Objective: Current research indicates that ineffective communication among health care professionals is one of the leading causes of medical errors and patient harm. The purpose of this study is to develop, implement, and evaluate a comprehensive team communication strategy, resulting in a toolkit that can be generalized to other settings of care. The specific aims include implementation of a standardized communication tool (SBAR); implementation of an escalation process tool to facilitate timely communication; daily multidisciplinary patient centered rounds using a daily goals sheet; and team huddles each shift. Sample: The setting for this study is the 398-bed hospital of Denver Health, an integrated urban safety-net system. Pilot units include one medical intensive care unit (MICU) and one acute care unit (ACU) for phase I of the study, and inpatient behavioral health units included for phase II. Method: Utilizing a pretest – posttest, repeated measures design this study involves data collection and analysis over a period of 24 months from July 2005 through June 2007. Pre-intervention data collection includes: the Hospital Survey on Patient Safety Culture, process analysis of discrete communication events between nurses and providers, and analysis of Patient Safety Net occurrences with specific focus on the contributing factors. Phase I pre-intervention data collection is complete, implementation of team communication techniques on the phase I units and phase II pre-intervention data collection is currently ongoing. Results: Phase I baseline data collection on MICU and ACU reveals significant findings among the sample population of care providers. Analysis of Patient Safety Net occurrences reveals 20.6% of all events are related to team factors and 84.4% of team factors are related to communication, which indicates Denver Health is consistent with national research on communication as a key factor in patient safety events. Our analysis of 247 discrete communication events on MICU and ACU identified patterns in the process of communication between healthcare providers, including: common communication types; common RN activities; common physician responses; and mean amount of time spent communicating. The Hospital Survey on Patient Safety Culture results revealed opportunities for improvement in 9 out of 12 dimensions in the MICU and 12 out of 12 dimensions in the ACU. Conclusions: The results of our pre-intervention data support the implementation of communication strategies to improve communication between healthcare providers and ultimately improve patient safety in the hospital. Following education of the staff and implementation of the communication strategies, the expected outcomes include: decreased communication failures among healthcare team members as a contributing factor in patient safety occurrences, decreased time to treatment for non-emergent patient care situations that require consultation between physicians and nurses, and improvement in a culture of patient safety through more effective team communication. Implications: The ultimate goal of this multi-year study is to develop and disseminate the communication techniques and findings of the study in the form of a generalizable toolkit for use in various hospital and healthcare settings. Strategies for enhanced teamwork and effective communication can be implemented across settings to improve patient safety.