How do you measure patient trust in a health care system?
“It is the question, and I don’t know that we’ve even begun to settle on an answer,” says Toyin Ajayi. She notes that patient-reported outcomes start to get at that question. Another approach is asking patients simple questions that allow providers to better understand how to include them as members of the care team.
“I cannot effectively and robustly measure trust, but let’s at least start with the presence of a relationship,” she says. For example, Ajayi will ask patients, “Do you know the name of your health care provider, of anyone on your health care team? Would you recognize them, and would they recognize you, if you ran into them in an unfamiliar setting on the street?”
In every relationship, trust is predicated on the ability to be reliable, says Ajayi. So to establish a trusting relationship with patients, providers must ask themselves, “Are we dependable and consistent as a health care system? Do we say what we are going to do?” There are many ways to measure this.
“It’s very hard to move things unless you measure them,” adds Nirav Shah. “Unfortunately, there is no scale of trust.” He suggests creating a drop-down field in the electronic health record for rating trust on a scale of 1 to 10. “When we start asking about it, when we start measuring it, we’ll do it wrong the first five, 10 times, but it’s an intentional improvement over time that shows this is important.”
From the NEJM Catalyst event Hardwiring Patient Engagement to Deliver Better Health at Kaiser Permanente Southern California, April 13, 2017.