Engaging and sustaining patient and community relationships in health care and health systems can prove challenging, but when health care is practiced in a culturally responsive manner, results can be both rewarding and beneficial to patients and clinicians alike. By utilizing a predetermined safe space for discussions and personal sharing, patients and relevant stakeholders (including front line staff and clinicians) are better able to capitalize on opportunities to listen and learn from one another.

Working together to develop and set terms of engagement can help frame how these discussions can move forward in an inclusive way – where all parties participate in a trust-building decision-making activity.

To facilitate such an activity:

  • Discussion participants should determine ‘why’ a change is needed and ‘who’ should be invited to the trust-building decision table.
  • Participants should discuss potential barriers to building trust in your health care setting using models where a person-centered balanced approach is taken, not a traditional hierarchal one.
  • The room must have appropriate representation. Discussion participants should include historically under-resourced and diverse community members who can provide productive insights so all participants can benefit and learn something new.
  • When reflecting on your organization or clinic and determining how to address equity and inequities, review internal anti-racism policies and brainstorm how to build trust within your care system. This is the time to reach out to your local community and invite community members as partners to create a care delivery model that works for them and for you.

Sacrifices will be made, and barriers will be dismantled, while paving relationships and determining together what trust in health care can be. Trust will likely be defined differently by each participant during your inclusive engagement activity. Make the time, be open for frank discussions, and open your heart to build trust and respect with each other. We are only humans after all.


Janice Tufte resides in Seattle and is a patient collaborator involved with health systems research, evidence production, clinical practice quality improvement and human readable digital informed knowledge generation. She recently co-authored a paper currently under review with the Journal of Health Design that discusses the importance of collectively designing research and is working with AcademyHealth’s Paradigm Project in developing a new research protoype.  Learn more about Janice at www.janicetufte.com.