Giving Hope as a High Reliability Function of Health Care

Abstract

We believe that reliably offering Hope should be one of the goals of the therapeutic relationship between clinician and patient. Establishing Hope as a target outcome creates opportunities for both patients and clinicians to find meaning in their journeys. This article defines Hope in a new way by quantifying Hope as the delta or increase in one's belief that a future positive state can be achieved.Though prior conceptual models of Hope have focused nearly exclusively on an individual's own agency and competence to achieve goals, we particularly emphasize the role of Other-specifically, that of the clinician-in promoting Hope for patients.We recommend a Hope Checklist for clinicians that incorporates (1) the process of eliciting and clarifying patient goals, (2) conveying the intent and ability to help, and (3) identifying realistic pathways forward with the specific intent to maximize patient confidence in the potential to achieve meaningful positive outcomes.

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