Ten attributes of a health literate healthcare organisation

Communication and Health Literacy

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A health literate organisation

Example of actions that can be taken


Has leadership that makes health literacy integral to its mission, structure and operations.

Assign responsibility to an individual or group for actions to improve the health literacy environment.

Design the physical environment to support effective communication and navigation.

Make clear and effective communication a priority across all levels of the organisation and all communication channels.


Integrates health literacy into planning, evaluation, patient safety and quality improvement.

Audit the health literacy environment in the annual audit program of the healthcare organisation.

Ensure safety and quality and other improvement initiatives reflect health literacy principles and are evaluated to ensure they improve the health literacy environment.

Align a focus on health literacy with other organisational priorities reducing health disparities and providing patient-centred care.


Prepares the workforce to be health literate and monitors progress.

Incorporate health literacy into orientation sessions and other training.

Provide training to administrative and reception staff.


Includes populations served by the organisation in the design, implementation and evaluation of health information and services.

Involve consumers in governance processes

Collaborate with members of the target community in the design and testing of interventions.


Meets the needs of populations with a range of health literacy skills while avoiding stigmatisation.

Adopt an approach to health literacy that does not make assumptions about levels of individual health literacy (a 'universal precautions' approach).

Provide alternatives to written information where possible, and create an environment that does not impose high literacy demands (such as walls and bulletin boards that are not covered with a lot of print information)


Uses health literacy strategies in interpersonal communication, and confirms understanding at all points of contact

Foster a culture that emphasises verification of understanding of every communication (clinical and non-clinical).

Plan for and provide language assistance where needed, and treat communication failures as patient safety issues.


Provides easy access to health information and services and navigation assistance.

Design healthcare facilities with features that help people find their way.

Use easily-understood language and symbols on signs.

Ensure information about local resources and services can be understood by consumers with low literacy levels.


Designs and distributes print, audio-visual and social media content that is easy to understand and act on.

Stock high-quality educational materials appropriate for consumers with low health literacy.

Choose materials that reflect health literacy principles.

Test consumer information publications with the target audience as part of the development process.


Addresses health literacy in high-risk situations, including care transitions and communications about medicines.

Identify high-risk situations and make plans to ensure safe communication in areas such as clinical handover, use of medicines, informed consent and end-of-life care.


Communicates clearly what health plans cover and what individuals will have to pay for services.

Provide easy-to-understand descriptions of health insurance policies and communicate the out-of-pocket costs for healthcare services before they are delivered.


The 10 attributes of a health literate healthcare organisation are sourced from C Brach, D Keller, L Hernandez, C Baur, R Parker, B Dreyer et al. Ten attributes of health literate health care organizations. Institute of Medicine, Washington DC, 2012, viewed 22 July 2014,

January 2019