Background: Health literacy involves individual health literacy and the health literacy environment. The health literacy environment is the infrastructure, policies, processes, material, people and relationships that make up the health system. It has an impact on the ways which people access, understand and apply health related information services¹ .
Aim: To review the Prince of Wales Hospital (POWH) Diabetes Centre (DC) health literacy organisational environment, in order to improve diabetes health outcomes and access to the DC.
Method: The multidiscipline Diabetes team, Diversity Health Coordinator and Consumer Health Information and Education  Resource (CHIER) buddies conducted an environmental audit in January 2015. The environmental audit involved reviewing accessibility to the DC, way finding, reviewing information provided to clients (e.g. appointment cards, information letters, telephone and sms messages) and information and education materials provided in patient waiting areas.
Findings: As a result of the audit the written material and education resources are being reviewed and redeveloped to use plain English, be direct and positive and to follow the POWH CHIER guidelines. After consultation with patients the centre signage of how to orientate around the centre is being replaced. The centre has been de-cluttered of out of date posters, pamphlets and information. The amount of information on walls and notice boards has been reduced. The centre now ensures all non-patient relation information is in staff-only areas. Office spaces have also been de-cluttered and rearranged to assist with patient access. Conclusion: The audit of the DC environment has commenced to embed health literacy into the DC culture. The feedback from patients has been positive. This has been a useful start point for building a health literacy friendly organisation. Future initiatives will build on this by exploring the role of health literacy within the clinical encounter.