Co-Designing Trust: Patient Experience, Relationships, and the Design of Care

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting with the historical changes in care delivery and relationship building to emerging trust-building frameworks, this commentary highlights the need to move beyond indirect indicators and toward measurable, observable trust-building behaviors, patient and team member co-design, and the design of organizational environments that support relationship-centered care.