The studies have typically been conducted in individual departments, often by implementing single interventions and without any follow-up [4] and [9]. Furthermore, it is unknown if any of these studies

have ever been translated into praxis on a larger scale. It has been suggested that large-scale effectiveness studies should be conducted to include elements that can improve a sustainable adoption and implementation of the intervention [10] and [11]. Studies that also take the complexity of the clinical praxis into account [12]. Even so, it has not been possible to find any large-scale scientific studies meeting these criteria. Based on the experience of implementing a communication skills training course in four different clinical departments at the hospital and on findings from both efficacy [13] and [14] PCI32765 and effectiveness studies [15] and [16] conducted in two of these departments, we were encouraged to provide the course to the entire hospital [17]. A project plan

that included an estimate of the costs for implementing the communication program was prepared and accepted by the managers of the departments and the hospital. The economic estimate showed that a department would spend 1.6 person-years for each 100 staff participating in the course, and that the total operating expenses would be approximately 2 million Danish kroners, corresponding to 270,000 EUR. The estimate was based on the assumption that NVP-BKM120 clinical trial there will be no decrease in production. In this article we describe the communication program, the implementation, and an initial assessment of the process thus far. The program is implemented at Lillebaelt Hospital, a regional hospital consisting of 18 clinical departments and 10 clinical service departments.

The total number of health professionals is approximately 3000. A steering committee is responsible for monitoring, adjusting, and further development of the program and the course administration is carried out by the hospital administration in close cooperation with the research group. The program includes mandatory and continuous BCKDHA communication skills training to all health professionals employed in the clinical departments and to staff in the clinical service departments, who usually has shorter patient contact (radiology staff, medical laboratory assistants, secretaries, and hospital porters). The communication program consists of the following parts: (1) Courses for health professionals employed in clinical departments. (a) Training of the trainers. The training course is the central part of the program. The training course is based on a communication course founded on Albert Bandura’s theory of social learning [18], and on the description of the specific communication skills referenced to the current evidence [19]. The intervention is comprised of three basic elements.