Objective. The purpose of this study was to investigate the characteristics of the Residential Aged Care Coronial Communique that have promoted previously reported professional practice change, and to explore the circumstances of these changes. Methods. This was an exploratory, qualitative study for which data was collected through semi-structured interview of 15 subscribers to the Residential Aged Care Coronial Communique. Results. The Residential Aged Care Coronial Communique was reported to promote self-reported practice change though the inclusion of case studies, by being associated with the Coroner, and by providing evidence to justify change. The combination of existing concerns about risk and staff awareness, in conjunction with reading the Residential Aged Care Coronial Communique was also reported to promote practice change, as was having the support of senior staff and the authority to implement change. Conclusions. The combination of narrative case studies in the context of an educational publication associated with the Coroner?s Office has been reported to provided evidence and incentive to promote professional practice change in an aged care setting. However the relative influence of the Residential Aged Care Coronial Communique, and other background circumstance and facilitating factors on practice change cannot be determined from this study.