Weaving Health Literacy Strategies Throughout the Fabric of Healthcare Organizations

Introduction

This chapter will describe how the integration of health literacy strategies is essential to the provision of safe and equitable care for all patients. Only 12% of American adults have achieved the health literacy skills needed to understand health information and adequately access or navigate the complex health care system (Kutner, Greenberg, Jin & Paulson, 2003). Limited health literacy is also a concern for the general population in European countries where approximately one third of the population exhibits similar limited health literacy skills (HLS-EU Consortium, 2012). Previously, limited health literacy had been mostly attributed to an individual users skill, however recently there has been an increasing appreciation of the contributory role that health care providers and organizations have in enhancing an individual’s health literacy. Even when looking at the evolving health literacy landscape, many have focused primarily on the health care professional’s role as an effective communicator to patients. The significant contributions that health care organizations can have in enhancing a patients’ ability to understand health information and improve their ability to navigate the complex health system have not been included (Annarumma & Palumbo, 2016). Weaving health literacy strategies throughout the fabric of all heath care organizations will enhance alignment of complex organizational demands with the skills and support needed for all individuals accessing health care. Ultimately, this will foster and promote the provision of equitable health care for all (Logan et al., 2015).

This chapter explores knowledge and skills that will enhance the reader’s ability to:

• 1.

  Understand the significance of integrating health literacy into a health care organization’s mission, operations and quality initiatives;

• 2.

  Understand the importance of health literacy relative to person-centered care, patient safety, engagement and activation;

• 3.

  Define organizational health literacy strategies that will lessen the burden for individuals accessing health care and lastly;

• 4.

  Discuss the need to include patients and community members in health literacy efforts that meet the needs of all populations being served.

Background

While the concept of health literacy was introduced several decades ago, the definition has continued to evolve (Berkman, Davis, & McCormack, 2010). Early definitions focused primarily on ability of individuals to apply reading and mathematical skills in a health care context (AMA Ad Hoc Committee, 1999) such as the constellation of skills required to function in the health care environment. This includes for example, the ability to read and comprehend medication bottles or appointment slips. A second early definition that focused on an individual’s skills, originally developed by Ratzan and Parker (2000) and later used by the Institute of Medicine, is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (IOM, 2004).

More recently, health literacy has been viewed as being multi-dimensional and dependant upon individual and system factors, including communication skills and knowledge of laypersons and professionals, along with the culture and demands of health care situations and systems (Pleasant et al., 2016).