Assess the health literacy environment of your workplace

Communication and Health Literacy

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It is important to establish health literacy universal precautions in your service.

Most people are not health literate. This affects the safety, efficiency, effectiveness and equity of healthcare and the ability of people to be involved in managing their health.

To establish health literacy universal precautions, first review the current practices and environment within your service to identify ways to improve the experience and outcomes for consumers and identify priorities for improvement.

Assessment tools in this toolkit are available for the following areas:

  1. Policies and protocols
  2. Spoken communication
  3. Written communication
  4. Signage
  5. Reception and Telephone etiquette
  6. Staff training.

Three steps to improve your service's health literacy environment

Step 1: Review the current practices and enviroment

Step 2: Consider the findings and set goals, with those best able to do so, including decision-makers and leaders.

Step 3: Implement changes.

Step 1: Review practices and the current environment

For the review, it is best to involve as many staff as possible (clinical and administrative) and at least one person from each area of your practice.1

This will help engage staff in communication and health literacy and help them see their practice from the consumer point of view. It is also important to include a small number of consumers.

Ask your reviewers to undertake a full walk-through assessment of your service.1 This involves assessing the whole experience from finding and accessing your service all the way through to having health needs met, and completing the relevant assessment tools.

Ask the reviewers to complete the review on their own, then meet to review the results and determine the findings.

The results should give you a good idea about what areas you need to improve. Pay special attention to areas that had questions answered with 'Needs Improvement' or 'Not Doing'.

Step 2: Consider the findings and set goals

Setting goals will support communication and help everyone understand the organisation's communication and health literacy priorities, and what your organisation wants to achieve. Engaging consumers to assist in setting priorities and in the development of health literacy improvements is extremely important.

It will be most effective if leaders and decision makers are involved in this step, and if your goals are SMART: specific, measurable, attainable, relevant and time-based. For example:

  • within the next three months, the service will provide scripts for frequent questions asked over the telephone
  • over the next six months, the service will review all patient education material routinely used and replace material as appropriate to meet the needs of our consumers
  • over the next three months, we will change procedures to routinely offer all consumers help completing our forms.

Step 3: Implement change

Its important to involve as many people as possible in making changes. The best people to lead change may include service managers, educators, senior receptionists, quality improvement staff and facilities management, communications and public relations staff. However, meaningful consumer participation is also a critical part of any change and assists in ensuring change is appropriate and supports improved health literacy.


1. D DeWalt et al., Health Literacy Universal Precautions Toolkit, Publication No. 10-0046-EF, Agency for Healthcare Research and Quality, Rockville, MD, 2014, viewed 21 July 2014, www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/index.html

January 2019