Disseminating from the centre to the frontline: the diffusion and local ownership of a national health policy through the use of icons

Regulatory bodies continually confront the issue of how to diffuse health policies effectively, particularly those directed at changing frontline clinical practice. Knowing how to disseminate, embed and sustain improvements is a universal challenge. Being able to achieve ownership of policy at a local level, while ensuring a consistent national message, is a further complicating dimension. In this study we sought to answer the question: how can the Australian Commission on Safety and Quality in Health Care (ACSQHC) know the extent to which the National Safety and Quality Health Service (NSQHS) Standards information is disseminated to frontline clinicians? To do so, we conducted a unique study examining the diffusion of the NSQHS Standards, represented visually by icons, across the healthcare system. Using document analysis of two administrative databases, the study identified that by mid-2015 over 440 applications to use the icons had been received from healthcare organisations. Icons are being used for educational and clinical awareness raising purposes in diverse settings within organisations, across all states and territories. The representation of policy in the form of icons has allowed for ease of distribution, uptake, presentation, and recognition. The icons are an effective strategy for both the widespread diffusion and local ownership of a national health policy to those at the frontline of healthcare delivery.