Dell Seton Medical Center Trust Challenge
Dell Seton Medical Center at the University of Texas (DSMC-UT) is a 210-bed urban, safety-net, academic hospital and Level-1 trauma center in downtown Austin, Texas. It serves as the primary teaching hospital for Dell Medical School at The University of Texas at Austin. DSMC-UT is part of the national Ascension health system.
Public trust is a key asset for clinicians and medical centers, contributing to positive health outcomes and sustainable work environments. Nationally, trust in health care institutions and health care leaders has declined substantially over the past few decades, a trend that worsened even further during the COVID-19 pandemic.
Over the past couple years, a number of initiatives at DSMC-UT, such as the B-Team (buprenorphine team) for people with opioid use disorder, has focused attention locally on building trust with patients. However, there had not been a concerted effort to specifically design initiatives that would aim to increase trusting relationships throughout the medical center, between clinicians and patients, as well as between team members.
In 2022, physician leaders at DSMC-UT, including Dr. Beth Schulwolf, Chief Medical Officer; Dr. Read Pierce, Chief of the Division of Hospital Medicine and Associate Chair for Faculty Development and Well-Being; and Dr. Chris Moriates, Associate Chair for Quality & Safety, teamed up with the ABIM Foundation for a Building Trust Challenge at DSMC, as part of ABIM Foundation’s national Building Trust Initiative. The goal was to raise awareness about the importance of cultivating trusting relationships, and to surface ideas from frontline clinicians that could be supported and advanced by hospital leadership.
DSMC-UT coordinated a number of overlapping activities in April 2022 to address the overall goal of cultivating trusting relationships. These activities were designed around a visit by Daniel Wolfson, EVP and COO of the ABIM Foundation, intended to launch the Building Trust Challenge, and included:
- A special rounds presentation for physicians and health care providers including small-group discussions;
- A rapid crowd-sourcing exercise and discussion at a RN-Resident Council Meeting; and
- An open call for ideas of trust practices submissions from physicians and health professionals via an online submission form.
In addition, the visit included Mr. Wolfson joining the Department of Internal Medicine’s regularly-scheduled Leadership Rounds, where members of the leadership team from the hospital, medical school, and the department of internal medicine join different medical wards teams for one hour of patient rounds at least twice per month. While leadership rounds are not a new concept, the DSMC-UT Leadership Rounds approach is unique in how it is explicitly designed to foster bidirectional learning: providing situational awareness for leaders regarding the experiences of residents and faculty, as well as visible leadership, presence, and support in clinical learning environments.7 Following rounds, the team debriefed with reflections on the challenges the team and patients faced and a conversation around how to support building trusting relationships, despite the many concerning national trends that can erode trust.