Sue Johnson, PhD, RN, NE-BC
When I first became a Nursing Professional Development educator many years ago, I was delighted to hone my teaching skills, develop, and present interesting programs assigned by organization leaders. After a few years, I was promoted to manager and my focus changed. Suddenly, I had to gain budgeting and personnel management skills. Of course, there were courses available that taught me the concepts. Whenever I could, I still liked to keep my hand in class delivery because I loved the positive feedback.
As I gained expertise in my new role, I found significant challenges that I didn't see as a staff educator. It was no longer enough to create positive learning activities. Now, I had to become a leader and change agent whether I wanted to or not (ANPD, 2016). It became obvious that I had to be "at the table" to understand and give input on organizational decisions that affected my department. Since I was well known in the organization, I pushed myself into planning sessions with the rationale that we would provide better service if we were involved in the planning process.
Naturally, there soon were too many committees and task forces for me to handle alone. Luckily, I had a core staff of ten educators and each was fascinated by involvement with different groups and challenges. Some of you are now saying, "Sure, it's easy with multiple educators". Actually, it's easier to get a handle on smaller numbers and you can start small and make a case for additional educators as projects evolve and the need for your services increases. The trick is to align your skills with organization initiatives and interprofessional teams to achieve results (Ives Erickson, Jones, & Ditomassi, 2013). This is an opportunity to make NPD indispensable and it will pay dividends when finances are tight and staffing cuts are being considered.
Visibility is vital! It's easy to cut in areas that aren't seen often. Out of sight, out of mind is true in health care as it is elsewhere. NPD must be visible to survive and thrive. Another point to consider is the worth of NPD services to the organization. I am not a math wizard, but I learned that a couple of simple (and they are) calculations for major programs can prove the department's worth to administrators and especially the finance folks. We need them as allies and they speak a somewhat different language from NPD specialists and leaders. I learned the importance of benefit-cost analysis and return on investment (ROI) to prove our department's worth to these organization leaders.
To perform benefit-cost analysis, just use the following formula:
Total benefits / Total costs = Benefit/Cost Ratio
You need to calculate the total benefits of a major program (prevention of ventilator-associated pneumonia) and determine total costs to develop and present the program to calculate the ratio in dollars (<$1=loss, > $1=profit).
For example: According to the Finance Department, each incident of VAP costs an average of $23,000. The organization had three of these in 2013. After your education, there were no incidents of VAP in 2014. Educators taught 60 critical care nurses pulmonary toileting and proper positioning (HOB up 30 degrees) as VAP prevention techniques in a 1-hour program followed by a check-off of each nurse. Salary numbers used are average salaries and may not be correct for your facility.
The cost of preparing and presenting the education included:
Supplies-Chlorhexidine mouth washes no expense to NPD
Educator salary (development) 10 x $35/hr. $350
Educator salary (coordination) 6 x $35/hr. $210
Educator salary (checkoff) 0.5/hr. x 60 x $35 $1,050
Salary for admin support 4 x $20 $80
Participants’ salaries 1 hr. x 60 x $30/hr. $1,800
Total costs $3,490
Total Benefits $23,000 x 4 = $92,000
Using the formula: $92,000 / $3,490 = $26.36 (benefit/cost ratio)
This indicates a benefit of $26.36 for every dollar spent justifying the time and resources spent to the organization.
The other formula is even better when communicating with Finance experts because it is a language they speak. It's called return on investment and the calculation is:
(Total Benefits - Total Costs / Total Costs) x 100 = ROI
It is always expressed as a percentage. Using the same data as above:
($92,000 - $3,490 / $3,490) x 100 = 2,536%
For every dollar spent, the organization received a return on investment of 2536%. That's phenomenal and certainly demonstrates the value of NPD services!
Using these formulas, especially ROI for 5-10% of your major education initiatives (DeSilets, 2010) in alignment with the organization's strategic plan demonstrates that you are truly an indispensable department and the Finance Department will be one of your biggest boosters.
I wish each of you well on your NPD leadership journey! Now, become indispensable!!