The concept of transparency has gained prominence over the last decade, especially within the healthcare industry. When appropriately implemented, transparency creates trust between leaders and healthcare professionals, patients and healthcare facilities, and the whole healthcare system. It helps improve morale, boost performance, lower job-related stress, and increase patients’ happiness. The best method to promote transparency is to start with leadership positions (Gille et al., 2020). For this reason, it is necessary to study and promote trust and transparency in the management and leadership of healthcare organizations.
Healthcare organization stakeholders—healthcare professionals, patients, shareholders, and government—have high expectations in terms of transparency. The environment no longer tolerates opacity. The retention, dissimulation, and manipulation of information, practiced a few years ago, are henceforth considered unacceptable. The speed of dissemination of information, cancel culture and the activity of society regularly add to the pressure for greater transparency in healthcare. Leaders attempt to comply with new regulatory obligations, but this takes significant effort. Transparency has become an overriding principle in regulatory discourse and practice and has the moral power to trump other principles. A broad definition of transparency is the degree to which information is available to outsiders, enabling them to have an informed voice in judgments and assess insiders’ decisions (Healy, 2017). Transparency is defined as an honest and open line of communication between a company and its clients, potential clients, and staff that does not hide any ulterior motives or circumstances. It is intended to build internal trust that spreads to the public so that customers may make more informed and better decisions.
Transparency of the prices, costs, effectiveness, and quality of medical services and products is an essential tool to gain trust and improve outcomes while information asymmetry experienced by patients and providers shields them from the information they need to make decisions about what works best for them (Yong, 2017). In the information age, anyone at any moment can find the answer within just a few seconds. Such immediate access to information create an opportunity for feedback through reviews and comments on social media. When information, especially negative ones, reaches the public or employees this way, it can lead to extremely undesirable consequences for the entire organization. Transparency allows leaders to smooth out such situations and can help the company to prevent them.
It gives impetus to building such valuable concepts as trust. Meaningful trust relationships can occur between different stakeholders from patients and their family members, to the whole society. Decision transparency positively affects citizen trust in any organization – a company, regulatory agency, or healthcare facility (Grimmelikhuijsen et al., 2021). To become trustworthy, health professionals have certain obligations, such as having attention and respect for patients, a sufficient level of knowledge and determination to act in the interests of the patient fulfilling particular roles such as the fiduciary one.
Another important value this concept carries in related to decision-making. Transparency may help decision-makers set priorities and make legitimate and fair decisions (Orsini et al., 2020). Health care is an area with constant risks, and there is always the possibility that something can go wrong, even if all decisions are made correctly and in accordance with the instructions. There is a risk of unintentional harm to patients. In this context, transparency becomes a tool that can protect healthcare professionals and patients from such unforeseen moments, which sometimes happen due to the nature of this area.
The public counts on the highest standards from health care, and there is no doubt that the majority of workers in this field are ready to honestly and efficiently perform their work, providing complete transparency of their actions and creating trust. But in some cases, transparency can have negative consequences. However, treating a patient is a complex and multi-layered process involving many technical procedures and staff working to the limit. Even with the highest quality work and regulation in such conditions, some misunderstandings and errors can occur. The publication of data on such cases and excessive transparency, on the contrary, can undermine the organization’s credibility and do more harm than good.
Healthcare leaders face different personal, organizational, and systems challenges in achieving trust and transparency. Kaplan (2018) asserts that it is the leadership team’s responsibility to develop an atmosphere with balanced accountability and constant improvement, and this is everyone’s shared duty. It means that leaders should, first of all, set an example, which is not always easy due to various personal and external reasons.
Leaders around the world consistently face the same challenges. The personal challenge lies in providing inspiration and motivation. The team expects the leader to provide inspiration and motivation to instill a culture of transparency. In a demanding work environment or if the leader is not feeling inspired, it could feel difficult. Leaders need to emphasize the importance of their work in order to motivate followers and support team members. A clear understanding of the benefits of transparency and trust can help with this. The leader should create a vision for a successful, transparent organization, share it with the team, and ensure each employee understands how their work affects the final result. It is essential for the team’s engagement in fostering openness and trust to support the team in finding meaning in their work.
