisor.