Organisational health literacy (OHL) is a relatively new concept and its role in improving population health outcomes is gaining recognition. There are several terms being used in relation to OHL but there is no consensus about the definition of OHL nor agreement on a single approach to its application within health services. This contested space continues to create discussion and debate between health literacy researchers worldwide. Increasingly, health service accreditation standards are moving towards including OHL and so services need to clearly define their roles and responsibilities in this area. Inherent in this is the need to develop and validate quantifiable measures of OHL change. This is not to say it needs a 'one-size-fits-all' approach but rather that terminology needs to be fit for purpose. This paper reviews the literature on OHL, describing and contrasting OHL terminology to assist practitioners seeking OHL information and health services clarifying their roles and responsibilities in this area.

PurposeHealthcare systems are increasing in complexity, and to ensure people can use the system effectively, health organizations are increasingly interested in how to take an organizational health literacy (OHL) approach. OHL is a relatively new concept, and there is little evidence about how to successfully implement organizational health literacy interventions and frameworks. This study, a literature review, aims to explore the operationalization of OHL.Design/methodology/approachA realist literature review, using a systems lens, was undertaken to examine how and why the operationalization of OHL contributed to changes in OHL and why interventions were more effective in some contexts than others. Initial scoping was followed by a formal literature search of Medline, CINAHL plus, Web of Science, Scopus, Embase and PsychINFO for original peer-reviewed publications evaluating OHL interventions until March, 2018.FindingsThe search strategy yielded 174 publications; 17 of these were included in the review. Accreditation, policy drivers, executive leadership and cultures of quality improvement provided the context for effective OHL interventions. The dominant mechanisms influencing implementation of OHL interventions included staff knowledge of OHL, internal health literacy expertise, shared responsibility and a systematic approach to implementation.Research limitations/implicationsThis study outlines what contexts and mechanisms are required to achieve particular outcomes in OHL operationalization. The context in which OHL implementation occurs is critical, as is the sequence of implementation.Originality/valueHealth services seeking to implement OHL need to understand these mechanisms so they can successfully operationalize OHL. This study advances the concept of OHL operationalization by contributing to the theory underpinning successful implementation of OHL.

Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants' change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals' knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable. Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels. This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices. Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues.