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Purpose: Patient empowerment has been variously depicted as a new paradigm inspiring the patient-provider relationship. To the authorsâ\u80\u99 knowledge, scholars have focused most of their attention on patient enablement. Alternatively, the ability of health care organizations to establish a comfortable and co-creating partnership with the patients has been overlooked. In an attempt to fill this gap, the purpose of this paper is to delve into the meaningfulness of health care organizations, embracing the â\u80\u9corganizational health literacyâ\u80\u9d perspective. Design/methodology/approach: In line with the exploratory nature of this research, a multiple case study approach was taken. It concerned three large public hospitals operating within the Italian National Health Service. The meaningfulness of health care organizations was investigated drawing on the organizational health literacy construct. Findings: The health care organizations were unaware of several crucial issues to improve their meaningfulness. Problematic organizational health literacy was found to prevent patient involvement and to negatively affect the quality of interaction between the patients and the health care professionals. Practical implications: Inadequate organizational health literacy impoverishes the ability of health care organizations to empower the patients and to engage them in value co-creation. The institutional purposes of empowering the patients and involving them in the provision of care require tailored interventions intended to improve organizational meaningfulness. Originality/value: This is one of the first attempts to examine the meaningfulness of health care organizations through the lenses of organizational health literacy. Both quality of care and health outcomes are expected to benefit from the enhancement of organizational health literacy

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Parker, Ratzen and Lurie (2003) pointed out that a silent epidemic is affecting the health status of the American population, namely poor health literacy. Actually, inadequate health literacy is the main cause of the patients’ inability to navigate the health care environment, paving the way for inappropriateness in the provision of care as well as for poor health outcomes. Moreover, it has been esteemed that a third of the European population is not able to properly understand, process and use health information (HLS-EU Consortium, 2012). The same issue has been identified in several Asian countries (see, for example, Nakayama et al., 2015; Pednekar, Gupta & Gupta, 2011). What is striking is that—until today—the attention has been focused on the individual determinants of low health literacy, while studies concerning the organizational health literacy—that is to say, the ability of health care organization to establish friendly and comfortable relationships with the patients—are uncommon (Weaver, Wray, Zellin, Gautam & Jupka, 2012). This article is aimed at exploring the way health care organizations deal with patients living with inadequate health literacy. Drawing on the prevailing literature (Brach et al., 2012; DeWalt et al., 2013; Matthews & Sewell, 2002; Murphy-Knoll, 2007; Stableford & Mettger, 2007) the main approaches to improve organizational health literacy are examined. Then, a distinction between formal and informal tools to address organizational health literacy is suggested and the effectiveness of both of them is compared. The findings of the research suggest that informal tools are more common than formal tools, even though the former have lower perceived effectiveness as compared with the latter. Health care organizations seem to be still far from effectively activating comprehensive organizational health literacy pathways. There is a desperate need for systemic efforts to enhance the awareness of organizational health literacy and to encourage processes of change towards health literate organizational environments.