Background
Hospitals can gain valuable insights into their current level of organizational health literacy (OHL) by
using self-assessment tools. OHL self-assessment tools can serve as useful instruments for supporting the planning
and implementation of OHL interventions aimed at promoting health equity and improving patient outcomes.
This explorative study aimed to pilot the International Self-Assessment Tool for Organizational Health Literacy
(Responsiveness) of Hospitals (OHL-Hos) among hospitals across six countries.

Methods
The OHL-Hos, grounded in a comprehensive theoretical framework consisting of eight standards, 21 substandards and 141 indicators, was piloted in seven hospitals: one in Austria, Germany, the Czech Republic, Norway and
Serbia, and two in Italy. In each hospital, the feasibility of using the OHL-Hos was investigated regarding acceptability,
implementation, practicality, and integration, identifying strengths and areas for improvement using descriptive
analyses. The self-assessment process included individual rating of an interdisciplinary and inter-hierarchical
assessment team regarding OHL-Hos indicators from their personal perspectives, followed by a joint assessment to
reach a consensus on different ratings. The process and experiences were documented in semi-structured forms,
while the ratings on the indicators were documented numerically.

Results
All hospitals successfully self-assessed their OHL, identifying strengths and areas for improvement. The
self-assessment process varied slightly among countries. While the tool was considered important but lengthy
and complex, introductory workshops facilitated successful implementation. The self-assessment process raised