Health literacy in perioperative care: toward better shared decision-making through navigation and communication design.

Perioperative care asks patients and their families or caregivers to make decisions and follow important instructions within a short and stressful period. They may need to understand risks and options, follow fasting and medication instructions, move across multiple appointments and care transitions, and manage recovery after discharge while anxious, tired, or in pain. Shared decision-making is increasingly emphasized in perioperative care, but meaningful participation depends on health literacy. In this setting, health literacy includes personal health literacy, navigational health literacy, and organizational health literacy. Limited personal health literacy has been associated with poorer understanding of perioperative information, lower adherence to instructions, and worse perioperative experiences and outcomes. Navigational challenges arise when patients do not know what happens next, who is responsible for each part of care, or whom to contact at different stages of the pathway. Organizational health literacy refers to how well services make information and care easy to find, understand, and use. Practical approaches include plain language, clear role and contact cues, teach-back, and better communication design across transitions. Anesthesiologists should play a central role in improving organizational health literacy to support clearer communication, safer navigation, and better shared decision-making in perioperative care.