Bill Klaproth (Host): This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. And with me is Giovanna Zito, Nursing Professional Development Specialist, or NPDS as we talk about advancing ambulatory excellence, the NPDS as a strategic leader in competency, standardization, workforce development, and system readiness. Giovanna, welcome.

Giovanna Zito: Hi, Bill. Thank you so much for having me today. It's a pleasure to be here.

Host: Yes, it's a pleasure to talk with you. So, thank you so much for your time. So, let's start with this, Giovanna. How has the NPDS role evolved beyond traditional education in ambulatory care settings?

Giovanna Zito: Yeah. Well, you know, Bill, the NPDS role, I've seen really take a shift. And that shift really went from being primarily focused on what we would consider basic teaching tasks or delivering isolated education, really to shifting that focus to serving as a strategic leader within the ambulatory system. And even though our title may not yet be that of formal leadership, we are technically informal, we are seeing that huge shift into even being the connectors and system architects.

We know that today, we are seeing our NPDSs being deeply involved in different things across the setting, like workforce planning, competency, standardization, things like onboarding, design, and even interprofessional education. So, what I've found really in my role, especially as I function as that connector, I'm really focusing on aligning education with those operational workflows, looking at those quality metrics and our leadership priorities across the board. So really, professional development directly is supporting our system readiness, that safety aspect, and even those patient outcomes rather than just existing in a silo. So, we see that roll heavily with the NPDS shift.

Host: So, let me ask you this, does the NPDS kind of work in concert then with a nurse leader?

Giovanna Zito: Yeah. I would tell you that we are the connection between all of the nurse leaders and a lot of times the connections even to us ourself as the informal leadership. We sit at the table with all of our leaders, those stakeholders, so that we can shift our focus and talk about the broader system impact that we're seeing at that neutral level that they may not be seeing.

Host: Yeah. And you were talking about education as well. So, what operational and workforce challenges prompted the need for system-wide competency standardization?

Giovanna Zito: We really identified a very big, significant variability that existed across clinics, specifically in how competencies were being taught, validated, and even sustained over time. Truthfully, the onboarding experiences were differing across sites. You can imagine then those role expectations weren't always clear. And then, kind of in tandem with that, there was limited consistency and how knowledge was being reinforced. So, these gaps contributed to me seeing this practice variation. I was also seeing decreased confidence amongst staff. I mean, gosh, how could they not? And just overall inefficiencies for our leaders. So, the system-wise standardization really became essential to our practice to ensuring that there was equity across the board in our training, reducing any redundancies, and even just creating a shared foundation for what we know to be that safe, high quality ambulatory care.

Host: Standardization is really good because everybody kind of knows exactly what to do. It's laid out. So, I could see where that's very important. So, how did you engage interprofessional stakeholders to ensure education initiatives like you were talking about, are relevant and sustainable?

Giovanna Zito: Yeah. And this is always the challenge I find too, within my own endeavors and those who come to me just seeking support for their own. What I've found is that engagement needs to start early and super intentionally. So, the way that I went about that was by partnering closely with the frontline staff, with those clinic leaders like we spoke about, and our physicians, including our APPs, and even our operational stakeholders because everybody was needed to really understand real workflow challenges. So, the education that I was bringing was co-designed using their feedback, which in turn then, as you can imagine, built trust and ownership.

And then through that, I was able to have sustainability because it came from aligning the initiatives with existing processes we had in place. And then, by clearly defining the roles and ensuring leaders had visibility into our outcomes, it really made the work feel embedded into our daily operations rather than being considered what we would know as extra work.

Host: So then, how did you use evaluation frameworks such as the Kirkpatrick model to demonstrate impact and accountability?

Giovanna Zito: So, the Kirkpatrick model, which I highly recommend to all leaders if you haven't been familiar with it, but it provided a real structured pathway for me to move beyond just looking at attendance or satisfaction metrics beyond just asking our teams, "Did you like the training?" We were able to address knowledge acquisition, really see that behavior change in practice. And then, in turn, the broader system impact through these model.

It also allowed me really to demonstrate not only the fact that staff learned the material, but it ultimately then translated into that improved confidence for our staff. We had more consistency and then workflow adherence throughput. So, I always recommend using some type of recognized evaluation framework because it really, really was pivotal to helping strengthen the credibility with leadership when I broached them, and supported the data-informed decision-making that exists in current state.

Host: So Giovanni, let's talk about results a little bit. What outcomes did you observe related to learner confidence, practice consistency or system readiness?

Giovanna Zito: Really happy to report on this part. We did see measurable improvements across the board. So, that being learner confidence and knowledge retention, particularly in the areas where education was standardized and reinforced over time. Practice consistency improved across those clinics. We had reduced variation and uncertainty for both staff and leaders alike, which was a really, really big piece.

And then, ultimately, from a system readiness perspective, the leaders were able to report greater confidence in their team's preparedness, especially during those pivotal moments of onboarding, audits, and periods of operational change that occurred.

Host: So looking ahead, how can NPDSs align their professional development initiatives with organizational strategy and leadership priorities? How do those things fit together?

Giovanna Zito: it's a great question really, because sometimes we think that they're a little bit siloed and not together. But I would say alignment really starts with that understanding about what matters most to your organizations. So, the quality metrics, the workforce stability, the patient experience, and then ultimately your regulatory readiness.

The NPDS should position education as a solution to these priorities. Like I said, This is not a separate initiative. And then, using that data, using the clear outcomes and the shared language with our leaders will help our professional development be viewed more as that strategic investment that is driving our organizational success.

Host: So as the NPDS strives for their own professional development, are you also lifting the department up at the same time? Is it fair to say that as well?

Giovanna Zito: Exactly. It's system level, it's unit level, it's department level. It's all hand in hand work. And so, we do an uplift of support at all levels, ultimately impacting the system.

Host: what advice would you give NPDSs or nurse leaders listening to this looking to replicate this work in their own organization?

Giovanna Zito: So, a piece of advice that was given to me early on that I love to share with other's as well, it's been really beneficial is. Start small, but think system wide. So with that, building those strong relationships with your stakeholders, listening closely to the frontline needs, and then using that data to guide decision-making .

I can't stress enough, but using and choosing frameworks that allowing you to demonstrate the impact like the Kirkpatrick I used is so important and not being afraid to step into those leadership conversations. We should be seated at the table because we are perfectly positioned in this role. And when NPDSs clearly articulate how this work is improving the readiness, improving our quality, improving our workforce engagement, we are positioning ourselves essentially as partners in organizational strategy.

Host: Absolutely. Well, this has been great, Giovanna. Thank you so much for your time today. I really appreciate talking with you.

Giovanna Zito: Thank you so much for having me, and it's been a pleasure to speak.

Host: Absolutely. Once again, That is Giovanna Zito. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you at aonl.org/nursing-leadership-podcast. This is Today in Nursing leadership. Thanks for listening.