Organizational health literacy – a neglected aspect of integrated care?

Abstract

Issue: Integrated care is predominantly characterized by complex value creation processes, different financing and remuneration concepts and dynamic network practices within the healthcare system. Collaborative interventions in and beyond the healthcare system are further accompanied by rapid digital transformation, quickly renewed knowledge, and a rise in overall health information. At the same time, the majority of healthcare users in Switzerland have difficulties in adequately dealing with health information. As current data show, almost half of the Swiss population have a limited level of health literacy and a corresponding need for support in dealing with health information as well as navigating the healthcare system [1]. However, sufficient health literacy is required – not only on an individual, but even more on an organizational and system level [2]. By enhancing organizational health literacy (OHL), a great step towards the successful implementation of integrated care could be taken: Embedded in dynamic and evolving contexts, healthcare organizations and professionals play a vital role in supporting people to find, understand, critically appraise, and apply health information, and thereby strengthening people’s health literacy [3]. 
 Description of the problem: Despite the latest research on the promising impact of OHL, current debates in the field of integrated care provide insufficient insights into how OHL could promote integrated care transitions and support healthcare organizations to align and integrate patient-pathways. We therefore aimed to elaborate on the role of OHL in integrated care and propose that a health literacy-oriented perspective is needed to ensure that integrated care services support people in making informed and sound decisions regarding their health. 
 Results: A first literature review and evaluation of selected health literacy tools and interventions on an organizational level show a promising potential of an OHL approach to improve integrated care processes and practices. OHL can improve the quality of care by strengthening communication practices between healthcare users and health professionals, promoting service delivery, and enhancing teamwork among health professionals. 
 Lessons: We have learned that practice-oriented and participative health literacy initiatives can provide promising approaches to strengthen both integrated care and collaborative team processes in and beyond healthcare organizations. Thus, in particular health literacy on the organizational level provides a crucial, yet still underestimated aspect of integrated care to co-design care journeys that respond to people’s needs. 
 
 Main message: Health literacy approaches offer valuable insights for work process in the field of integrated care and thus can improve our understanding, conceptualization, and implementation of integrated care in practice. 
 [1] De Gani SM, Jaks R, Bieri U, Kocher JP. Health Literacy Survey Schweiz 2019-2021. Zürich; 2021.
 [2] Farmanova E, Bonneville L, Bouchard L. Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues. Inquiry. 2018;55:46958018757848. doi:10.1177/0046958018757848.
 [3] Stuermer N, Gani SM de, Beese A-S, Giovanoli Evack J, Jaks R, Nicca D. Health Professionals’ Experience with the First Implementation of the Organizational Health Literacy Self-Assessment Tool for Primary Care (OHL Self-AsseT)—A Qualitative Reflexive Thematic Analysis. IJERPH. 2022;19.