Return on investment (ROI), economic impact, and cost analysis—these words can get nursing professional development (NPD) practitioners and other non-revenue generating health care departments running in the opposite direction.

But it doesn’t have to be this way. At their core, these terms demonstrate the impact projects and educational programming have on an organization. Return on investment is the value of a program based on a cost and benefit(net) ratio (Dickerson, 2017). In simplified terms: Is this educational offering, program, or project worth the time, resources, and money?

In today’s health care climate, there is a focus on being more efficient and doing more with less. It is imperative for NPDs to continuously demonstrate their impact and value to their organizations as a non-revenue generating department. Proving the value of NPD work can feel insurmountable; however, all you really need to do is ask the right questions.

Who Is Your Target Audience? 

Targeting education to the correct audience(s) is one way to prevent excess costs, and doing so creates cost avoidance. We work hard to ensure that education is only provided to those who really need it. Through a review of regulatory requirements, policies, and analyzing quality data, you can pinpoint more specifically where a problem might exist. This will then determine whether an educational intervention is needed, and then we can identify the correct target audience. NPDs should be evaluating the evidence and data to drive our decision-making.

Advocate Health demonstrates ROI through a process we call the Regulatory Required Education Assessment and Competency Tool (REACT). The process involves as-needed assessments of regulatory topics, rather than just having every department automatically conduct education and competency  annually. For example, we previously had the entire clinical staff team take a hazardous waste course every year, but through as-needed assessments, we found all staff were meeting the benchmark and therefore did not need to take the course for that year. This saved the organization almost $800,000 and demonstrated 100% ROI. Not only do these examples provide cost avoidance, but they also eliminate unnecessary education and additional workload on staff.

What Do You Base ROI Calculations On?

While many NPDs may struggle to calculate the ROI for their educational programs, it’s important to note that ROI is not calculated through everything learning-related, but on projects with the most significant impact on organizational effectiveness (Opperman et al., 2016). ROI is typically calculated on those programs with high visibility and high importance to administrators who are related to the strategic plan and have a far-reaching impact (Gorbunoff & Kummeth, 2014).  

NPD work must link to organizational priorities and the strategic plan. Another example is NPDs at our organization who were implementing the Donna Wright Competency Approach (DWCA). During their environmental scanning and needs assessment, they identified a need for competency on falls. The site reported 76 falls in 2020, costing approximately $508,744 (site cost per fall: $6,694). By implementing the DWCA, falls decreased to 43 across the site, bringing the cost down to $287,842. The expense of implementing this approach was only $24,701. This is a significant cost savings, and demonstrated an ROI of 63%.

Why Calculate ROI?

The general purpose of evaluating ROI is to measure the impact of education on the financial bottom line, but ROI can also be measured in qualitative impacts—such as patient outcomes, patient and staff satisfaction, or increased team member engagement. Benefits of this type of ROI range from dollars to satisfaction.

A great example of a qualitative economic impact is Advocate Health’s Motivational Interviewing (MI) course offered to ambulatory nurses. Through the course evaluation, teammates reported the following: “By using MI techniques, a patient realized he was eating over two grams of salt daily, and he came up with his own plan to change this habit…Patient now takes medications as directed…I can explore and pinpoint patients’ concerns and fears” (Waters-Fechter, 2022). Qualitative feedback can demonstrate a direct impact of education on our teammates and patients outside of increase in knowledge and into the realm of patient-centered care.

In today’s health care environment, data can be a driver for change and decision-making. It is imperative to use data to inform decisions, continuously measure outcomes, and keep a finger on the pulse of the direction to help clearly identify needs and gaps. Interventions and educational approaches are not one size fits all—it is critical to use data to drive tailored interventions to improve outcomes for both the staff and the patients. These ROI factors are how NPDs impact organizational effectiveness and are essential to healthcare.

For more details on our journey to demonstrating return on investment, watch the ANPD webinar recording Return on Investment – Changing the Game.

References: 

Dickerson, P. (2017). Core Curriculum for Nursing Professional Development (5th ed.). Association for Nursing Professional Development.

Gorbunoff, E. & Kummeth, P. (2014).  Review and resource manual: Nursing professional development. Nursing Knowledge Center.

Mitchum, C. (2016). Objectives and outcomes NPD quick guide series. Association for Nursing Professional Development.

Opperman, C., Liebig, D., Bowling, J., Johnson, C. S. & Harper, M.  (2016).  Measuring return on investment for professional development activities. Journal for Nurses in Professional Development, 32(3), 122-129.

Opperman, C., Liebig, D., Bowling, J., Johnson, C., Stiesmeyer, J., & Miller, S.  (2022). Measuring return on investment for professional development activities: Literature update and the ongoing challenge. Journal for Nurses in Professional Development, 38(6), 333-339. DOI: 10.1097/NND.0000000000000921

Opperman, C., Liebig, D., Bowling, J., Johnson, C., Stiesmeyer, J., & Miller, S. (2022).  Measuring return on investment for professional development activities: Pandemic impacts and revised known cost of outcomes. Journal for Nurses in Professional Development, 38(6), 340-346.  DOI: 10.1097/NND.0000000000000914

Waters-Fechter, A. (2022, March 22-25). Evidence-based motivational interviewing (MI) education leads to positive practice change [Poster presentation]. Association for Nursing Professional Development Annual Convention 2022, San Antonio, TX.