Author: Building Trust

On March 25, 2022, former Vanderbilt University Medical Center nurse RaDonda Vaught was found guilty of criminal negligent homicide and abuse of an impaired adult for her role in the death of 75-year-old patient Charlene Murphey. The trial – a rare example of a health professional facing prison for a medical error that happened as a result of many contributing systems factors – was closely watched by clinicians, hospital staff, and patient safety advocates.

Patients, families, and the public must be able to trust that organizations providing care, and the oversight organizations that protect the public, are doing their jobs and can be held accountable. In addition, those who provide care must be able to feel safe to speak up and report mistakes (as is their professional ethical responsibility) to guide improvements that reduce harm.

Members of the Institute for Healthcare Improvement Lucian Leape Institute, Julianne M. Morath, BSN, MS, CPPS, an advisor and leadership coach in quality and patient safety; Susan Sheridan, MIM, MBA, DHL, a founding member of Patients for Patient Safety; and Susan Edgman-Levitan, PA, Executive Director of the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital, spoke about this loss of trust from various perspectives.

From 1935 until 1973, the Milbank Memorial Fund paid for services associated with the burials of men who died in the course of the United States Public Health Service Syphilis Study at Tuskegee and Macon County Alabama. The funds included burial stipends that were used to incentivize their families to consent to autopsies.

The Fund has formally apologized to members of the Voices for Our Fathers Legacy Foundation (VFOFLF) and provided a financial gift. The Fund has also formed a partnership with VFOFLF and made organizational, programmatic, and communications commitments to racial equity.

Christopher F. Koller, President of the Milbank Memorial Fund, Lillie Tyson Head, President of VFOFLF, and Pamela Browner White, Chief Diversity, Equity and Inclusion Officer and Senior Vice President of Communications at the American Board of Internal Medicine and the ABIM Foundation, spoke about the importance of building trust by acknowledging past harm, committing to do better, and partnering for the long term to improve trust in the health system.

Kyle Christiason, MD, the Medical Director for Unity Point Accountable Care, joined us to discuss the development of the Prairie Parkway LGBTQ clinic and share what he has learned about providing patient-centered care to the LGBTQ+ community he serves.

For over 20 years, The Leapfrog Group has analyzed health care data on quality and safety so people can make better health care decisions for themselves and their families. But quality and safety cannot be assured without first building trust.

Leah Binder, President and CEO of The Leapfrog Group, and Richard J. Baron, MD, MACP, president and CEO of the American Board of Internal Medicine and ABIM Foundation, discussed how loss of trust can put patient safety in jeopardy, why transparency – both when things go right and wrong – is critical to building trust, and how lessons learned from the Building Trust initiative can lead to measurable improvements in quality.

Previous Webinars:

During our April Learning Network webinar, we explored how institutions can build trust with patients and families.

Alan Dubovsky, Vice President and Chief Patient Experience Officer at Cedars-Sinai, spoke about the organization’s Experience Collaborative, and Candace Henley, Founder of the Blue Hat Foundation, shared her experiences acting as a patient and family advisor.

Previous Webinars

The U.S. represents the second-highest number of gun deaths in the world. AFFIRM at the Aspen Institute (AAI) is dedicated to decreasing firearm-related harms, injuries, and deaths using a practical, scalable, and immediate health-based approach.

Christopher Barsotti, MD, FACEP, FAAEM, Co-Founder and Program Director of AAI, Megan Ranney, MD, MPH, FACEP, Co-Founder and Senior Strategic Advisor of AAI, and Pamela Browner White, Chief Diversity, Equity and Inclusion Officer and Senior Vice President of Communications at ABIM and the ABIM Foundation, discussed AAI’s approach to firearm injury as a public health issue. Dr. Barsotti and Dr. Ranney also shed light on their work to reframe the national conversation surrounding firearm-related injuries and shared how they’ve built trust with gun owners and non-gun owners alike through community-led action groups.

Clips

Previous Webinars

Is your institution trying to rebuild trust, but you don’t know where to start? Or do you have success stories that would help others learn, but don’t know how to share them?

The ABIM Foundation’s Building Trust initiative was created to increase conversation, research and best practices to elevate trust as an essential organizing principle for improving health care. Health care leaders spoke about their efforts to build trust at their organizations. Micah T. Prochaska, MD, MSc, FHM, Assistant Professor of Medicine at the University of Chicago, Donna Cryer, JD, President & CEO of the Global Liver Institute, and Daniel Wolfson, MHSA, Executive Vice President & COO of the ABIM Foundation, discussed the tools they used, challenges they faced, and the successes they saw.  

