Becker's Hospital Review

25 CMO / CARE DELIVERY The building blocks for organizational trust in healthcare By Paige Twenter Building trust in healthcare cannot be accomplished with a checklist. ere's a plethora of research that analyzes patient-clinican trust, but two important relationships oen capture less attention: e trust between healthcare organizations and their employees, and trust between healthcare organizations and the communities they treat. In collaboration with the Institute for Healthcare Improvement, six healthcare organizations tested a three-step framework to repair, create and fortify trustworthiness through an antiracist research approach. e three steps are acknowledging past breaches of trust, closi wng current trust gaps and building systems to strengthen future trust. Two healthcare leaders who led this effort — Surabhi Bhatt, health equity lead at primary care company Oak Street Health, and Elizabeth Goelz, MD, chief wellness officer of Minneapolis- based Hennepin Healthcare — said trust must be bidirectional. "A lot of times our operational leaders were like, 'We gotta close our quality gaps, we gotta reduce our admission rates, we gotta —' but we weren't giving our front- line teams the autonomy to really do their job in the way that they were trained to do, right?" Ms. Bhatt said. To find out what might obstruct employees from accomplishing these goals, Ms. Bhatt and Oak Street's Chief Wellness Officer Deb Edberg, MD, dedicated time to hear employees' concerns. ey didn't start with questions; Ms. Bhatt and Dr. Edberg entered conversations by simply listening. "People were so incredibly open," Ms. Bhatt told Becker's. "And to this day, I truly am honored by the level of trust that was placed in us because they knew that we were going to do something with it." is feedback is critical, because if the loop is not closed, that "is a great way to subtly chip away at trust," Dr. Goelz said. "I don't think any organization intends to break trust," she added, "but that's one way that it happens over time." For example, a young Black physician told Ms. Bhatt that he oen sits in his car before returning home. is practice helps him refrain from unloading residual trauma with his family. Seventy percent of Oak Street Health's patients are people of color, according to Ms. Bhatt. For staff members with similar race or ethnic backgrounds as their patients, she said Oak Street underestimated the burden of vicarious trauma before beginning this work. Health systems might hesitate to admit former breaches of trust out of fear of liability. Kate Hilton, an Institute for Healthcare Improvement faculty member, said this perceived danger is a misconception. "People feel like if I admit that we did something wrong, then we'll get sued," Ms. Hilton said. "In fact, the finding is the opposite: If I admit that we did something wrong, and I apologize, we're much less likely to get sued." Many did not want an apology for former breaches of trust, Dr. Goelz said. Rather, they oen sought to be heard, seen and valued. Based on the results, the Institute for Healthcare Improvement will provide healthcare organizations with an assessment tool to self- examine their trustworthiness in spring 2025. n 5 medical breakthroughs in 2024 By Paige Twenter M edical innovations in 2024 include progress in xenotransplantation and first-time FDA approvals, ABC News reported Dec. 23. Here are five medical breakthroughs from the past 12 months: 1. An 11-year-old boy who was born with a rare form of deafness caused by one gene mutation recently gained hearing from a gene therapy. Also, in a six- person clinical trial of children with a form of genetic deafness, five of the patients recovered their hearing. Both results were announced in January. 2. In March, surgeons at Boston's Massachusetts General Hospital transplanted the world's first genetically edited pig kidney into a living human. The recipient, Richard Slayman, was a 62-year-old man with end-stage kidney disease. He later died from an unexpected cardiac event, the hospital said, adding that the field of xenotransplantation is growing and could offer hope for thousands of patients. 3. Researchers at Brigham and Women's Hospital in Boston and Northwestern Medicine in Chicago have identified a potential cure for lupus. Patients with the autoimmune disease have an imbalance of T-cells, the researchers found and reported in a July Nature article. Based on this new information, they said either activating the aryl hydrocarbon receptor pathway with small molecule activators or limiting "the pathologically excessive interferon in the blood" could diminish the disease-causing cells. 4. In September, the FDA approved the first schizophrenia treatment in more than 30 years. The drug, Cobenfy, is an oral capsule manufactured by Bristol-Myers Squibb. The twice-daily pill helped study participants manage common symptoms such as hallucinations, delusions and disorganized thinking. 5. The FDA also approved the first combination COVID-19 and flu test. In October, the Healgen Rapid Check COVID-19/Flu A&B Antigen Test received the regulatory green light for over-the-counter use. It can provide a result within 15 minutes for COVID-19 and influenza A and B. The test's accuracy is 99% for negative COVID-19 samples, 92% of positive COVID-19 samples, 99.9% negative flu samples, and between 92.5% and 90.5% for positive samples of influenza A and influenza B, respectively. n

• Cover