Organizational health literacy in German hospitals and nursing homes: state and perspectives

Background. It is unclear to what extent hospitals and nursing homes in Germany make it easier for people to navigate, understand, and use information and services to take care of their health, that is, demonstrate organizational health literacy (oHL), and which aspects are essential for identifying approaches to promoting oHL. Methods. The basis is formed by three independently conducted research projects: (1) a survey of hospitals (HO) and nursing homes (NH) (EwiKo, 2021), (2) a survey of hospitals (GK-KH, 2022), and (3) a consensus process to reduce a detailed self-assessment tool (SAT-OHL-Hos v1.1; 2024). In (1) and (2), all German hospitals and the 1475 NH in Saxony and Thuringia were included, and the HLHO-10 (range 1 to 7, high values = high oGK) was used. The consensus process was carried out in the WHO network M-POHL with the aim of reducing the 141 indicators by about two-thirds while maintaining the depth and breadth of the concept in three steps: prioritization of indicators at the national level, merging of national votes, consensus in the international working group. Results. Evaluable questionnaires were received from 195 NH, 62 HO, and 291 HO (response rate: 13.2%, 3.2%, and 11%, respectively). The mean values of the 10 HLHO-10 standards ranged from 3.5 to 5.7, with no substantial differences between hospitals and nursing homes. The consensus process led to a reduced instrument of 54 items. Among other things, the discussion addressed the question of what can be expected across countries. Discussion. For the first time, data on oHL in nursing homes are available. The self-assessed oHL of the surveyed institutions is in the medium to good range. The SAT-OHL-Hos V2, now shortened by about one-third, is a "short, detailed" and internationally applicable instrument ready for empirical testing.