Douglas Flora, Executive Medical Director of Yung Family Cancer Center at St. Elizabeth Healthcare, President-Elect of the Association of Cancer Care Centers, and Editor in Chief of AI in Precision Oncology, shared a post on LinkedIn:
“The Other KPI: Patient Suffering Burden (PSB).
Most of us stepped away for a moment over the holidays.
Not completely—leaders never do—but enough to let the noise quiet just a bit. Enough to remember what rested thinking feels like.
Enough to notice which questions keep resurfacing when the inbox finally stops refreshing.
I found myself thinking not just about rebooting after a long year—but about what it means to reboot operations, too.
Because operations are not abstract.
They are moral instruments. They determine whether care is rushed or thoughtful, fragmented or coherent, humane or merely efficient.
This week, as many of us return to dashboards and stoplight reports, I want to run a parallel exercise.
I’m calling it The Other KPI.
Not instead of the metrics that keep our cancer centers solvent—those matter deeply—but alongside them.
The measures that patients experience viscerally. The ones clinicians carry quietly. The ones leaders feel, even if they rarely appear on a slide.
Each day this week, I’ll share a new KPI: what it captures, what red, yellow, and green feel like from the inside, and how technology—used carefully—might help us improve it.
Think of this as a gentle operational reset. A reminder that systems don’t just move volume—they shape lives.
There is a form of suffering medicine has learned to count—and another it has not.
We are adept at measuring toxicity, complications, and adverse events. But suffering is rarely confined to physiology alone.
It seeps into waiting rooms, financial statements, relationships with the people we love and our own bodies, and the long stretches of uncertainty between appointments.
After my own diagnosis, I understood that suffering is not only pain. It is the exhaustion of not knowing.
The quiet fear of becoming a burden. The sense that life is narrowing without your consent.
Today’s suggestion for our first new KPI: Patient Suffering Burden (PSB).
It is the cumulative weight of physical discomfort, emotional distress, and financial strain borne by patients and families as they move through care.
It is not evenly distributed—and it is often invisible until it erupts.
When suffering remains unseen, systems appear to function well even as people quietly unravel.
Today’s exercise: Imagine what PSB scores would look like in your system—not as a number, but as a lived experience. Where does suffering quietly pile up? Where does it finally get noticed?
If this series feels useful, consider hitting save or sharing so you’ll see the full set. And if you find yourself inventing an ‘Other KPI’ of your own to suggest, share theme here in the comments. I’ll collect a list of the best and brightest, and reflect on them next week.
Sometimes the most important work isn’t adding new metrics—but remembering what we meant to measure all along.”
More posts featuring Douglas Flora.