10 tips to cultivate trust within your workforce

Here are 10 other things for healthcare leaders to consider in building an organization on a foundation of trust.

Nearly a decade ago, the American Hospital Association issued a whitepaper entitled "Trust Counts Now." In it, the association reported on the findings of an extensive study that spoke about the public's loss of trust in the healthcare system and the challenges hospitals faced in rebuilding that sacred bond.

Since that time, the industry has had its hands full in overcoming a host of concerns that have combined to further erode the public's trust in healthcare. Among these are ongoing reports of medical errors, the industry's inability to arrive at a universally understood way to measure quality, the rise in the uninsured, patient safety and the general aroma of distrust that has infected many of our nation's businesses and institutions. Still the battle goes on, and all of us within the industry must do our part to regain the public's trust.

Building an industry of trust begins with building individual organizations of trust — two-way trust from management to staff, trust between business partners, trust among colleagues, and trust from provider to patient. Perhaps in no other industry is trust more vital to relationships or more fundamental to success.

A "Building Trust in Business" study reported in Fast Company specifically identifies three reasons why we trust our work colleagues:

  • Past behavior: If you've behaved as expected in the past, I trust you to behave that way in the future. In this case "past performance" may very well predict "future returns."
  • Capability: We trust people based on our perception of their capability, so I trust my doctor to treat my illness because of her training.
  • Alignment: If you and I are trying to achieve a common goal, I'll trust you to do your part. Soldiers trust each other with their lives because they are pursuing a shared goal.

Subscribing to those three basic principles is a great place to start. Here are 10 other things for healthcare leaders to consider in building an organization on a foundation of trust:

1. Do what you say you are going to do. It is the most simple of all the elements of trust, but it is the underpinning upon which everything else is built. If you consider the four essential elements of trust — integrity, honesty, promise-keeping and loyalty — they all come back to this basic notion.

2. Model your company's behavior after people you admire. Think of the people you consider most trustworthy. Odds are you can count on them to do the right thing, even when it's unpleasant or costly. They never lie or deceive, and they are faithful to their promises and their friends. Building a trusting organization begins with a culture and understanding that everyone at every level and in every interaction is expected to practice these same qualities.

3. Be transparent in your actions and communicate openly. We often tend to focus on outcomes and ignore the process; but understanding how a decision was made and the thought process behind it can have a huge impact on how readily people buy in. This often means involving people in decisions that directly affect them. When people are involved, even if they don't make the final call, they are more likely to support the decision. Treating people as capable adults shows you trust them to be part of good decisions. They'll trust you more in return.

4. Look for good values and good hearts in the people you hire. The success and long-term sustainability of any business depends on the quality, competencies and ethics of its people. By the time a potential employee walks through the doors, they are already fully baked: They can't say, "Starting tomorrow I am going to be trustworthy." They either have it or they don't. If you hire people with good values and good hearts, the technical aspects of any task can be learned. In filling supervisory positions in particular, hire and promote people who are capable of forming positive, trusting interpersonal relationships and focusing on shared rather than personal goals. The supervisor's relationship with reporting employees is a fundamental building block of trust.

5. Demonstrate your reliability through consistent performance over time. It was once said that "Life is not a series of glorious experiences, but rather a chain of small happenings." Every link on that chain is an opportunity to build trust. Be solid. Be consistent, and lead by example in terms of how you display trust in others. Never forget that your team members are always watching and taking cues from you.

6. Stay true to your values, even in arduous times. Companies that care deeply about retaining trust don't dodge the hard questions when the going gets tough. Trustworthiness is a lot more than telling the literal truth or relying on legalistic loopholes to get by. Deception through clever wording or half-truths is essentially dishonest. Don't fall into that trap. It is easy to be forthright, candid, sincere and truthful in good times, but what about those times when you need to deliver hard news or admit mistakes? That's when trust and leadership are really put to the test.

7. Turn "not knowing" into your advantage. People seldom trust a know-it-all. Good leaders can help build organizational trust by recognizing that they don't have all the answers and by surrounding themselves with smart people (often smarter than they are), who enjoy debate and honest discussion. Nothing builds trust more effectively than a manager saying that he doesn't know and will find out so that everyone is informed. The worst reaction occurs when a manager pretends to know and offers faulty information. Employees forgive a lack of knowledge — they never forgive a liar.  

8. Be an effective change manager. Recognize that historically people lose trust as their way of life, and many of the institutions they have come to rely on go through change. Perhaps no industry is undergoing change as constant as healthcare. New regulations. Assorted mergers and acquisitions. New competition from unexpected sources. New clinical demands. New information technology. As a leader of a healthcare organization, take the time to help employees navigate these changes, and recognize that everyone accepts change at a different pace.

9. Consider developing a "code of ethics" that includes an emphasis on trustworthiness. This may also involve developing a senior oversight committee and instituting "culture" audits. Make trust and ethics a board-level, corporate governance issue, and establish a formal system of measuring trust that touches all parts of the organization. Build a recognition and rewards program that acknowledges such actions.

10. Avoid the five lethal behaviors. Make it a point to avoid the five behaviors that undermine trust: overpromising, lying and spinning the truth, poor delivery of a difficult message, not extending trust first and engaging in a personal conflict.

Above all else, remember that trust is a valuable asset that needs to be developed and nurtured in every relationship. It is not something that a marketing team nor an executive team can take aim at directly. The person who says "trust me" is usually the last person to be trusted if the deeds haven't supported the words. Think of trust as a process; and remember, of all the ethical principles contained in the idea of character, trust is the most complex and the most fragile. It is hard to obtain and even more difficult to regain.

Tom Peterson is president and CEO of Clear Vision Information Systems, which helps Medicare Advantage plans and the physicians who work with them improve their own profitability as well as the health and quality of life of their patients.

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