Key Points:

• Good environmental health literacy makes your service easier for consumers to access and improves health outcomes.
• Strong partnerships between health care providers, consumers and carers lead to better health outcomes and improved satisfaction with services.
• There are a lot of tools to help you assess the health literacy of your service and identify what you are doing well and how you might make improvements.

Why is the health literacy of your organisation important?

Good environmental health literacy is a key responsibility of Australian health services. It makes it easier for people to use and benefit from your services, and be healthy and well. Some examples of environmental health literacy include:

• Making sure your buildings are welcoming and easy to navigate
• Providing clear written information that people can act on and that is easy to find
• Involving service users in the design of services and information materials.

Good relationships and strong partnerships between health care providers, consumers and carers lead to better health outcomes and improved satisfaction with services [i].

There are a number of tools and resources that you can use to assess your service’s health literacy environment and make improvements.  These self-assessment tools will help you to measure your services against the best practice model outlined in Ten Attributes of Health Literate Health Care Organisations.  They can help you can find ways to reduce the complexity in your service’s environment and make it easier for consumers to understand your information, to navigate your service, and to work in partnership with your staff[ii].

Health Literacy Self-Assessment Tools

These tools will help highlight any gaps in health literacy practice and identify how your organisation is tracking toward best practice health literacy standards. Most of the tools also help map and document health literacy actions to different Australian quality and accreditation standards.

Health Literacy Northern NSW

Health Literacy Northern NSW is an initiative of the Northern NSW Local Health District. One of the tools they have developed is a Health Literacy Handbook which is a guide to health literacy best practice for your health service.

They have also produced a quick Checklist for Health Literate Organisations that measures features of a health service against the 10 Attributes of a Health Literate Organisation and provides practical strategies to help improve outcomes against the 10 measures.

Gippsland – Victoria

The East Gippsland Primary Care Partnerships have created The Gippsland Guide to becoming a Health Literate Organisation. This Guide provides tools and resources to support your organisation to become more health literate.

The Guide was developed specifically to align with the accreditation standards of Gippsland health services but it provides useful tools and assistance for other heath areas.

It also has a Mini Health Literacy Checklist which is a condensed version of The Gippsland Guide to Becoming a Health Literate Organisation. This condensed version will help highlight opportunities for improvement and identify how your service is tracking toward best practice health literacy standards.

The checklist will also help you to develop a service wide improvement plan.

Make it Easy

HealthWest Partnership and Inner North West Primary Care Partnership in Victoria have produced the Make it Easy handbook to help health care organisations to become more health literate.

The Make it Easy handbook will help you to:

• understand what it means to be a health literate organisation,
• conduct a mini self-assessment of your organisation (16 indicators),
• give you specific ideas for making improvements, and
• direct you to high quality resources.

HeLLO Tas!

The HeLLO Tas! Toolkit was developed by community sector workers for community sector and smaller community health organisations. These organisations are less complex than hospitals and other large institutions that a lot of health literacy materials have been designed for.

The toolkit provides:

• a step-by-step process for doing a self-assessment and developing a Health Literacy Action Plan
• practical tools to help you with these tasks
• links to accreditation standards, resources and further reading material.

You can find more information and tools on the HelloTas! website.

The Agency for HealthCare Research and Quality

AHRQ in the US has developed some survey questions to measure the health literacy of communication between clinicians and patients.  The primary goal of these questions is to capture the patients’ perspective on how well health information is communicated to them by health care professionals. They are useful as  a measure of whether health care professionals have succeeded in reducing the health literacy demands they place on patients and as a quality improvement tool.

Providers can use patients’ responses to the Health Literacy Items to identify factors that may be affecting their scores on the survey’s communication measure and to improve their health literacy practices. For example, based on their survey results, providers could do the following:

• Identify specific topic areas for quality improvement (e.g., communication about test results, medications, and forms).
• Recognize particular behaviours that inhibit effective communication (e.g., talking too fast, using medical jargon).
• Assist in designing a safer, shame-free environment where patients feel comfortable discussing their health care concerns (e.g., showing interest in questions, explaining forms).
• Measure the effect of behaviours that promote effective communication (e.g., confirming understanding through teach-back, using visual aids).

Additional Resources

Assessing the Health Literacy Environment – tools from the Harvard School of Public Health

Internationally recognised resources to help you understand and assess health literacy barriers and develop interventions to address them. The Health Literacy Environment of Hospitals and Health Centres, 2nd Edition (2019) – A guide by Rima Rudd et al from the Harvard T.H. Chan School of Public Health.

References:

[i] Australian Commission on Quality and Safety in Health Care, ‘Health Literacy National Statement | Safety and Quality’, https://www.safetyandquality.gov.au/publications/health-literacy-national-statement/, (Accessed 22 March 2017)

[ii] Australian Commission on Safety and Quality in Health Care 2017 Health Literacy Fact Sheet 1: An introduction to improving health literacy in your organisation at https://www.safetyandquality.gov.au/sites/default/files/2019-05/health-literacy-fact-sheet-1-introduction-to-improving-health-literacy.pdf