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Warum sollten und wie können Krankenhäuser ihre organisationale Gesundheitskompetenz verbessern?

Why should and how can hospitals improve their organizational health literacy?

Zusammenfassung

Unter Gesundheitskompetenz (GK) wird eine spezifische Kompetenz verstanden, die in spätmodernen „Multi-Options-“ -bzw. „Gesundheits-“ Gesellschaften notwendig ist, um die Fülle der anfallenden gesundheitsrelevanten Entscheidungen bzw. Aufgaben zu bewältigen. Das Konzept wurde in den USA zunächst in der Krankenbehandlung verwendet und seine Auswirkungen auf deren Erfolg vor allem bei PatientInnen mit limitierter GK untersucht. Dabei wurde deutlich, dass GK ein relationales bzw. kontextuelles Konzept ist. Das heißt, ob die persönliche GK ausreicht, hängt nicht nur von dieser, sondern auch von den Anforderungen ab, die Organisationen an ihre NutzerInnen stellen. Durch dieses Verständnis von GK wurde es möglich, neben der individuellen GK von Personen auch die Sensibilität für GK von Organisationen, also „organisationale Gesundheitskompetenz“, zu messen und gezielte Maßnahmen zu deren Verbesserung zu ergreifen. Die zehn Merkmale einer Gesundheitskompetenten Krankenbehandlungsorganisation des US-amerikanischen Institute of Medicine stellen einen ersten systematischen Versuch dar, diese Strategie für die Krankenbehandlung zu nutzen, der inzwischen auch auf andere Settings angewandt wird. Die AutorInnen entwickeln diesen Ansatz unter Einbezug von Erfahrungen des Netzwerks Gesundheitsfördernder Krankenhäuser und der Qualitätsbewegung in der Krankenbehandlung weiter zum Wiener Konzept des Gesundheitskompetenten Krankenhauses, das alle Stakeholder und Aufgaben des Krankenhauses berücksichtigt. Ein Selbstbewertungsinstrument wurde entwickelt und getestet als Basis für die gezielte Entwicklung zum Gesundheitskompetenten Krankenhaus. Dadurch können Krankenhäuser in einer „Gesellschaft von Organisationen“ ihren Beitrag zur Förderung der GK als gesamtgesellschaftliche Aufgabe leisten.

Abstract

In late modern “multi-option” and “health” societies, health literacy (HL), understood as a specific competence, is considered necessary to successfully deal with the multitude of health relevant decisions and tasks to be taken every day. The concept has been used in the US, primarily in healthcare, to research the consequences of HL on the outcome of treatment specifically in patients with limited HL. In this context, it became evident that HL has to be understood as a relational or contextual concept. That is, the adequacy of HL does not only depend on personal HL, but equally on the demands organizations put on their users. This understanding of HL opened the road to measure not only individual HL, but also the HL sensitivity of organizations, i.e. organizational HL, and to use targeted measures to improve it. The ten attributes of a health-literate healthcare organization, as defined by the US Institute of Medicine, are a first systematic attempt to use this strategy in healthcare. In the meantime, the strategy has been used in other settings as well. Using experiences from health-promoting hospitals and the quality movement in healthcare, the authors develop this approach further into the comprehensive Vienna concept of the health-literate hospital, which considers all stakeholders and tasks of the hospital which are relevant for HL. A self-assessment tool was developed and tested as a basic instrument for developing a health-literate hospital. By doing so, hospitals are empowered to make a contribution to the promotion of HL as an important societal task.

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Correspondence to Jürgen M. Pelikan.

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J.M. Pelikan und C. Dietscher haben diesen konzeptuellen, nicht auf Daten basierenden Beitrag nach bestem Wissen und Gewissen und orientiert am aktuellsten Stand der Forschung verfasst. Sie geben an, dass kein Interessenskonflikt vorliegt.

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Pelikan, J., Dietscher, C. Warum sollten und wie können Krankenhäuser ihre organisationale Gesundheitskompetenz verbessern?. Bundesgesundheitsbl. 58, 989–995 (2015). https://doi.org/10.1007/s00103-015-2206-6

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  • DOI: https://doi.org/10.1007/s00103-015-2206-6

Schlüsselwörter

  • Gesundheitskompetenz
  • Krankenhaus
  • Krankenbehandlung
  • Gesundheitskompetente Organisation
  • Gesundheitskompetentes Krankenhaus

Keywords

  • Health literacy
  • Hospitals
  • Health care
  • Health-literate organisation
  • Health-literate hospital