THE PATIENT JOURNEY AS AN ORGANIZATIONAL PROCESS: BARRIERS TO HEALTH LITERACY IN OUTPATIENT CARE

Abstract

Introduction: Health literacy is influenced by individual capabilities and by how organizations structure care processes and respond to users’ needs. Objective: To develop strategic guidelines to strengthen health literacy and improve care processes by integrating barriers, facilitators, and opportunities for improvement identified during the outpatient journey of users with type 2 diabetes mellitus. Method: A single-case study with a mixed-methods approach and an exploratory-descriptive design, using a multiphase structure and sequential data integration. Data were collected through two Likert-type scales, in-depth interviews, and non-participant observation of the patient journey. In the second phase, a workshop with physicians was held to discuss findings and improvement opportunities. Results: A moderate level of health literacy (58.3%) and a high perception of practices related to Diversity, Equity, Inclusion, and Accessibility (DEIA) (83.3%) predominated. The integrated evidence supported four strategic guidelines: journey predictability and transparency; responsiveness to diverse needs; institutionalization of clear communication; and strengthening of support and continuity. Conclusion: Healthcare organizations not only respond to users’ varying levels of health literacy but can also increase or reduce the demands for comprehension, navigation, and decision-making through the design of their processes.