Author: Anthony Suchman & Diane Rawlins

Building Organizational Trust, Moment by Moment, with Awareness and Intention

Posted December 19, 2022

The ABIM Foundation’s Building Trust initiative is bringing attention to the need for greater trust in relationships throughout health care, including trust in organizations. The initiative has created a repository of trust-building examples, all conducted at the meso or macro level of organizations and made possible by some level of organizational sponsorship (whether it be financial support or buy-in from the leadership team).

We would like to call attention to organizational trust-building at the micro level, which can be initiated by anyone, requires no extra resources, and can take place within existing work structures and processes. All that’s required is a bit of awareness, intention, and courage.

Trust building at the micro-level is all about creating culture. Whether we are aware of it or not, we are all creating culture in every moment by the way we treat each other as we do our work. Culture is the aggregate of what happens in all the little moments of every day.

The phrase “whether we are aware of it or not” makes a crucial point. If we are not aware of and intentional about relationships, problematic patterns – and toxic cultures – can arise accidentally. Consider, for example, a scenario in which an honest misunderstanding or a problem that crops up suddenly causes tension and anxiety, resulting in some some harsh words being spoken. Others observe this and out of friendship or loyalty they take sides. Before long, there is a pattern of conflict – us versus them – that draws people into it and keeps itself going, sometimes for years after the initiating event. The fact that no one intended this to happen doesn’t matter; the damage is done. In the absence of active ongoing attention to the quality of relationships, a bad pattern has been established and performance will suffer.

It is extraordinarily rare for a problematic culture to be created deliberately. Almost always it results from neglect – a lack of awareness, a lack of active tending.

Now replay that scenario, this time with an awareness of relational quality and an intention to maintain trust and respect. The harsh words might be toned down or retracted with an apology after a moment’s reflection. The recipient of those words or a bystander, recognizing the underlying anxiety, might offer some empathy to help everyone feel supported and to lower the emotional temperature. With these small actions, delivered intentionally to maintain trust, the group can avoid a long-standing conflict that would likely sap commitment and divert energy from the real work.

We all have the power to be intentional about the kinds of relational patterns we create and our direct contributions to organizational culture. More than that, we can encourage and help others to learn how to do it, too. One step higher, organizations can encourage a culture of trust through recruitment, selection, and onboarding processes that favor emotional intelligence; equitable values and practices; individual and team development programs; meeting practices that encourage inclusivity, psychological safety, reflection and dialog; and meaningful behavioral standards and accountability processes.

Even as these organizational interventions can help us become more heedful and skillful, the ultimate responsibility for culture always remains in our hands. It’s about what we do in every moment. There’s much to gain and no extra work if we can approach each interaction with an awareness of relationships and the intention to create trust.

A substantial early-bird discount is available for registrations received by December 23, 2022.