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. 2021 Nov-Dec;19(6):521-526.
doi: 10.1370/afm.2732.

Where Trust Flourishes: Perceptions of Clinicians Who Trust Their Organizations and Are Trusted by Their Patients

Mark Linzer  1 , Hannah Neprash  2 , Roger Brown  3 , Eric Williams  4 , Crystal Audi  5 , Sara Poplau  5 , Kriti Prasad  2 , Dhruv Khullar  6 ; Healthy Work Place Investigators
Affiliations

Where Trust Flourishes: Perceptions of Clinicians Who Trust Their Organizations and Are Trusted by Their Patients

Mark Linzer et al. Ann Fam Med. 2021 Nov-Dec.

Abstract

Purpose: Trust is an essential component of health care. Clinicians need to trust organizational leaders to provide a safe and effective work environment, and patients need to trust their clinicians to deliver high-quality care while addressing their health care needs. We sought to determine perceived characteristics of clinics by clinicians who trust their organizations and whose patients have trust in them.

Methods: We used baseline data from the Healthy Work Place trial, a randomized trial of interventions to improve work life in 34 Midwest and East Coast primary care clinics, to identify clinic characteristics associated with high clinician and patient trust.

Results: The study included 165 clinicians with 1,132 patients. High trust by clinicians with patients who trusted them was found for 34% of 162 clinicians with sufficient data for modeling. High clinician-high patient trust occurred when clinicians perceived their organizational cultures to have (1) an emphasis on quality (odds ratio [OR] 4.95; 95% CI, 2.02-12.15; P <.001), (2) an emphasis on communication and information (OR 3.21; 95% CI, 1.33-7.78; P = .01), (3) cohesiveness among clinicians (OR 2.29; 95% CI, 1.25-4.20; P = .008), and (4) values alignment between clinicians and leaders (OR 1.86; 95% CI, 1.23-2.81; P = .003).

Conclusion: Addressing organizational culture might improve the trust of clinicians whose patients have high trust in them.

Keywords: communication; organizational culture; quality of health care; trust.

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Figures

Figure 1.
Figure 1.
Proposed conceptual model of work conditions, mediators, and final outcomes. Note: Variables tested in the present study are highlighted in bold below column headings. The primary outcome of the study was consonance of clinician and patient trust.
Figure 2.
Figure 2.
Organizational culture variables and probability of clinicians having high trust in their organization and patients having high trust in their clinician (high-high). Note: Increase in probability of being in high-high quadrant for each percentile increase in organizational culture items.
Figure 2.
Figure 2.
Organizational culture variables and probability of clinicians having high trust in their organization and patients having high trust in their clinician (high-high). Note: Increase in probability of being in high-high quadrant for each percentile increase in organizational culture items.
Figure 2.
Figure 2.
Organizational culture variables and probability of clinicians having high trust in their organization and patients having high trust in their clinician (high-high). Note: Increase in probability of being in high-high quadrant for each percentile increase in organizational culture items.
Figure 2.
Figure 2.
Organizational culture variables and probability of clinicians having high trust in their organization and patients having high trust in their clinician (high-high). Note: Increase in probability of being in high-high quadrant for each percentile increase in organizational culture items.
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