Amid financial pressures, it’s easy for leaders to rely solely on return on investment as the primary measure for success, but for Frantz Berthaud, “return on humanity” is just as important to measure.
“It’s a point of orientation and a point of destination too,” Mr. Berthaud, senior vice president of oncology services at University Medical Center of El Paso (Texas), said in an episode of Becker’s “Oncology Leadership Podcast.” “The ROI asks what a strategy returns to the balance sheet, whereas return on humanity asks what a strategy returns to the human beings in the organization.”
This includes patients, staff and the community. In many cases, ROH can explain what ROI misses. For example, patient navigator programs, extended infusion hours, transportation support or a survivorship clinic are not big margin-producing initiatives, Mr. Berthaud said. If looked at only through an ROI lens, these initiatives won’t work, but run them through an ROH lens and it’s clear that these initiatives lead to fewer abandoned treatments, staff who feel part of a mission and families who can receive care without missing work.
“When we only fund what pencils out financially, we slowly optimize the humanity out of cancer care,” he said. “Our wager is a way of making sure that human return is visible, so it can compete for resources on equal footing.”
ROI and ROH belong side by side in the same business case, and should be evaluated with the same rigor. Although humanity is not a measurable metric, the “footprints that it leaves” can be measured. This includes measures like financial toxicity, screening rates, caregiver burden, interventions delivered, patients reporting feeling seen or heard, community trust, how many lives navigation touched, and even metrics like no-show rates and treatment abandonment which are often only used in ROI discussions.
ROH does not only apply to patients; it’s just as important for the workforce. Measures like turnover, vacancy rates, burnout, moral distress and staff likelihood to recommend the facility as a place to work and receive care can help leaders determine if their workforce programs are delivering a positive ROH.
ROH should also become embedded into hospital culture.
“If we as senior leaders are only asking what the margin is, staff learn that language, and they learn that the mission statement is a little bit of decoration,” he said. “So, asking that return on humanity question out loud in budget meetings, in boardrooms, and really starting to live that. Imagine having open leadership meetings with a patient or staff story tied in. Maybe you open board meetings with a patient story or invite a patient who received care at your hospital to every single board meeting. I think those are real tactics for embedding this in a culture, because we know data is helpful in convincing people: it convinces the head, but stories are what convince the heart. If we celebrate and promote people because of how tied to the ROH concept they are, we’re going to see the financial returns, but I think you’ll also see the workforce and cultural returns within the organization.”
ROH becomes most impactful when an organization is going through hard times.
“Protect the ROH, because culture is what you refuse to cut in a bad budget year,” he said. “If ROH investments are the first thing sacrificed, staff will obviously conclude it’s just branding — your mission statement becomes decorative, and no one actually believes in what you’re doing.
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