Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN
University of Minnesota, Minneapolis, MN.
Ann Fam Med. 2021 Nov-Dec;19(6):521-526. doi: 10.1370/afm.2732.
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.
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.
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; <.001), (2) an emphasis on communication and information (OR 3.21; 95% CI, 1.33-7.78; = .01), (3) cohesiveness among clinicians (OR 2.29; 95% CI, 1.25-4.20; = .008), and (4) values alignment between clinicians and leaders (OR 1.86; 95% CI, 1.23-2.81; = .003).
Addressing organizational culture might improve the trust of clinicians whose patients have high trust in them.
信任是医疗保健的重要组成部分。临床医生需要信任组织领导者能够提供安全有效的工作环境，而患者则需要信任他们的临床医生能够在满足其医疗保健需求的同时提供高质量的护理。我们旨在确定信任组织且其患者信任他们的临床医生所感知到的诊所特征。
我们使用健康工作场所试验的基线数据，这是一项在中西部和东海岸 34 家初级保健诊所中进行的干预措施以改善工作生活的随机试验，以确定与高临床医生和患者信任相关的诊所特征。
该研究纳入了 165 名临床医生和 1132 名患者。在具有足够建模数据的 162 名临床医生中，有 34%的临床医生及其信任他们的患者表现出高度信任。当临床医生认为其组织文化具有以下特征时，会出现高临床医生-高患者信任：（1）强调质量（优势比 [OR] 4.95；95%置信区间，2.02-12.15；<.001），（2）强调沟通和信息（OR 3.21；95%置信区间，1.33-7.78；=.01），（3）临床医生之间的凝聚力（OR 2.29；95%置信区间，1.25-4.20；=.008），以及（4）临床医生和领导者之间的价值观一致性（OR 1.86；95%置信区间，1.23-2.81；=.003）。
解决组织文化问题可能会提高其患者对其信任度较高的临床医生的信任。
