Communication gaps can be devastating for any business in today's competitive and fast paced environment. In the hospital setting it can literally be a matter of life or death. The purpose of the project was to develop and evaluate the effect of three evidence-based internal communication practices on employee engagement for pediatric hospital in Louisville KY. This was the first known systematic investigation of communication strategies in a hospital setting. The evidence based practices include: Interactive Employee Forums Wednesday Weekly newsletter and a Communication Portal page. After one year of this practice change the following questions were asked and evaluated: Will internal communication practices have a significant impact on this hospital employee engagement? As compared to peer institutions within this multi-hospital organization will this pediatric hospital have a greater increase in mean engagement scores as a result of these practices? The result were not statistically significant however some ceiling effect was observed. The pediatric hospital did increase percentage of engaged by 3% the highest improvement of all five hospitals within the system.