The Key to Achieving Health and Health Equity? Trustworthiness.

Earlier this year, the Association of American Medical Colleges (AAMC) launched their “Principles of Trustworthiness” and it got us thinking about the role we all play in facilitating trust (or distrust) with communities and how we can support organizations in being deserving of that trust.

It is no secret that trust in our nation’s healthcare institutions – and institutions broadly – has been overwhelmed by a deep and justified sense of skepticism built up over centuries. And the relevance of this as it relates to the COVID-19 pandemic cannot be understated. The situation we are in is not just the result of a spreading virus, but of a pervasive sense of distrust in the people and places that are supposed to be healing.

But in knowing that this distrust exists, we cannot afford to be inactive, because the health of the people we serve depends on trust. Public health depends on it. True patient-centered care depends on it. And the achievement of health equity and justice depends on it.

Healthcare, therefore, has an opportunity – and an obligation – to take action, to be deserving of trust, and to shift from transactional to transformational. We do this, in large part, by building relationships and connecting with communities. But how can you create stronger patient-provider relationships? How can you partner with communities, leverage community assets, and align your mission and values with those of the community?

There are many initial steps you could take to connect with the people and communities you serve. Attend a community meeting or event. Visit the community-based organizations you are referring patients to. Volunteer, and – if in an administrative position – give other staff the opportunity (i.e., dedicated time) to volunteer, attend meetings, or otherwise connect with community organizations. Community Health Workers are another approach that is known to enhance trust and relationships. As members of the community, they can foster connections between healthcare systems and the communities they serve.²

Providers should also strive to engage in shared decision-making with every patient. Healthcare organizations should be transparent about their measures and what success looks like, and reward what matters. Collaboration with community organizations should be based on a shared vision, and all parties should be seen as equals.

But all of this requires building capacity of staff, ensuring well-structured referral processes and open communication channels, allocating sufficient resources, and structuring sustainable funding and infrastructure. It also requires providers and staff of healthcare institutions to reflect on their own positions of power and to deeply value the lived experiences of the individuals and communities they serve.

We at HealthTeamWorks are on a constant journey of recognizing and reconciling our own power and privilege, and the power and privilege of the institutions we serve. In response to this, we are actively researching and developing allyship supports and trainings for healthcare providers and staff, with a strong emphasis on local community engagement and ownership.

Often, external support can provide guidance and accountability along the way, so if your organization would benefit from such support in your own journey, our team is here to help.

AAMC also offers additional guidance on engaging communities, from pre-work to reflection, and we highly encourage everyone to take a look at these resources.

Written by Katie Ebinger, MPH, MSW - Facilitator, Advancement & Healthcare Transformation, HealthTeamWorks

References

1. Association of American Medical Colleges. (2021). The principles of trustworthiness. Available at https://www.aamc.org/trustworthiness#principles
2. Center for Health Care Strategies. (2020). Recognizing and sustaining the value of Community Health Workers and Promotores. Available at https://www.chcs.org/resource/recognizing-and-sustaining-the-value-of-community-health-workers-and-promotores/