Case Study: SickKids Orthopaedic Surgery Fellowship
Ed. note: This case study is a selection from the 2014 “Justified” competition, for which an esteemed jury identified 19 submissions that demonstrate the value of design in a clear, compelling and accessible way. To learn more about the jury’s perspective on this selection, see the juror comments below.
The Sick Kids Department of Paediatric Orthopaedic Surgery had long been known for its fellowship program. The department would draw top fellows from around the world and have its first pick of top applicants. As time went on, the department noticed a change in the ability of their program to attract top-tier fellows. They recognized this change was due to an overabundance of similar programs, making it very competitive and difficult for them to differentiate themselves. The existing communication strategy of the department relied on its history, as opposed to an honest representation of their forward-thinking approaches.
We developed a strategy geared towards prospective applicants seeking cutting edge fellowships at renowned institutions. The outcome was a series of three annual publications over a three-year period that captured the nuanced experiences and the hands-on education found within their program. The annuals were distributed internationally to selected universities, hospitals and conferences. The change was immediate; the department noticed a spike in traffic and saw an increase in opportunities to review top-tier fellows for their program. We have since launched a website to match the annual. The website incorporates interactive data visualizations and deeply integrated analytics. Both the printed annual and the website have remained an ongoing project with the Department of Orthopaedic Surgery at SickKids. Success was measured through client testimonials and web-based analytics.
The goals of this project were determined among the program directors, our team and an external consulting firm. The goals were to design a communication strategy that would attract top-tier fellows to the Department of Paediatric Orthopaedic Surgery Fellowship program—specifically, fellows who would push the program forward—and to refresh the perception of the department among peers.
The audience for this piece can be broken down into three categories. The primary audience was the fellows and their mentors; the secondary audience was colleagues in the field of orthopaedics and peers whom they would meet at conferences; the tertiary audience was practitioners beyond the field of orthopaedic surgery who are still relevant to a surgical practice.
Fellowships represent a critical facet of practice-based education in healthcare. Fellows attend programs for hands-on experience, building of social networks and opportunities to inject new knowledge into their field. Practicing surgeons benefit from fellows as the international reach of the program introduces new knowledge that would otherwise be distant; fellows bring research to the department and offer more opportunities to publish. The hospital benefits by training fellows with highly focused skills that may be lacking in other parts of the world. By graduating great fellows, the hospital exports leading-edge techniques and knowledge representing the department’s relevance within the field.
The department was considered to be of high pedigree; however, its exposure and reach to its intended audiences had dwindled. They had lost touch with their target community. The strategy was for the department to establish a better forward-facing communications strategy that emphasized collaborative practice-based education, social networking, publications and good placement opportunities.
The healthcare industry is exceptionally broad, spanning consumer and business-to-business markets. The region of interest for this project was within the field of paediatric orthopaedic surgery. This area represents a very focused area of the orthopaedic and surgical practice. Its scale and specificity makes it a niche and consequently, highly competitive when it comes to jobs and fellowships. In our case, the competition is considered to be other hospitals and universities offering similar fellowship programs.
These programs are most competitive within the United States and Canada, with some of the most visible competitors utilizing printed collateral, strong web presences and takeaways to acquire prospective fellows. The fellowship brochure is competing against similar design considerations made in many departments of this type. Although there is competition, the domain is relatively small and allows our strategy to remain highly focused.
Development budget: $5,001–$10,000
This project is: Either a retainer relationship nor an in-house on-going monitoring relationship
Production/execution budget: $30,000–$100,000
Source of funding: Client
Our initial research informed the publication from the outset. There was a lot for us to learn and observe before beginning the ideation stage. The design team had a cursory understanding of the department and their needs. Rather than looking to strategies and designs found in healthcare, we observed the competitor landscape and realized an opportunity for a new approach. We looked to photojournalism, documentary media and editorial design for their ability to tell honest and compelling narratives. These fields would inform our new approach.
Because of our limited knowledge of the field and the industry, we formulated a strong research plan that would allow us to learn and inform our direction. Our team knew that the department needed a strong communication strategy. However, we didn’t know the most appropriate strategy, aesthetic direction, distribution models or conventions. We had seven months to complete the first printed annual. It was crucial that the brochure be launched in early September, which is the beginning of the academic year and the fellowship year. We have maintained the September launch date of the brochure and companion website.
Our original intent was to focus on the work at the forefront of research in the field. The publication would show the academic rigor at the research level of the department. Through our interviews and third-party research, however, we learned that fellows were not looking for this type of fellowship; they wanted a different type of rigor, one that was practice-based and hands-on when it came to patients and procedures. This was a great insight for our team, as it pushed us to reframe our focus from a lab to an operating room, from a library to a clinic and from microscopy to arthroscopy. This insight was formulated into our creative direction, which would focus on what life was like within the fellowship program. This concept was considered across the entire content strategy, including the procedures and people in the program and even life in the city of Toronto. This has continued to define the primary thematic of the annual.
We relied on fundamental approaches found in a design-oriented ethnographic process. This involved stakeholder interviews, site visits, content and brand audits and the review of a third-party department audit. We looked at similar publications in the domain of healthcare in North America and found that the vast majority of printed and web communications strategies relied heavily on outdated stock photography. This led us to choose a photojournalistic approach as part of our creative direction. Our photographer spent three weeks collecting imagery and documentation in offices, operating rooms and clinics. In addition our in-depth research revealed that the tools of the profession were an engaging and important aspect of the field. This research informed our direction in two ways, as it revealed the culture of the department and the needs of the fellowship program.
The objectives of this project were to draw in top-tier fellows and refresh the image of the Paediatric Orthopaedic department in order to make it more relevant within the field. The design of an annual brochure with a companion website was the most appropriate solution to fulfill the department’s needs. The brochure gave the department an easily transportable high-quality book to show and send prospective fellows and their institutes. Through a documentary style approach, the brochure content placed an emphasis on the hands-on experiences and lifestyle around the fellowship program. This concept is especially recognizable in our choice to include tools of the field. These objects are unfamiliar to laypeople, but for surgeons, fellows, and residents, they tell a story of their own. By introducing specific tools next to a faculty profile an apprentice can quickly recognize a surgeon’s area of specialization. This motif is found throughout the publication and website. The website brought in organic traffic and offered another source for fellows and colleagues to engage. The web has a more extensive reach than print and has offered the department valuable insights into the content users frequent. As the website is essentially an interactive version of the printed piece it will yield insights that can be used to refine the printed annual.
One of the challenges we encountered during the initial stage of the project was a result of the project scope. The scope was large from the outset as we were starting from nothing. The first year would be the hardest, as we would need to frontload the process with research, creative direction and content creation. An additional challenge was finding a balance between the SickKids brand and this sub-brand that needed to appear aesthetically distinct from SickKids. To meet this challenge, we consulted the client’s marketing and communications team throughout the process.
The department has lauded the design from the outset. They have cited the design as a radical, yet necessary departure from the conventional materials. The project has been a valuable solution to their initial problem and has broadened their scope regarding the role of design in the hospital. Our approach not only addressed the necessary needs of representation but also positioned their department as a leading-edge group within the field of paediatric orthopaedic surgery. Since the launch of the book and website, the department has been getting the fellows that they want.
From the client perspective, this book and website were considered long-term investments. Since the launch of the first book, we have worked closely with the client to define better resource management while adding new value annually. The quantity of printed books has been reduced, and the printing process has changed from full-color to two colors. These valuable reductions allowed more consideration of design and strategy.
This past year we implemented fine-grained analytics to better understand website usage. Our focus was to collect data that would give us a better sense of visitor engagement. From the website’s launch on November 26, 2013 to April 21, 2014, the analytics have shown a high level of visitor engagement across all devices. Overall, the site has seen a total of 896 users, 26,518 page views and an average visit duration of 11 minutes. The bounce rate is a low and steady at 31.98%. The site has a high reuse value, as seen with 371 returning visits. This data demonstrates that the site has excellent user retention and visitor engagement. Although these metrics do not appear to be high, it is important to note the scale of this niche audience as well as our focus on engagement over traffic volume.
The brochure was designed and printed to be precious, something that would find its way onto a bookshelf rather than a recycling bin. Although the long-term value of the publication itself may have kept the book out of the recycling bin, we also considered the paper, and printed on Cougar by Domtar, which features FSC certification, Rainforest Alliance Certification, SFI Certified Sourcing, 10% post-consumer recycled content and is acid-free for archival quality.
This project was represented well within the design community and has won awards for every new instance of the publication. Although the target audience was surgeons in this field, other departments (both local and international) have taken notice and have reached out to request similar strategies. We have seen a noticeable change in the attitude towards design from healthcare practitioners within various fields.
The work we have done for The Hospital for Sick Children has been recognized in the following competitions:
- Canadian Design Regional Awards 2013/2014
Coupe International Design and Image Competition Awards 2013
- 43rd Annual UCDA Design Show 2013
- Applied Arts Design Awards 2013
- CMYK Magazine's Professional Showcase 2013
- 42nd Annual UCDA Design Show 2012
- Canadian Design Regional Awards 2012
“ALSO Collective had an extraordinary ability to understand our brief, take it away and research, design, reiterate and produce stunning works to exceed our expectations of how we could be promoted to distance ourselves from all others in our industry. They respected the existing history and strong branding of the hospital, which was fundamental to our standing, but to push the limits of this association and come up with something entirely new.
"ALSO Collective engaged in a detailed research and design process where they studied the people, environment and society in which we function. They were very adept at extracting from us the very things that made us unique, allowing us to explore and understand ourselves and to be able to then use that information for their design process. They utilized a variety of media from ultra-high quality print brochure, foldout poster to digital media viewable on a variety of platforms. All media interlinked beautifully with each other. We are now into the fourth year of this process, and our publications are developing into an anthology of our surgical division.
"The impact has been extraordinary on a local and international level. Within the hospital, there has been fantastic feedback and request to use our template to explore their own identities. Our brochures, posters and website are widely available internationally. The response has been extraordinary in the medical community with requests for copies of our brochures from Europe, Central America, the USA and beyond.” —Dr. Simon Kelley MBCHB, FRCS
Comments from the Jury
“The design solution is a nice departure from the traditional approaches we often associate with hospital communication design. Paediatric Orthopaedic Surgery is a profound and important subject, and this design program tells the story in a sensitive and impactful way.” —Dana Arnett
“This project displays fantastic graphic design. It’s informative and attractive. It takes information that could be dry and makes it approachable and compelling. It feels modern and has an effective web translation to go along with the print. It’s no surprise that the fellowship program saw a spike in applicants after this project was released.” —Kate Aronowitz
“The project simply demonstrates the fellowship program’s vision. Through approachable mixed media storytelling, it engages potential medical applicants by successfully communicating the hands-on experience they will gain in participation.” —Cameron Campbell
“This one stood out for sharp design, great cause and measured impact.” —Joe Gebbia
“Sick Kids used a communication campaign to reconnect with top-tier medical fellows and it worked. The research process informed the design decisions, which were handled with good taste and an appropriateness that looked outside of the industry for inspiration.” —Jennifer Kinon
“The designers developed a visual language that spoke directly to the target audience—children’s orthopedic surgery interns. The piece compelled these people to apply for the surgery fellowship, transforming a failing program into a vital one.” —Jeremy Mende