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.