Transforming the Veterans Health Administration into a Health Literate Care Organization

The Veterans Health Administration (VHA), the largest integrated health system in the United States, has made Organizational Health Literacy (OHL) a priority for assessment and improvement.

Beginning in 2021, the VHA assembled a project team that utilized strategies for assessment and improvement. VHA is using the Health Literate Care Model as a foundational framework to operationalize health literacy across the organization. The team developed a 16-question environmental assessment about patient education and health literacy, which was sent to 120 VHA national programs. The team then hosted a planning and visioning session for VHA leaders. In 2022, they created workgroups of national experts and hosted a 2-day symposium and workshop.

The environmental assessment (n = 55 responses) found substantial heterogeneity across programs in the development, dissemination, maintenance, evaluation and delivery of patient education content and materials. The leadership planning session and the symposium and workshop each had over 70 participants. They identified essential activities, including establishing leadership support, workforce preparation, development of national health literacy standards, and measurement. Since beginning this initiative, VHA has made significant strides in implementation of these efforts, initiating a new national program (Patient Centered Learning) and a Community of Practice focused on health literacy.

To create meaningful improvement in OHL, significant planning needs to occur with support from the highest levels of an organization. VHA can serve as an example for incorporating OHL into a large, multi-faceted healthcare organization.