This contribution explores the professional figure of the hospital pedagogist as a ‘director’ of care processes within pediatric contexts, delineating their strategic role and systemic competencies. Drawing from a qualitative inquiry, funded by the Next Generation EU program and conducted through a multiple case study at the university hospital “Azienda Ospedaliera Universitaria Meyer” (AOU Meyer) in Florence and major pediatric hospitals in Madrid, the research highlights the necessity for a pedagogical professional with inter-institutional and inter-professional coordination functions. The comparative analysis with the Spanish system, where the figure of the director of the hospital classroom is already institutionalized, provides a reference model for the Italian context, in which such normative recognition is absent. The research, therefore, defines a set of key competencies – planning, relational, organizational, and metareflective – that qualify the pedagogist as a promoter of holistic care. Finally, the paper argues for the need for both a ‘top-down’ institutionalization and a ‘bottom-up’ validation to integrate the pedagogical perspective as a foundational axis of the National Health System.