Organizational communication climate and trust in health systems

Trust in health care is associated with positive health outcomes. While individual clinician communication has been associated with trust, the relationship between organizational factors and trust in health care is unknown.

We measured the communication climate in 13 health care organizations - 6 hospitals and 7 health centers - using a validated assessment tool. Data were collected from November 2006 to August 2007. A subset of patient surveys included 4 items from the validated Health System Distrust Scale, measuring 3 domains of trust: confidentiality, competence and honesty. Relations between 9 domains of organizational communication climate, measured using a 0-100 scoring system, and the 3 domains of trust were compared in bivariate and multivariable models.

Almost all of the 9 domains of organizational communication were significantly correlated with each of the 4 trust items. Some relationships were especially striking. For instance, one of the communication climate domains is “community engagement” and for each 1-point increase in score on this domain, the odds that patients at that organization would agree that they receive high quality medical care (a measure of the competence domain of trust) increased by 9% (OR=1.09; p<0.001). Similarly, for every one point increase the odds the organization's patients would agree that “if a mistake were made in my care the system would try to hide it from me” (a measure of the honesty domain of trust) dropped by 6% (OR=0.94; p<0.001).

The communication climate in health care organizations is strongly correlated with patient trust in the health care system.