Testing organizational health literacy self-assessment in Belgian and Dutch hospitals

Background

Despite growing interest in Organizational Health Literacy (OHL), its implementation in hospitals remains inconsistent. The OHL-Hospital self-assessment tool was proposed to support organizational change and measurement of OHL practices, yet its applicability in hospitals remains unclear. This is particularly relevant in neighbouring contexts such as Belgium and the Netherlands, where cross-system adaptation is needed to ensure contextual relevance.

Methods

Within the OHL-Hospital self-assessment tool working group context, the Belgian and the Netherlands team piloted the short version with health professionals. To better understand the tool’s acceptability among the hospital staff and professionals, multidisciplinary hospital teams tested it. More specifically, participants tested the survey, commented on its content, and brainstormed implementation challenges. Data were analysed to identify implementation challenges, contextual adaptations, and perceived value for practice. After adapting the tool, the questionnaire was distributed on a larger scale.

Results

Findings show that health professionals’ feedback focused on definitions of key concepts, clarity, and comprehensibility of items and answer categories. While the tool raised awareness and supported reflection on strengths, weaknesses, and opportunities for improvement, it was critiqued on a more pragmatic level. Participants raised issues relating to its form, target audience, and intelligibility. The feedback was similar in both the Netherlands and Belgium. Preliminary results from the questionnaire diffusion show that, despite high completion rates, the tool’s complexity necessitated facilitation and led to variability in interpretation across professional groups.

Conclusions

The OHL-Hos-SF is valuable for guiding OHL improvement, but successful implementation requires clearer definitions, plain language, tailored examples, streamlined routing, and coordination across departments.

Key messages

• Relevance to Health Promoting Hospitals: Strengthening organizational health literacy enhances patient-centered communication, safety, and equitable access—core goals of Health Promoting Hospitals.

• Health Equity Across the Life Course: By reducing comprehension and navigation barriers, organizational health literacy supports fairer health outcomes for people of all ages and backgrounds.