The Vienna self-assessment questionnaire, a tool towards more health-literate hospitals ? Three explorative case studies in Belgium

Abstract
Title: The Vienna self-assessment questionnaire for hospitals, feedback from three explorative case studies in Belgium
Background
One way to develop adequate health literacy responsive policy and strategies in hospitals is the use of self-assessment tools to raise awareness, help prioritize action and mobilize stakeholders. In this study we have piloted the French version of the Vienna Health Literate Organisation (V-HLO-fr) tool in three hospitals to explore its feasibility.
This thesis focuses on the ability of health care institutions, such as hospitals, to take into account the level of health literacy of users, i.e. their ability to find, understand, evaluate and use health information. It is based on the observation that the population's level of health literacy is too often insufficient to cope with the sometimes complex demands of health systems. It is motivated by the conviction that this complexity is one of the faces of social exclusion.
Methods
We performed explorative case studies in the three main hospitals of Liège (Belgium). Our mode of application of the V-HLO-fr was inspired by the ‘RAND Appropriateness’ method: first, individual members of an internal multidisciplinary panel filled out the questionnaire and then the results were discussed collectively in each hospital during a ‘round table’ meeting. The feasibility of the process was assessed by direct observation of the round tables and with semi-structured phone interviews
Results
The V-HLO-fr tool was fully applied in the three targeted hospitals and the process seems to be acceptable, practicable and integrable. Its mode of application, formalized by taking inspiration from the RAND method, could be further improved, e.g. by paying more attention to recruiting and supporting participants. Strengths (e.g. the facilitation of patient navigation to the hospital) and weaknesses (e.g. the provision of easy to read, understand and act on health information materials) in terms of health literacy responsiveness have been highlighted.
Conclusions
V-HLO-fr could be a suitable tool to create awareness and formulate targeted actions to further strengthen hospitals health literacy responsiveness.
Main messages:
Those explorative case studies give:
- an overall positive signal about the feasibility of the V-HLO-fr
- useful feedback to further formalize and refine its procedure of application.