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

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; <.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).

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