Communication strategies in acute health care: evaluation within the context of infection prevention and control R. Edwards a , N. Sevdalis b , C. Vincent b , A. Holmes a, b, * a Department of Infectious Diseases, and Centre for Infection Prevention and Management, Imperial College London and Imperial Healthcare NHS Trust, London, UK b Department of Surgery and Cancer, and Centre for Patient Safety and Service Quality, Imperial College London, London, UK A RT IC L E I N F O Article history: Received 1 October 2011 Accepted 21 May 2012 Available online 17 July 2012 Keywords: Communication Infection prevention and control Behaviour Behaviour change Training S U M M A RY Background: Communication in healthcare settings has recently received significant attention in the literature. However, there continues to be a large gap in current under- standing of the effectiveness of different communication channels used in acute healthcare settings, particularly in the context of infection prevention and control (IPC). Aim: To explore and evaluate the main communication channels used within hospitals to communicate with healthcare workers (HCWs) and to propose practical recommendations. Methods: Critical review of the main communication channels used within acute health care to communicate information to HCWs, and analysis of their impact on practice. Findings: The analysis covers verbal communications, standardization via guidelines, education and training, electronic communications and marketing strategies. Traditional communication channels have not been successful in changing and sustaining best practice in IPC, but newer approaches (electronic messages and marketing) also have pitfalls. Conclusion: A few simple recommendations are made in relation to the development, implementation and evaluation of communications to HCWs; top-down vs bottom-up communications; and the involvement of HCWs, particularly ward personnel. ª 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. Introduction Communication and the channels through which it occurs within hospital settings are critical for effective clinical care. However, there continues to be a large gap in current under- standing of the effectiveness of different communication channels used in acute healthcare settings. From the perspective of infection prevention and control (IPC), there is often a need to disseminate information rapidly to healthcare workers (HCWs), particularly in instances of infection outbreaks, epidemics, and national or local emergencies. It is therefore necessary to identify which communication channels are (most) effective. Systematic mapping and analysis of communication processes in health care have highlighted both the complexity and fragility of communication channels in acute care envi- ronments, and demonstrated that the communication process is prone to error. 1e5 At present, throughout developed healthcare systems, substantial funding goes in to developing and disseminating a range of communications throughout hospitals (Table I). Unfortunately, these communications are often undertaken without consideration of the appropriateness * Corresponding author. Address: Centre for Infection Prevention and Management, Imperial College London, 2nd Floor, Hammersmith House, Du Cane Road, London W12 0HS, UK. Tel.: þ44 (0) 203 31 33251; fax: þ44 (0) 208 38 33235. E-mail address: alison.holmes@imperial.ac.uk (A. Holmes). Available online at www.sciencedirect.com Journal of Hospital Infection journal homepage: www.elsevierhealth.com/journals/jhin 0195-6701/$ e see front matter ª 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jhin.2012.05.016 Journal of Hospital Infection 82 (2012) 25e29