From policy to practice: organizational health literacy in cancer A qualitative focus group
C Jeitani, S Van den BrouckeAbstract
Background
Health systems struggle to translate organizational health literacy (OHL) standards into routine clinical practice, particularly in oncology hospital settings, where high-dependency patient populations are within complex care pathways. This gap reveals structural barriers putting patients at increased risk of inequitable access to and participation in care. OHL is therefore not an abstract concept within systems, but is realized through clinical practice, thereby making healthcare professionals the appropriate unit of analysis.
Methods
A qualitative focus group including 14 health professionals was conducted at the cancer department of the Europe Clinics in Brussels, Belgium. The aim was to examine how OHL practices can be implemented and operationalized in routine care. Data analysis was conducted using reflexive thematic analysis informed by OHL framework structuring. An interpretative and realist approach was adopted.
Results
Findings revealed a systematic misalignment between policies and practice. OHL implementation was said to be constrained by the absence of structural guidance and the accumulation of institutional demands, including digitalization. Implementation discussions shifted to individual-level practices, with OHL framed as an added burden rather than embedded within routine care.
Conclusions
Professionals themselves are having a hard time navigating organizational challenges, and expectations of patient navigation are unrealistic. Strengthening OHL implementation requires investment in capacity building, attention to department variation, and targeted support in system changes.
Key messages
• Organizational health literacy remains unrealised when it is not embedded within institutional structures as well as routine clinical practice.
• Strengthening organizational health literacy implementation requires structural support, including capacity building and alignment between institutional demands and frontline practice.