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Mar 12, 2013
Case Study

Email Marketing: Health care system rebuilds program for small list, sees 700% clickthrough rate increase

SUMMARY: Small email lists usually translate to small staffs and a small budget, which can make it difficult to properly assess and overcome email program shortcomings.

Unity Health System has a modest list from which to recruit nursing students to join its staff. See how it re-evaluated its overall message to make each name count and improved clickthrough rates by 700% and open rates by 23%.
by Courtney Eckerle, Reporter


Unity Health's small list of around 125 names is generated mostly from job fairs, where nursing students will sign up to receive information from them.

"We were trying to build a steady supply of graduate nurses that we could bring in each year that we could hire. So we wanted to make the juniors aware of us and then get the seniors to apply," said Jeri Dube, Communications Partner, Unity Health System.

"We went from nothing to doing this on a pretty regular basis," she said.

The program had gone from no emails to sending four a year — twice in the fall and twice in the spring. On top of that, the emails were differentiated based on graduation dates.

"This whole cycle that we brought [students] into was: [Students] came in as a first-semester junior and then got different emails as [they] progressed to become a graduating senior, and so it was really complicated," Dube said.

Dube came to the conclusion the program needed to be simplified to fit the small list, and the message be changed to reflect the evolved objectives of Unity Health and encourage more engagement. To do this, she decided to only produce two emails a year — one in fall and one in spring, with the same email going out to all students, regardless of graduation time.

Putting together and improving an email campaign on a small list and budget can be difficult Dube said, and requires a lot of work and innovation on one marketer.

Having to write, and compile the video in this email campaign herself, Dube said she reached out to the person who is in consistent contact with her audience, the recruiter who speaks with nursing students for Unity at job fairs. This helps her get an outside and informed perspective without having multiple people working on the emails.


To change the emails sent out to their small list of nursing students for the fall of 2012, Dube needed to rework the HTML campaign to reflect the evolving needs of Unity Health.

Aside from cutting down the emails sent, Dube implemented design and message changes that would elicit better engagement overall from their fairly unresponsive audience.

Step #1. Consistently evaluate email program needs

Dube said as the needs of the health system changed, it became clear to her the email program needed to reflect those needs, and simplify in the process. Sending different emails to students in different stages of nursing school was no longer necessary or practical.

"It was actually very clever and smart, but as the needs have changed … there was no need to push the seniors in a way that was very different from the juniors. So the message was O.K. to merge and make it more of an awareness message," she said.

"It sounds like I was just lazy, but it wasn't," Dube joked.

Instead of creating the four different emails, she consolidated the process so there was only one email going out each fall and spring.

"Whether you are junior or senior, whatever you are … this is what you are going to get," she said.

The first problem evaluated in making other changes was "the open rate was O.K.," but the clickthrough rate wasn't nearly what they wanted to see, and getting it to where it needed to be became a priority.

Step #2. Limit the number of calls to action

The first effort in improving the clickthrough rate, according to Dube, was assessing the amount of call-to-actions in the email.

Looking at the emails Unity Health sent out previously, Dube noted while the open rates were what she categorized as "decent," ranging from 12% to 20%, "in terms of clickthrough … it was like, 'This is appalling, nobody is even looking at it.'"

Losing people after opening was a frustration for her, and it became clear re-working the emails was a necessity.

In order to figure out what was going wrong with the emails, she had to put herself in the mindset of the student nurses reading it.

"It didn't hit me at first that I should reduce the number of options or calls to action until I started thinking about what should they be, and until I felt how complicated it was even to think about it," she said.

Dube said previous emails included up to four calls to action, including:
  • "Explore a variety of clinical and non-clinical positions at Unity right now!"

  • Recommended reading

  • Progress to Unity's website

Realizing there were too many call-to-actions showed an immediate place for Dube to improve upon the existing clickthrough rate.

"So, there were four calls-to-action … when we realized our needs are different, I just simplified and went to one call-to-action which was, 'Click on this video,'" she said.

Step #3. Re-evaluate the message

Dube said along with changing the message to reflect the needs of Unity Health, it became obvious the message needed to change in order to get, and keep, their audience’s attention.

The message change was two-fold.

"Part of it was a situation change. So, we weren't so intent on getting them to do something with us, the message became more about awareness in general," Dube said.

