Less than Half of Patients Say they have Confidence in the US Health Care System

Eight health systems, spanning diverse communities in three U.S. time zones, are trying to flip the script of wariness and mistrust in health care systems.

The Institute for Healthcare Improvement (IHI), with sponsorship from the ABIM Foundation, is testing new approaches that ultimately could improve health outcomes, reduce inequities, and increase well-being in the workplace. The 10-month project comes as public trust in the health care system is at an abysmal rate of 38% by one measure, a 50% drop from 1975 when it was at 80%.

The eight systems will test several evidence-driven approaches to improve trust between their organizations and respective communities, and with the clinicians and leadership teams they employ. They will use a blueprint for how to build and strengthen trust – developed in an earlier phase of this project – as a guide in their efforts.

Approaches include acknowledgement of historical harms, development of methods to assess needs, and system approaches to address identified issues, among others. The information and data gathered will be used to create resources to not only scale up operations with the participating organizations, but also to export their findings and recommendations to health care systems throughout the country.

The systems involved in this pilot include:

Banner Health – Phoenix, Arizona

Denver Health – Denver, Colorado

Indian Health Services – Arizona

M Health Fairview – Minneapolis, Minnesota

Oak Street Health – Chicago, Illinois

Parkland Health – Dallas, Texas

Providence VA Medical Center – Providence, Rhode Island

Rise Up East New York – New York City, New York

"It's imperative that communities and clinicians trust the health care system so that patient care and employee well-being can improve. That's why this work is so important. Building trust may not be something leaders are thinking about as they seek to improve the health of the population they serve, but we know that when people trust the health care system, they get better care. We want these systems to become the model, and hope that every health system in the country feels the ripple effect of this work and buys in to the importance and value of making becoming trustworthy a core operating principle," said Richard J. Baron, MD, president and CEO of the American Board of Internal Medicine and the ABIM Foundation.

"Trust in your health care provider is predictive of whether a patient receives high quality, evidence-based care. We cannot improve health equity without addressing the lack of trust and we cannot strengthen our workforce until we restore trust. IHI's work with the ABIM Foundation is addressing the essential challenge of how to rebuild trust between health care organizations and their communities and clinicians. This prototyping network will help us validate a clear set of pragmatic actions that health systems can take now to start restoring the trust that our health depends on," said Kedar Mate, MD, president and CEO of IHI.

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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 LinkedIn or follow on Twitter.

About the Institute for Healthcare Improvement
The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organization based in Boston, Massachusetts, USA. For more than 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.