Twitter Training Wheels: Hospital Twitter Etiquette for Beginners

flickr: Dottie Mae

So, you’ve finally convinced your CEO and staff that social media is an essential tool for your hospital. Congratulations! … Now what?

We often hear from beginners who are nervous about looking like, well, beginners, when they enter the social media arena. We’re here to help you navigate your first steps of this journey through a series of posts about etiquette for Twitter, Facebook, and YouTube. First up—Twitter: Part One. In this post, I’ll address the basics of getting started. In the next part, I’ll take you a little bit further into the Twitterverse. If you have questions you’d like addressed, please leave them in the comments.

Isn’t Twitter just a bunch of self-absorbed people detailing what they ate for breakfast?

This common misconception from non-tweeters is probably fueled by vague recollections of celebrity Twitter overexposure (tsk tsk, John Mayer and Miley Cyrus).

However, Twitter as used by ordinary citizens and professionals is a different matter. When I explain Twitter to non-tweeting friends, I often explain that it’s 140-character communication at its best. Which means that news, events, inspiration and opinions are condensed into quick nuggets that can be conveyed quickly with links to more detailed information, photos, or video. If your tweets are reaching the right audience at the right time, they’ll click through to learn more or enter the conversation.

How do I know whom to follow and how do I attract followers of my own?

One of the great things about Twitter is that you initially follow a few people who seem invested in your same area of expertise (health news, physicians, patient advocates, etc.) and then your network blossoms as you encounter more and more relevant tweeters. So, don’t worry about following all the right people immediately—your sense for which tweeters are pertinent, interesting, and helpful will develop over time.

I usually read through someone’s tweets before I follow him or her to make sure they really have information I’ll appreciate on an everyday basis. If you follow someone and then discover that his or her tweets aren’t what you’d hoped, just click on his or her handle and choose “Unfollow.” I will often clean out my Twitter stream to ensure I’m only spending time reading tweets that resonate with me.

In terms of who follows you, you don’t have much control over that aspect of Twitter. The most you can do is make sure you’re sharing content that is relevant, while also reaching out to people you’d like in your community. Be patient. Your audience will find you (hashtags can help, we’ll discuss these in part two). If you do happen to acquire a bully follower or spammer, Twitter has tools to deal with him or her.

What are Twitter handles and avatars and how should I choose them?

A Twitter handle is basically your username. It’s how your Twitter community will encounter you, so make sure it’s clear and easily remembered (@hometownhospital rather than @hmtwnhosppa55555).

Your avatar is the photograph that goes along with your handle. Again, choose something easily visible that conveys the professional identity of your hospital. Your logo (if up-to-date) or a photo of your hospital is a good choice, if tweeting generally. If you have a specific physician, nurse or staff member tweeting, he or she should use his or her real name and a friendly headshot.

Uh…what should I Tweet?

Don’t worry, this part’s fun! I recommend beginning with bright spots (“Had a 12-year-old patient go home cancer-free today!”), helpful advice (“Learn more about heart disease prevention here: http:linkhere”), and upcoming events (“Blood drive on May 30th”).

Make sure you stay under 140 characters (though some applications will accept longer tweets, I believe shorter is better). As you get more comfortable with Twitter, you can branch out to joining conversations with other tweeters, starting your own discussions, sharing research and development, and dealing with negative comments (see our free e-book for help with this).

One rule of tweeting is simple: be courteous. You may encounter some biting sarcasm or heated opinions or even blatant misinformation. However, take a few breaths before responding, as you would under any other circumstances. Virtual tone and context can be hard to interpret, so assume the best.

Another thing to remember while tweeting is that you are not a texting 13-year-old. Avoid compressing your thoughts into illegible abbreviations and acronyms (@hometown patient ws ur ER time ok or omg didja hv 2 wait 4ever? lol?). If your thought is too long to tweet, think of an appropriate teaser with a link or split it into more than one readable post.

Another rule of thumb is to always proofread (read it twice!) before sending out a tweet. If you’re not sure of someone’s handle, double-check. Make sure your links really work.

Finally, do not tweet the same thing over and over again. It’s obnoxious and a waste of people’s time. However, you can tweet the same information at different times of day to catch different audiences, but do this very sparingly. You quickly lose authenticity when you appear to automate and repeat yourself.

What are @Mentions?

