Shared trust of resident physicians in top-management and professional burnout: A cross-sectional study towards capacity for patient-focussed care, peer support and job expectations

Rational: Hospitals desire to achieve the strategy of patient-centred care but burnout inhibits its implementation. Management has a role in responding to needs of patients, junior professional staff, and the hospital, in the present and future. Aim: To test the association between shared organisational trust (OT) of resident physicians in top-management, a systemic organisational process, and professional burnout among residents. Methods: Participants in this cross-sectional study, are 316 residents assigned to 31 internal medicine departments at eight out of 15 academic Israeli general public hospitals in various locations and sizes. All measures were published: Burnout, patient-focussed care, shared trust in top-management, and antecedents of organisational trust, which are: peer support, clinical autonomy, meeting expectations, and value congruence. Structural Equation Modelling was performed. Results: The structural equation modelling model was recursive, explaining 14% of the variance in burnout. Shared trust in top-management was the strongest antecedent of burnout. The facilitation of patient-focussed care created shared trust in top-management which reduced burnout. Discussion: To achieve patient-centred care, management is called upon to reduce burnout by aligning organisational processes with patient-focussed care. Shared trust in top-management may reduce burnout and enhance residents' sense of meaningfulness, engagement, and well-being.