What would a medical encounter look like if we were focused on Healing Oriented Practices and Environments (HOPE) in health care?
I propose it would consist of four components that are essential to creating health. These would be in addition to the areas already included in the traditional medical assessment called SOAP, which are the subjective-objective-assessment and plan assessment that come in making a traditional medical diagnosis and treatment.
The four components of HOPE are reflected in the following questions:
1. What is your goal and intention for your healing? What do you want to heal?
- This may be a certain percentage less pain, ability to climb stairs or play with a grandchild
- Rate your health and what you expect can happen (1-10)
- Why are you here in life? What is meaningful for you? What is your purpose?
This addresses a person’s the inner environment — their desires, their beliefs, and their needs—their reason for getting up in the morning, their purpose in life—what’s meaningful for them? What gives them a sense of wellness and motivation?
Sometimes a simple thing such as spending time in the woods, or with family, is the primary avenue into treating their pain. Sometimes the goal of being able to play with their grandchildren will generate the physical activity necessary to prevent a future illness or disease that could impair them. Sometimes it’s the desire to serve their country, or their God.
2. What are your connections and relationships?
- Do you have family, friends, live alone, have hobbies, and have fun? Can you get rides to airport?
- Tell me about yourself. Tell me about your traumas. Do you have a best friend? Are you part of a group? A club? How often do you meet?
So often the reason and process for healing has to do with social relationships — with family, friends, communities and colleagues. Therefore, after we finish putting lines around the box of the diagnosis and the treatment, let’s capture the social components and the interpersonal components that drive an individual in their daily life.
3. What do you do during the day? What is your lifestyle like?
- Do you smoke or drink? What about diet, exercise, sleep and water?
- What do you do for stress management? How do you relax, reflect and recreate?
- What is your CAM use (supplements, herbs, other practitioners)?
Lifestyle and behavior can impact up to 60-70 percent of chronic illnesses; therefore these behaviors are essential for creating health.
4. What is your home like? Your work environment? Do you get out in nature?
- This includes light, noise, clutter, colors, plants, walls.
The communities, the work sites, the schools and the environment in which our patients live, often dictate what they’re able to do, what happens, how long they live, and how well flourish, and how well they function. The physical environment, then, needs to be explored.
Let’s make asking these questions a routine part of medical care.
The HOPE note is one powerful component in transforming your practice into an Optimal Healing Environment. To learn more about Samueli Institute’s research into Optimal Healing Environments, visit SamueliInstitute.org.