Health professionals’ perception of OHL policies and their implementation in Belgian hospitals

Abstract Background Organisational health literacy calls for a focus on the professional and organizational level to address the health literacy (HL) challenge, but the professionals’ role in implementing policies related to HL is not always clear. The aim of this qualitative study was to investigate the health professionals’ perception of HL and on how it can be implemented in the hospital setting. Methods Semi-structured interviews were held to collect information from 24 paramedical and medical professionals in the oncology/hematology department of two Brussels based hospitals. The interviews were structured via a questionnaire based on the Enliven OHL Self-Assessment Resource, CDC's attributes of a health literate organization, and the International Self-Assessment Tool for OHL Responsiveness of Hospitals. Interview data were transcribed and analysed using the Framework analysis method. Results Five themes were identified: patient-centered approaches, professional-centered approaches, policies, language and culture. Participants understood HL in terms of ensuring comprehension through adapting communication by questioning, clarifying and information sharing, often preceded by an assessment of patients’ HL levels based on gender, education, income, or minority group. Professional-centered approaches involved teamwork, collecting information, division of responsibility, and redirection. Policies and protocols specific to HL practices were often considered absent. The language approach involved jargon adaptation, the hospital's language policy and prioritization of the patient's linguistic preference, while culture was often interpreted through aspects of religions and ethnicities. Conclusions The study highlights the recognition of the importance of HL practices by healthcare professionals within hospitals, even if they are not always named as such. A structured approach to implementing OHL would allow for a more comprehensive understanding and impactful application of OHL.