Organizational Trustworthiness in Health Care

Bolender T, DeSmidt B, Feske-Kirby K, Imbeah K, Sampath B. Organizational Trustiworthiness in Health Care. Boston: Institute for Healthcare Improvement; 2022. (Available at

Trust between patients and clinicians, between clinicians and the health care organizations where they work, and between communities and their health care organizations is essential. Over the past 50 years, however, this trust has measurably declined, particularly in communities of color.

The Institute for Healthcare Improvement partnered with the American Board of Internal Medicine Foundation to identify key organizational-level drivers and change ideas that repair, build, and strengthen trust between health care organizations and clinicians, and between health care organizations and the communities they serve. The project distinguished between interpersonal and institutional trust, the latter being the focus of this report, and centered equity by seeking to learn from and design for the experiences of historically marginalized communities.

This report describes a theory of how to repair, build, and strengthen trust, presented as a three-step approach with specific change ideas and associated measures for improvement.

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