Another personal challenge that leaders face when building a culture of transparency in the organization is leading changes. Leading a team through a considerable change like the pandemic is a unique challenge for leaders. Employees will seek to leadership for direction and certainty while the nature of work is changing like never before. Change can often feel overwhelming or uncertain. For this reason, it is essential to validate team members’ feelings. Lowering their resistance to change might be accomplished by assisting them in this challenging experience (Uslu, 2019). It creates an even greater burden on the leader and forces him to turn to personal leadership skills and qualities that are not inherent in every leader.
One of the effective tools for achieving transparency is the practice of issuing transparency reports. However, it creates some systems challenges because Transparency is defined in its own unique way, depending on the organization. For this reason, the methods of achieving transparency, its goals, and outcomes may vary. Leaders increasingly decide to issue transparency reports outlining the scope and scale of their operations. Still, there are concerns about the risks connected to data on sensitive subjects if a healthcare organization leader decides to publish data on safety incidents. To stakeholders, such information may seem like a confirmation of the insecurity of the organization. However, such information does not really say that the organization is ineffective, does not perform its functions qualitatively, or is dangerous to the life and health of patients.
Instead, revealing this information should motivate other organizations to publish their reports, make efforts to improve their services, and help each other to provide better levels of care and patient care while minimizing errors.
Punishing organizations for publishing this data will lead to the fact that information will be withheld and patients simply will not know the whole truth, and the healthcare system will not develop and improve.
Building transparency and trust also comes with organizational challenges. One of them is that the trust patients have in organizations is fragile, and healthcare organixations should not take that trust as a matter of course. Transparency in the collection, processing and use of information, for example, is critical to maintaining and improving trust (McCormick & Hopkins, 2021). Disclosure of any information that patients may find negative or inappropriate may undermine the organization’s credibility and lead to negative consequences and the destruction of trust. Another challenge is that transparency requires responsibility and honesty not only from leaders but from all staff. The introduction of new reports or publication of some information may anger employees or cause a wave of resistance to such openness.
Not many events have led to such leadership challenges and workforce impact as COVID-19 did. Governments, organizations, and people all throughout the world were shaken by the pandemic’s start. The public’s confidence in healthcare institutions and widespread acceptance of response actions are essential for the success of a COVID-19 control plan. Because trust varies between communities, generic mistrust, concerns about the open use of information, perceptions of how decisions are made, and the dissemination of evidence may have an impact on how the public views the pandemic response (Enria et al., 2020). Some organizations, like those in Sweden, used a variety of “technologies of trust,” such openness, accountability, and reflexivity, to adapt to local conditions and increase trust in the epidemic containment methods. Others have chosen extensive and nearly total societal lockdowns in several parts of China.
The experience of these two different approaches has shown that the most credible organizations were those that transparently showed the realities, and at the same time insisted on strict measures of restrictions. It proves that transparency is the basis for trust and when the truth is known, people are more likely to follow recommendations. The same applies not only to individual organizations but to the healthcare system as a whole. The pandemic has made it clear that people’s trust and information transparency is key for people to follow the necessary recommendations that negatively affect their usual way of life. LoMonte (2020) states that Public trust is essential to public health. The public’s willingness to accept sacrifices is diminished if they believe they are being misinformed.
Another example of how trust and transparency have become important in the fight against the pandemic is the use of COVID-19 tracing apps. These technologies have played a significant role in controlling the spread and tracing of the disease; however, their use is fraught with various uncertainties. These uncertainties regard to the apps’ processing of sensitive user data that creates privacy hazards. People may worry about being subjected to social pressure or being excluded from society whether they use or don’t use the tracing app. But all these fears have been successfully reduced through using the right tools, including honest contact, social impact, and trust. Research by Oldeweme et al. (2021) found that transparency measurements revelation, exactness, social impact, and confidence in government foster the adoption procedure. People who are against any healthcare innovation may produce trust through influenceable means, like transparent communication.