Read Donna Cryer’s blog post: Trust that we won’t go back

Philip Alberti, PhD, Founding Director of the Association of American Medical Colleges (AAMC) Center for Health Justice, and Pamela Browner White, Chief Diversity, Equity and Inclusion Officer and Senior Vice President of Communications at ABIM and the ABIM Foundation, discussed the AAMC’s new Center for Health Justice, which was created in 2021 to address health inequities and improve community health across the US.

Philip also offers insight into the newly developed health equity communication guide, which was published jointly by the AAMC Center for Health Justice and the American Medical Association to support clinicians’ conversations with patients. The comprehensive guide promotes a deeper understanding of equity-focused, first-person language and why it matters. Philip and Pamela discussed why this language is so important in building trusting relationships and its impact in delivering equitable care for all.

Clips

Thomas H. Gallagher, M.D., general internist, Associate Chair for Patient Care Quality, Safety, and Value, and Professor at the University of Washington, and Carole Hemmelgarn, MS, MS, Senior Director of Education for the MedStar Institute for Quality & Safety, and Senior Director for the Executive Master’s program for Clinical Quality, Safety & Leadership at Georgetown University discussed how UW Medicine’s Communication and Resolution Program (CRP) seeks to provide support for patients, families, and involved clinicians following a patient harm event by promoting empathic, transparent, and ongoing communication about what happened and what patients and families most need in its wake.

The organizations will use an evidence-driven approach to identify behaviors and practices that make health care providers and organizations more worthy of trust, with the goal of replication nationwide

PHILADELPHIA and BOSTON, November 22, 2021 – Trust at all levels of the health care system is at historic lows, affecting quality of care and equity among patients and communities. According to a survey released by the ABIM Foundation in May 2021, about one in every eight adults say they have been discriminated against by a US health care facility or office, with Black individuals being twice as likely to experience discrimination in a health care facility compared to white counterparts. That’s why the ABIM Foundation and the Institute for Healthcare Improvement (IHI) are partnering to identify and promote practices, policies, and behaviors for rebuilding trust in US health care systems.

IHI will spearhead an effort to assess the current landscape of trust in health care, including reviewing existing literature and conducting interviews with leaders and clinicians at health systems that have achieved high levels of clinician-patient trust. The findings will enable IHI to develop a clear set of actions health care systems can take to enhance trust between providers and the patients they serve, with a particular focus on strengthening relationships with communities of color.

This theory of change will incorporate and build on the system-level drivers of clinician-patient trust that the ABIM Foundation has identified as part of its work in this area: Competency, caring, compassion, comfort/equity, and cost.

“We launched the Building Trust initiative to elevate the importance of trust as an essential organizing principle to guide operations and improvements in health care, including promoting health equity,” said Richard J. Baron, MD, President and CEO of ABIM and the ABIM Foundation. “We’re well on our way of creating a vanguard community of organizations interested in addressing trust, and now is the time to build on this work and move toward deriving a specific set of trust-enhancing practices that can easily be spread across health care systems.”

“Rebuilding trust is critically important to our efforts to improve health and health care worldwide, and to addressing health equity in particular,” said Kedar Mate, MD, President and CEO of IHI. “Our hope is to build on this work by pilot-testing trust-building practices with a small group of US health care organizations, and eventually scale the effort across the country.”

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About the ABIM Foundation 
The ABIM Foundation’s mission is to advance medical professionalism to improve the health care system by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policymakers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect on Facebook or follow on Twitter. 

About the Institute for Healthcare Improvement (IHI)
The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organization based in Boston, Massachusetts, USA. For 30 years, IHI has used improvement science to advance and sustain better outcomes in health and health systems across the world. IHI brings awareness of safety and quality to millions, catalyzes learning and the systematic improvement of care, develops solutions to previously intractable challenges, and mobilizes health systems, communities, regions, and nations to reduce harm and deaths. IHI collaborates with a growing community to spark bold, inventive ways to improve the health of individuals and populations. IHI generates optimism, harvests fresh ideas, and supports anyone, anywhere who wants to profoundly change health and health care for the better. Learn more at ihi.org.

Media Contacts

ABIM Foundation
Jaime McClennen, 609-703-6909
jmcclennen@abim.org

Institute for Healthcare Improvement
Joanna Clark, CXO Communication, 207-712-1404
joanna@cxocommunication.com