Becoming a health literate organization: Formative research results from healthcare organizations providing care for undeserved communities

Abstract

Background Integrating health literacy into primary care institutional policy and practice is critical to effective, patient centered health care. While attributes of health literate organizations have been proposed, approaches for strengthening them in healthcare systems with limited resources have not been fully detailed. Methods We conducted key informant interviews with individuals from 11 low resourced health care organizations serving uninsured, underinsured, and government-insured patients across Missouri. The qualitative inquiry explored concepts of impetus to transform, leadership commitment, engaging staff, alignment to organization wide goals, and integration of health literacy with current practices. Findings Several health care organizations reported carrying out health literacy related activities including implementing patient portals, selecting easy to read patient materials, offering community education and outreach programs, and improving discharge and medication distribution processes. The need for change presented itself through data or anecdotal staff experience. For any change to be undertaken, administrators and medical directors had to be supportive; most often a champion facilitated these changes in the organization. Staff and providers were often resistant to change and worried they would be saddled with additional work. Lack of time and funding were the most common barriers reported for integration and sustainability. To overcome these barriers, managers supported changes by working one on one with staff, seeking external funding, utilizing existing resources, planning for stepwise implementation, including members from all staff levels and clear communication. Conclusion Even though barriers exist, resource scarce clinical settings can successfully plan, implement, and sustain organizational changes to support health literacy.

A Scoping Review on How to Make Hospitals Health Literate Healthcare Organizations

“…However, only three studies [40,80,98] reported "costs" as an outcome. Health organizations need resources and strategies to save staff time and costs [128]. It would be desirable to justify health literate interventions by linking them to saving staff time or reducing costs to convince more health organizations (including business-driven health organizations) to transform themselves to meet health literacy goals.…”

What if things go wrong in co-producing health services? Exploring the implementation problems of health care co-production

“…In spite of these considerations, scholars and practitioners are used to deal with individual and organizational health literacy as unrelated issues (French & Hernandez, 2013), neglecting the interdependencies which exist among them (Rikard & McKinney, 2017). From this point of view, it is not surprising that little is known about the overall impacts of inadequate health literacy on both health services' quality and health outcomes (Adsul et al, 2017). In fact, the evidence supporting the effectiveness of the interventions intended to improve individual health literacy may be considered to be unreliable, since the role played by organizational health literacy in promoting patient involvement and in fostering the health care professionals' willingness to perform as enablers of the patients' sleeping resources is generally overlooked.…”

Organizational Health Literacy in Facilities for People with Disabilities: First Results of an Explorative Qualitative and Quantitative Study

“…The main aim of OHL is to establish the promotion of HL in all structures and processes within organizations [18,23]. Improving OHL is likely to enable health care organizations to be adapted to the needs of patients [17], to strengthen patient satisfaction [24], to improve the quality of care [25], and to provide equal access to health care tailored to the capacities and competences of the general population [26]. By doing so, not only can certain groups of people (e.g., those with limited HL) benefit from OHL measures, but all stakeholders in a particular setting [27].…”

“…Guides of health-literate organizations differ greatly in their scope and context of application [33]. Particularly in English-speaking countries, there are numerous guides available to strengthen OHL [23,25,29,32]. It seems that guides on organizational health promotion are mainly located in health care organizations (i.e., hospitals) [18,21,27].…”

“…In particular, interventions are recommended that make it easier, for example, for clients as well as other stakeholders, to access and find their way to and through the organization. Previous studies unanimously emphasized formal and, above all, organizational or organizationally anchored measures focusing on the living and working settings of staff members, while clients are particularly effective in establishing and strengthening OHL [5,17,23,25,40]. Those interventions include, for example, formal or organizational measures integrating OHL in all planning processes (e.g., new departments in the organization, organizational events), the provision of financial and human resources [33], and interventions tailored to the organization, such as the introduction of a structured feedback culture or a barrier-free guidance system [18].…”