@Mentions are when another tweeter mentions you in a tweet, or you mention another tweeter in your tweet. You do this by including someone’s handle in your tweet (for example @hometown hospital or @hometownpatient). In the first case, I think of this as a kind of “cc” or shout-out—it can mean that someone wants you, specifically, to be aware of pertinent information (@hometownhospital Our blood drive is May 30th, can you pass along?) or that they’re praising/ribbing/including you (@hometown hospital Grandma only waited 10 minutes in your ER last night! Impressed!).

It works the same way when you mention someone—you’re specifically including him or her in the conversation (@hometownpatient Learn more about our efforts to reduce ER wait time here: http:link). On your Twitter page, mentions also include instances in which you’ve been retweeted (and, depending on your application, favorited).

How do I reply to a mention?

To reply to a mention, choose “Reply” from the tweet options. This will create a tweet-chain others can follow, which is important when they’re only seeing half the conversation in their feed and are wondering what you’re talking about. If you’re on the Twitter website, a small circle with an arrow pointing to the right appears on the right corner of the tweet when you mouse over it. Click on the arrow and it will show you the entire conversation (other applications handle this in different ways). It will also give you the short bios of anyone mentioned in the tweet, in case you want to follow them. This whole tweet-chain system is one of my favorite aspects of Twitter.

What is a direct message?

A direct message is basically Twitter-format e-mail (or instant messaging, if you’re quick!). It is a completely private message between you and the other person. You send a DM by writing “D” (NOT “DM”) before the handle (without the @), like this: “D hometownpatient Glad to hear your ER experience was satisfying. We love feedback from our patients and their families.” This way, no one else is involved in your conversation. This is especially important for healthcare providers who must consider HIPAA.

One DM rule to live by: double-check that you’re actually DMing before you send your response! Like e-mail, a public response that should be private can lead to trouble.

Some people send automated DMs saying a variation of “Thanks for following” when you follow them. We think this is impersonal and should be avoided. If you really are grateful, express your gratitude in an authentic way.

Important note: You may only DM people who are following you. If they are not, but you’re hoping for a private conversation, it’s perfectly acceptable to request that they follow you.

How do I know if I should use a mention or a direct message?

This is an excellent question. It all boils down to privacy. If what you’re saying is appropriate for the public sphere and can benefit (or amuse) other people, feel free to use a mention. However, if the conversation is extensive or should be private, use a DM.

Also, DMs are often avenues for requesting further information in order to continue interactions via traditional e-mail or phone (D hometownpatient Our staff person would be happy to discuss this matter with you. Her number is 555-555-5555). In fact, if you are at all nervous about HIPAA, we encourage you to send a DM suggesting a phone conversation with the tweeter instead. (More about HIPAA and Twitter in my next post.)

What is a retweet and how to I do it?

A retweet is when you find someone else’s information so valuable, you’re compelled to share it. This is one of my favorite things about Twitter. I think of it as creating webs of great material—passing along fascinating links from one community to the next.

In order to retweet, you choose “ReTweet” in your interface. If you’re on the Twitter website, it will automatically retweet it like this (RT @hometown patient Blood drive May 30th, more information here: http://link). Sometimes, however, you may want to add in a comment before you retweet (agreeing, disagreeing, clarifying, etc.). In this case, you will need another Twitter application that allows you to edit before retweeting (I’ll discuss this in my next post). Then, you can add in your two cents (Worthy cause! RT @hometownpatient Blood drive May 30th, more information here: htt://link).

One thing to remember when tweeting is to make your tweets easily retweet-able. If your tweets always use up all 140 characters, they’ll be too long once the RT handle is added in. It’s best to leave room so that all your information is visible when shared.

How do I decide whether to mention or retweet?

Sometimes, it’s hard to decide whether to reply with mentions or simply edit a retweet. A few questions will you help decide what to do in this situation:

1. Is the information in the original tweet necessary, or is it okay to assume people will read your tweet-chain if they’re interested?

2. Do you have enough room to retweet without resorting to deleting a lot of important information or creating illegible abbreviations?

3. Which method will be the most generous and situation-appropriate? Always make choices that fall on the side of building relationships.

What about hashtags, customizing my background, HIPAA, favorites, photos, etc.?

Don’t worry, I’ll address all these subjects in my next post. Stay tuned!


How we help

Hive Strategies helps hospitals engage patients through social media. We don’t manage social media. Instead, we help hospitals develop an effective social media strategy and mentor them through the implementation process. Start a conversation. Email us or call us at 503-472-5512.


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