Helping other people to learn from your experience, helps to spread good practice to other areas. The temptation is to move on quickly to the next problem area you’ve identified. However, it is crucial that we start to share our results and how we achieved them.

We would like to encourage you to share your work widely through:

• Posting it on twitter
• Consider publishing it on BMJ Quality and Safety
• Sharing it within your local community

Don’t feel that other people will only be interested in projects that have been successful (although it’s always nice to share success stories!). It will be just as valuable to share information on projects that have not been successful or where things didn’t go quite to plan. This is where keeping a ‘lessons learned’ log as you go through your improvement journey is useful, as it will help you remember the ups and downs of delivery.

This final phase of the journey is often called ‘dissemination’ or ‘diffusion’; have a look at the table below for the difference between the two terms.

  Dissemination Diffusion
Definition Spread of innovation is planned, formal, centralised and occurs through vertical hierarchies Spread of innovation is unplanned, informal, decentralised and largely horizontal or peer-mediated
Methods Wide range of methods: presentation in conferences and seminar, leaflets, peer-reviewed publications, formal dissemination programmes, websites, etc Word of mouth through existing professional and social networks. Use of opinion leaders, champions and boundary spanners can accelerate the diffusion of innovation.
Strengths The message and means of communication used can be tailored depending on the target audience Fewer resources required, as it happens more naturally and organically. Effective if influential key people buy into the idea
Weaknesses It usually attracts early adopters only. Often the initial will of early adopters fades away before any action has been taken. No control of the message and its reach.

Spread can be defined as the process of communicating and sharing new ideas or innovations outside the original system. Take a look at our practical guide on the adoption and spread of innovations and improvements for more information. This process is important because it increases the impact of successful improvement for more patients.

There are two widely-recognised approaches to spread: dissemination and diffusion. It must be noted that these are the two ends of the spectrum and not distinct and independent approaches.

When planning spread, a combination of both approaches is recommended as both can be effective ways of spreading innovations.


The Health Foundation has produced useful resources to help with communication approaches and on writing for publication: