Can design infuse hope in patients? More importantly, is infusing hope important? Shouldn’t treatment itself be sufficient? While treatment constitutes the central focus, treatment efficacy and recovery is very much associated with the notion of hope. Here is my argument:

Let’s start with the concept of placebos. Although certainly not 100% effective, the fact that sugar pills or false surgeries demonstrate performance comparable to drugs and surgical interventions in a sizable and comparable proportion of patients is certainly noteworthy. Why (or how) is that possible? There are theories in medical literatures that, in essence, suggest that the perceived interventions or treatments results in an expectancy of cure, which contributes to improvements.

The key concept here is the "expectancy" or the "belief" that the current events will lead to a healthier future state. In that sense, it could be argued that the act or the state of treatment, with or without placebos, instill hope, and the positive state of hope contributes to recovery.

If hope is the key mediator, can physical design infuse hope? Three concepts can be attributed to infusing hope in patients: 1) treatment, 2) caregiver demeanor, and 3) environment of care. The physical design has a strong role to play in all three areas.

Treatment: Agency for Healthcare Research and Quality has articulated seven dimensions of quality healthcare. Of these, two dimensions have physical design implications from an efficiency perspective—care at the right time, and in the right way. Delay in care could potentially contribute negatively to hope. Delays can occur in inpatient and outpatient care owing to such issues as inflexible physical design, inappropriate adjacencies and physical distances, among others. A second aspect of healthcare quality affected by the physical environment is providing care the right way. Standardization of the physical environment can contribute considerably to safe care delivery.

Caregiver demeanor: A positive attitude and smiling demeanor is critical—and is dependent on the cultural-organizational setting as well as physical work environment. The two types of environments interact in meaningful ways. Studies show that numerous aspects of the healthcare cultural-organizational environment influence staff members’ satisfaction with their workplace. Many of these correlates of workplace satisfaction are influenced by the physical design. The physical environment can also have a direct impact on caregivers through proven environmental stressors—noise, daylight, views, coping opportunities, etc.

Environment of care: The impact of the environment on patients through stress mitigation (noise, privacy, environmental control, nature access, positive distractions, etc.), avenues for coping and stress reduction, and emotional well-being is well documented. A low stress level and emotionally supportive environment can be a significant contributor to hope.

The hope perspective is not only intuitive and simple, it also encompasses most strategies used in contemporary healthcare design—from lean processes to therapeutic environments. It provides a meaningful framework to comprehend process and physical design interactions. It may contribute to the most vital topic of today—healthcare cost.

Shouldn’t instilling hope be the first guiding principle of any healthcare project?