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In Chapter 4, we considered the health literacy opportunities and challenges provided by digital communication platforms. While we explored the distinctive health literacy skills described as eHealth literacy, the focus of the chapter was on how we create information access and utility for those seeking health information online—reducing system complexity more than developing individual health literacy skills. This chapter continues in this direction by examining health literacy at an organisational level.
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Most existing national health literacy policies and strategies recognise that the responsiveness of the health system to variations in the health literacy of patients needs to be improved. These make clear that organisational change is required, with the necessary action expressed in different forms, such as “embedding health literacy into systems” and “promoting changes in the healthcare system”. Though most attention has been given to the health system, the strategy to reduce organisational complexity can be applied to other organisations and settings, such as schools.
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In this chapter, we focus on this concept of “organisational health literacy”, identifying relevant models and frameworks as well as examples of current best practice.
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5.2 Characteristics of health-literate organisations
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Healthcare organisations, their frontline health professionals and health services administrators all play a major role in building, promoting and sustaining health literacy for patients and caregivers. Systematically addressing health literacy at an organisational level has the potential to deliver a range of benefits in higher healthcare quality, reduced costs and improved health outcomes.
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“Organisational health literacy” has been defined as “an organisation-wide effort to transform the organisation’s delivery of care and services to make it easier for people to navigate, understand and use information and services to take care of their health” (Brach, 2017).
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Over the past 20 years considerable attention has been given to the translation of the concept of a health-literate organisation into a set of well-defined and measurable attributes. This has been backed by the development of practical tools and, increasingly, by real-world experience with implementation.
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In the US, the Institute of Medicine (IOM) has identified 10 attributes of health-literate organisations, including, for example, leadership that makes health literacy integral to its mission, structure and operations; an engaged and well-trained workforce; co-design; implementation and evaluation of health information and services; and the distribution of print, audio-visual and social media content that is easy to understand and act on. Although this listing of attributes was designed with US healthcare organisations in mind, it has wider applicability to most healthcare organisations. The Australian Commission on Safety and Quality in Health Care (ACSQHC), for example, has used this framework to identify practical actions that health organisations, such as hospitals and clinics, can take as a response to these attributes. Table 5.1 combines information from both sources to provide a comprehensive checklist for use in assessment, action and monitoring ...