Part 2
The Effects of Diminished Trust on Patient Care: (Re)Building Clinician-Executive Trust
1) Distrust between clinicians and administrators can have detrimental effects on patient care and safety.
When clinicians and administrators are not aligned, it can lead to inefficient processes, inappropriate resource allocation, and suboptimal patient outcomes. For instance, if clinicians do not trust the decisions made by administrators regarding resource distribution or organizational policies, they may be less likely to adhere to institutional protocols and guidelines, potentially compromising patient safety and care quality.
2) Employee Morale and Retention
A lack of trust can also affect staff morale and retention. Clinicians who feel unsupported or undervalued by administrators are more likely to experience job dissatisfaction, burnout, and ultimately, leave the organization. This turnover can be costly and disruptive, leading to a loss of experienced professionals, their essential mentoring role, and continuity of care issues.
Strategies to Bridge the Trust Gap: (Re)Building Clinician-Executive Trust
1) Collaborative Leadership
My colleague, Paul DeChant, MD, MBA and I are strong proponents of dyad and triad leadership models wherein clinical leaders are teamed with a lead financial/business leader and supported, in turn, by designated liaisons from key support areas such as HR, risk management, and IT. Another effective way to bridge the trust gap is actively involving front-line clinicians in decision-making processes. Establishing joint clinical-administrative committees can ensure that clinicians have a voice in organizational governance and further expanding the range of voices and of issues for follow-up.
2) Transparent Communication
Enhancing transparency and communication is crucial. Regular, open dialogues between clinicians and administrators can help build mutual understanding and trust. For example, we often recommend discontinuing the largely performative and ineffectual senior leader rounding in favor of senior leaders doing extended (multiple hours) of job shadowing with front-line staff. Forming one or more CEO-Clinician Council(s) with rotating membership from front-line clinicians but consistently producing—and widely distributing—problem-oriented minutes with updates on problem-resolution is also highly effective in demonstrating authentic listening and engagement.
Periodic town hall meetings; regular email, Zoom, and/or video updates; and inclusive forums where both parties can share concerns and suggestions are additional practical steps towards achieving greater communication transparency.
3) Creating Shared Goals and Incentives
Aligning goals and incentives between clinicians and administrators can also help bridge the trust gap. Initiatives such as shared performance metrics and joint accountability for outcomes can ensure that both parties work towards common objectives. Financial incentives tied to satisfying both clinical outcomes and cost-efficiency can impel collaboration and a more unified, aligned approach to patient care.
Conclusion
The lack of trust between clinicians and healthcare administrators is a significant and growing issue that can hinder the effectiveness of care delivery, staff retention, and organizational performance. Addressing this trust deficit requires a multifaceted approach, including fostering collaborative leadership, enhancing communication, and aligning incentives. By taking these steps and focusing on (re)building clinician-executive trust, healthcare organizations can create a more harmonious and effective working environment, ultimately benefiting patients, provider organizations, and clinicians alike.
Ready to transform your hospital or workplace?
Are you frustrated by adversarial relationships between front-line clinicians and senior leadership? Organizational Wellbeing Solutions was formed to enable senior leaders to identify the specific drivers of clinician burnout in their organization; and to support leaders in designing and executing a comprehensive plan to stop clinician burnout, increase retention, and improve operating results. A hallmark of our consultancy is correcting the all-too-frequent distrust and alienation clinicians feel toward the c-suite generally and the CEO in particular. Let us help you help your organization and its clinicians develop a more trusting, aligned, and productive working relationship.
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