Blog: A Service User’s family’s perspective of accessing healthcare in an Irish Hospital

Although, the IMPACCT project defines health literacy as the “The degree to which people are able to access, understand, appraise, and communicate information to engage with the demands of different health contexts to promote and maintain health across the life-course” (Kwan et al., 2006), the importance of healthcare organisations creating health literacy friendly environments to support patients’ health literacy needs cannot be overstated. Recently, this was brought to our attention when a service user’s family recalled their experience of trying to access healthcare in an Irish hospital for a family member.

Service User’s Family’s Perspective

The family, in recounting their experience felt that they had not been listened to by some health professionals they encountered which was a source of great upset. Indeed, they recalled a situation where some healthcare professionals were talking to one another as “if you were not there” and “not listening to you” (Service User’s Family). This experience had a negative impact on the family and they felt that what they had to say was not valued. This situation created a communication barrier for the family and was further exasperated by a lack of health information, procedures not being clearly explained and inconsistencies regarding follow-up appointments. The service user’s family did recall that “the nice doctor tried to explain things” but generally the family found that this was not the “norm”.

Qualities of a Health Literate Healthcare Organization

In order to support service users’ health literacy needs it is essential that health care organizations   create a culture that encourages interpersonal communication between all participants and the perspectives of all participants’ are equally valued (Brach et al., 2012). The seminal work of Brach et al.( 2012 ), “Ten Attributes of health literate healthcare organizations “ also recommends that all staff striving to create a health literacy friendly environment for their service users  need to engage in  communication strategies such as active listening to deliver person-centred care. This is also important for enabling service users to engage in shared decision making which is a core component of delivering person-centred care and supporting patients’ health literacy needs. In addition, healthcare professionals need to facilitate access to health information including clearly explaining health information and providing opportunities for service users to ask questions about their healthcare. Service users cannot engage in shared decision making if such opportunities are not provided by healthcare professionals.

We can do better

Finally, we can do better to support service users’ health literacy needs so that the “norm” is that all healthcare professionals are providing accessible health information and creating supportive healthcare environments to facilitate this. Our IMPACCT project will help to build undergraduate medical and nursing education in health literacy competences in this area and thereby supporting patient -centred communication and shared decision making.

Checklist for Healthcare Professionals

  • Actively listen to your service users and members of their support networks
  • Create a supportive environment that encourages service users’ participation
  • Facilitate accessing health information
  • Avoid inconsistency in health information


Brach C, Keller D, Hernandez LM, Baur C, Parker R, et al. Ten attributesof health literate health care organizations. Discussion paper. Washington,DC: Institute of Medicine, 2012 ( [accessed 05November 2018]).

Kwan B, Frankish J, Rootman I, et al (2006). The development and validation of measures of “health literacy” in different populations. UBC Institute of Health Promotion Research and University of Victoria Community Health Pr