Hope as a patient-centered outcome

We’re in the throes of Patient Experience Week, and I want to take some time to reflect on the underlying purpose of PX. Why do we focus on the patient experience? Moreover, why is it so important to understand how patients experience care? While the answers to these questions might seem obvious, there’s an important nuance to consider.

Once we’ve done the important work of healing people, so much of our time is spent using patient experience data as a source of insight for quality improvement and understanding the outcomes that are critical to the organization—like patient trust and loyalty. But the original intent of patient experience measurement was to understand the outcomes that are important to patients. Like feeling safe. Feeling confident they’re in the hands of skilled and empathic clinicians. And feeling hope—hope for positive outcomes and a brighter future.

I use the word “hope” here intentionally. In healthcare, you might even say we’re in the business of hope.

Where hope and health intersect in patient experience

Hope is an interesting concept. It’s a feeling you have, in the present, about what you expect will happen in the future. In healthcare, this almost always means that a patient’s hope is that the future will involve less suffering, more healing, and include greater overall well-being.

Hope Theory¹ (Snyder, 1991) provides a jumping-off point for understanding how hope develops and what can be done to create hope as part of the care journey.

To put it another way: What can we do to help patients feel optimism, whether they’re in our office for a routine checkup, or are seeking a path forward after a life-changing, life-threatening diagnosis?

First, there needs to be an object of hope. A goal to be achieved. That could mean gaining something desired, or avoiding something dreaded.

In Hope Theory, the inputs required to achieve that goal are a combination of "agency” (“the will”) and "pathways” (“the way”). But Hope Theory focuses mostly on a person’s confidence in their own agency to find their own pathways to reach their goal. Hope Theory even quantifies the experience of “hope” as simply the sum of a person’s confidence in achieving their goal.

But there’s more to that story.

How to operationalize hope in healthcare

Patients seek healthcare because they need help. And in seeking that help, patients must rely on others. We need to acknowledge that hope doesn’t always come from within. It can come from the way others support and communicate with us—how they help find and adhere to the path toward healing. We need to recognize that when clinicians seek to understand patients’ goals and gently guide them toward goals that are both realistic and meaningful, they are making hope possible. When staff convey their intent and commitment to help patients, they are demonstrating that they believe there is reason for hope. And when they help patients understand the next steps in the plan of care and the pathways that similar patients have taken to achieve similar goals, they are showing that their hopes may be realized.

Importantly, these behaviors change how a patient envisions the future. They give patients more confidence that desired healthcare outcomes can—and will—be achieved. And what’s most dynamic about hope is positive mindset shift. The improvement in outlook is the essence of hope. You might say that creating hope is the process of turning up the dimmer switch in a dark room so the future looks better than you thought it would be.

3 ways to build optimism into the patient experience

1. Help patients think about their goals and align toward goals that are meaningful and attainable. This requires getting to know the people you care for—listening to your patients and understanding their hopes and fears. But to do this, you also need the courage to guide patients toward realistic goals that will have a meaningful impact on their lives.
2. Show patients that you care about them. Give them your attention, acknowledge and validate their feelings, and reaffirm your commitment to help them in their journey to health.
3. Clarify the path ahead. Explain the next steps in their plan of care, and respond thoroughly to their questions to make sure they understand it. Describe what that’s looked like for other patients in their situation. Help them know what mile markers lie ahead and how you will make decisions, together, along the pathway to health and treatment.

These key actions, which convey emotional intent (the will) and educate about the next steps in care (the ways), are all things that clinicians and staff do on a daily basis. They’re part of optimizing the care experience, but staff should realize that they're participating in the creation of hope at the same time. Doing so provides the motivation to ensure we act with great reliability, for every patient. And it also helps staff connect back to their reasons for being in healthcare in the first place: to make the future better for patients than it might otherwise have been. And then it reminds us that the most important outcomes are those that are important to patients.

This Patient Experience Week, I’m hoping we can all take a few minutes to reflect on what we’re doing—individually, and systemically—to encourage hope, to build systems that foster optimism among those in our care. How are you listening to patients? How are you building teams around empathy and genuine connection? And turning your organization into a system of gratitude and love? To continually drive PX improvements, it’s important that we put our heads together—this work can’t, and won’t, materialize in a vacuum.

I’d love for our team to chat with you, so we can continually raise the bar on Human Experience, and hope. To chat 1:1 with a member of our team, reach out to a patient experience expert.

1. Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, Yoshinobu L, Gibb J, Langelle C, Harney P. The will and the ways: development and validation of an individual-differences measure of hope. J Pers Soc Psychol. 1991;60(4):570‐85. PMID: 2037968. https://doi.org/10.1037//0022-3514.60.4.570.