The second aspect was to build a relationship with the nursing students on the list, and, "I didn't feel like that was happening … pardon the use of the term, it was so clinical what we were doing," she said.

Dube said she wanted the emails to not simply be thought of as a place to apply for a job, but "they could think of Unity as an organization that they could eventually trust, and I also wanted to engage them with humor and playfulness … show that we were empathetic to them."

Focus on the subscriber, not the company

The previous emails took a more serious tone, Dube said. The previous headline was, "Ready for a career in nursing? Get ready to call Unity," according to Dube, which was too focused on Unity, and not the subscriber.

Also, she said, "It's not as empathetic or genuine. This is about the skills, knowledge and attitude that will make a difference in patient's lives every day. The path you have chosen will be rewarding, and [Unity] can help you get started."

Part of implementing empathy into the email was recognizing that, "Hey, we know it's hard being in nursing school, it's stressful and there is a lot going on," she said.

The subject line, "Time for a study break, your future is calling" went along with the change in message Dube was enacting.

"I changed the whole tone of it and I think I made it a little bit more fun," she said.

Dube said she wanted to hit on the difficult parts of being a nursing student in order to guide students into remembering "why [they are] doing this, and I also wanted [the email] to be very relevant, and very soft-touch kind of advice."

Design the email to be consistent with the message

Dube said going along with the message shift, she changed the colors from plain blue to incorporate orange and purple. Still in the brand color spectrum, but it helped lend an air of fun and creativity to the emails.

Click here to see the updated email send.

"Before you know it, you’ll be out in the world — living the dream you're working so hard to achieve. But do you really know what makes a job your dream? We invite you to take a short break from studying to find out."

"We really tried to hit something … to really fit in their shoes, and think about myself in college, when I was thinking about the real world," Dube said.

In the spirit of that, the email then asks the reader to view a video to meet Emily, a nurse who "started working for Unity a little over a year ago right out of nursing school. She's been where you are. Her past is your present. And her present could be your future."

Dube said she really wanted the students reading the email to relate to Emily, and "try to let them see themselves as her."

On such a small budget, the video, which is both uploaded onto YouTube and embedded in the email is "very, very YouTube-y," Dube said. "There is no production value at all, and you have this little hand held camera that's really tiny and at that point I didn’t have a tripod … So it's very shaky."

On a low budget, the lower quality of the video didn't bother Dube, and she doesn't believe it bothers the students receiving the emails, either.

"It doesn’t need to have that production quality, because my subject was just so compelling and they just needed to listen to her, because she was just like telling it like it is … she was very genuine," she said.


"Simplify and empathize … I think those are the two big things," Dube concluded about the campaign.

Dube is currently working on the email going out in the spring, and she is trying a different angle on the same message, away from the nurse that was very close to the age of the nursing students, choosing this time to focus on someone they can view as a potential mentor.

"[This email will feature]somebody that they will probably work closely with, and this woman is a mentor to a lot of the new nurses that come in, and also to existing nurses," Dube said.

With the changes enacted for the fall 2012 email, Dube was able to meet her goal of engaging more effectively with clickthrough rates increasing by 700%, and open rates by 23% overall.

Spring 2012Previous version of email sent to nursing students (three different emails sent based on graduation dates) 178 total recipients

Graduating seniors - 132 recipients
39 opens
1 click

First semester juniors - 41 recipients
12 opens
1 click

Second semester juniors - 5 recipients
3 opens
1 click

Fall 2012Current email, 124 total recipients
Seniors - 98 recipients
36 opens
14 clicks

Juniors - 26 recipients
10 opens
7 clicks

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Creative Samples

  1. Original Unity Health Email (Juniors)

  2. Original Unity Health Email (Seniors)

  3. Updated Unity Health Email


Unity Health

Netcentix – Unity Health’s ESP vendor

Related Resources

Download a free excerpt of the MarketingSherpa 2012 Email Benchmark Report

Email Design How-to: 5 insights to improve open and clickthrough rates

Email Marketing How-to: Overcome 3 common errors to increase clickthrough

Email Marketing: 17.36% higher average clickthrough rate in 7 personalized subject line tests

SMB Marketing in 2013: 68% of small businesses to increase marketing budget

See Also:

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