title: Exploring the role of communications in quality improvement: A case study of the 1000 Lives Campaign in NHS Wales.
abstract: BACKGROUND
  Effective communication is critical to successful large-scale change. Yet, in our experience, communications strategies are not formally incorporated into quality improvement (QI) frameworks. The 1000 Lives Campaign ('Campaign') was a large-scale national QI collaborative that aimed to save an additional 1000 lives and prevent 50 000 episodes of harm in Welsh health care over a 2-year period. We use the Campaign as a case study to describe the development, application, and impact of a communications strategy embedded in a large-scale QI initiative.
  
  
  METHODS
  A comprehensive communications strategy guided communications work during the Campaign. The main aims of the communications strategy were to engage the hearts and minds of frontline National Health Service (NHS) staff in the Campaign and promote their awareness and understanding of specific QI interventions and the wider patient safety agenda. We used qualitative and quantitative measures to monitor communications outputs and assess how the communications strategy influenced awareness and knowledge of frontline NHS staff.
  
  
  RESULTS
  The communications strategy facilitated clear and consistent framing of Campaign messages and allowed dissemination of information related to the range of QI interventions. It reaffirmed the aim and value of the Campaign to frontline staff, thereby promoting sustained engagement with Campaign activities. The communications strategy also built the profile of the Campaign both internally with NHS organizations across Wales and externally with the media, and played a pivotal role in improving awareness and understanding of the patient safety agenda. Ultimately, outcomes from the communications strategy could not be separated from overall Campaign outcomes.
  
  
  CONCLUSIONS
  Systematic and structured communications can support and enhance QI initiatives. From our experience, we developed a 'communications bundle' consisting of six core components. We recommend that communications bundles be incorporated into existing QI methodology, though details should be tailored to the specific context and available resource.
authors: 1000 Lives Improvement, Public Health Wales, Cardiff, UK.
authors: Andrew
authors: A
authors: Cooper
authors: Ko Awatea, Counties Manukau District Health Board, Auckland, New Zealand.
authors: Jonathon
authors: J
authors: Gray
authors: 1000 Lives Improvement, Public Health Wales, Cardiff, UK.
authors: Alan
authors: A
authors: Willson
authors: Public Health Wales, Cardiff, UK.
authors: Chris
authors: C
authors: Lines
authors: Billions Institute, Boston, USA.
authors: Joe
authors: J
authors: McCannon
authors: Waitemata District Health Board, Auckland, New Zealand.
authors: Karina
authors: K
authors: McHardy
keywords: Communications strategy; Evaluation; Patient safety; Quality improvement; Safety culture; Wales