Transparency and trust impacted pandemic reaction effectiveness, even at the clinical coalface. Professional clinicians communicated authoritatively to decision-makers, concentrating on assistance, safety, and quality. Quick adaptability, past event experience, team priority, and systematic thinking enabled European Union leadership (Phillips et al., 2022). Transparent communication, cooperation, mutual respect, and trust have built relationships between frontline clinicians and top-level administrators.
It is essential to note the role of transparency and trust in the issue of COVID-19 vaccination. General trust in vaccination is weak (Schwartz, 2020). COVID-19 vaccination programs will advance the greatest if there is a prevailing belief that vaccines are safe and sufficient. Trust in science and expertise is endangered, as the pandemic has demonstrated destructive results.
This trend towards transparency and trust is not limited to the pandemic time. Its influence on medicine and its development is much more substantial than it might seem. An example is a participation in healthcare study. Lacking trust is a significant obstacle to participation in such research. However, returning health information objective transparency positively impacts confidence in the study. Participants want their health data returned and would improve their belief in the study (Mangal et al., 2022). Transparency encourages people to do more than just follow recommendations more effectively and get better outcomes in treating or preventing health problems. It also helps medicine move forward and continuously improve.
To achieve transparency and trust, it is essential to understand which leadership theories contribute to this. The leadership field is overcrowded with different theories. Mango (2018) contend that the number of leadership theories is over 66. Given the existence of many theories, it is crucial to choose those most effective in creating transparency and trust and applicable to healthcare leadership. One of them is a trait model based on the characteristics of many leaders and is used to predict leadership effectiveness (Northouse, 2018). The lists of traits of a potential leaders likened to those of successful leaders to evaluate their probability of advance.
Trust is the essential trait linked with leadership. A leader cannot guide if his followers do not trust him (Orsini et al., 2020). A leader finds the employee’s issues and attempts to solve them. Still, the trust that the employees hold in the leaders tells whether they have anough knowledge and skills required to solve the problems. It may be characterized as an optimistic view that others will not perform through expressions, final conclusions, or acts opportunistically (Viola & Laidler, 2021). Trustworthiness, tenderness, and completion of individual and unique objectives help the leaders gain the trust of the employees and society. When trusting a leader, people want to be involved in achieving common goals with the leader and may be sure that their stakes and rights will not be harmed. The primary elements in building trust are truth and honesty, loyalty, mastership and competency, sincerity, trustworthiness, and openness. The leader always informs employees, shares emotions, stays honest and objective, allows others to constantly direct their decisions, maintains promises, and earns followers’ respect (Wickramasinghe, 2019). All this traits and habits can help leaders overcome the challenges they face in building a culture of transparency. They will help to become a leader for the entire organization and lead it to transparency and trust.
A trust-centered leadership will counteract concerns, low morale, and apprehensions by creating a reliable climate where workers feel secure, can fully demonstrate their abilities, and rely on help and support. In such climate people can work much more productively, are not afraid to contribute ideas and follow innovations, work more efficiently and motivated, take initiative, share their views, feel unhesitant to take risks, and contribute completely in such an atmosphere of trust (Wiig et al., 2018). Instability and unpredictability of healthcare organizations today, building trust between managers as leaders and their employees is essentially required.
In the conditions of fierce competition, dynamically changing conditions, and requirements in healthcare organizations, it is vital today to build trusting relationships between managers and their employees.
Among the core traits of healthcare leaders are achievement drive – a high level of effort, ambition, energy, and initiative. Leadership motivation – an intense desire to lead others to reach shared goals. Self-confidence – belief in oneself ideas and ability. Honesty and integrity – trustworthy, reliable, and open. The cognitive ability that means the capability of exercising good judgment, strong analytical abilities, and conceptually skilled as well as Emotional Maturity, Knowledge of business, charisma, flexibility, and creativity.
Building a culture of trust and transparency is not an easy task and comes with various challenges. However, its achievement carries much more significant benefits for everyone, from employees of the institution to the whole society. This difficult task is entrusted to the leaders of health organizations and requires them to use all their skills and abilities.
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