Abstract
The clinical ladder program (CLP) at a large Texas healthcare system is a strategy for enhancing professional well-being through fostering a culture of professional development. An opportunity to evaluate and enhance the CLP arose with an impending change to the workforce management solution that would no longer support the current compensation model. Intentional inclusion of direct care nurses (DCN) allowed for shared decision making (SDM) on the CLP changes.
In addition to compensation changes, inclusion of diverse generational needs, diversity/equity/inclusion, and well-being considerations enhanced the CLP. With direct input from DCN groups, the CLP enhancements correlate more contemporary professional/organizational needs of time reduction, increased activities, leveraging technology, support through the process, and clear guidance.
The impact of the CLP transformation is evident through: improved communication between nursing, human resources (HR), and compensation teams; increased participation in the CLP; and enhanced employee engagement. The interprofessional partnership with HR and compensation required overcoming barriers in place due to siloed work. Frequent communication and open dialogue strengthened relationships that will further benefit future work. Utilizing SDM throughout the process was lengthy, but necessary. Often DCN are overlooked as participants in conversations of compensation or program change but provide vital expertise that led to overall enhancement of the CLP.
The work was done through rapid change cycles, meeting to enhance and refine the CLP with DCN. The DCN elevated current needs that would lead to improved satisfaction of the CLP and provide opportunity for increased participation. The HR partners participating directly in conversation with DCN stakeholders removed barriers of relayed communication and delayed responses. Leveraging the CLP digital platform, reduced timeframe, and improved peer support, give the program appeal to a wider group of DCNs. With the primary goal of the CLP modernization being program sustainability, this engagement ensures that the CLP remains relevant and effective.
As a large healthcare organization, each entity holds its own culture, but the CLP is scalable across all entities. It is important to revise and modernize CLP with significant input from DCN to provide program sustainability and desirability. The CLP showcases tools that can be adopted by different organizations and widely applied.
Notes
Hakvoort, L., Dikken, J., Cramer-Kruit, J., Nieuwenhuyzen, K. M., van der Schaaf, M., & Schuurmans, M. (2022). Factors that influence continuing professional development over a nursing career: A scoping review. Nurse Education in Practice, 65, 103481. https://doi.org/10.1016/j.nepr.2022.103481
Leamon, M., Zedreck-Gonzalez, J., Coe, P., & Fennimore, L. (2023). A roadmap to a comprehensive evaluation of a clinical ladder program. Journal of Nursing Administration, 53(2), 104-109. https://doi.org/10.1097/NNA.0000000000001250
Li, Y. H., Chou, M. C., Lin, L. D., Tsai, C. C., & Lin, M. H. (2022). Relationships between willingness to participate in the nursing clinical ladder program and its related factors among clinical nurses. Healthcare, 10(2), 369. https://doi.org/10.3390/healthcare10020369
Robinson, K., Eck, C., Keck, B., & Wells, N. (2003). The Vanderbilt professional nursing practice program: Part 1: Growing and supporting professional nursing practice. Journal of Nursing Administration, 33(9), 441-450. https://doi.org/10.1097/00005110-200309000-00004
Slagle, A., Wakim, N., & Gray, S. E. (2023). A global examination of clinical ladder programs - A synthesis of commonalities and opportunities for standardization. Worldviews on Evidence-Based Nursing, 20(1), 56-63. https://doi.org/10.1111/wvn.12622
Stamps, D. C., Beales, S., & Toor, M. (2019). A model to streamline career progression for nurse managers and retain emerging leaders. Nursing Management, 50(10), 28-34. https://doi.org/10.1097/01.NUMA.0000580600.38004.c1
Tomaszczuk, K. C., Nichols, E., & Mandrell, B. N. (2022). Redesigning a clinical advancement program to promote and strengthen competencies of clinical nurses. Journal of Nursing Administration, 52(9), 462-468. https://doi.org/10.1097/NNA.0000000000001183
Tucci, R., McClain, B., & Peyton, L. (2022). Beyond a clinical ladder: A career pathway for professional development and recognition of oncology nurses. Journal of Nursing Administration, 52(12), 659-665. https://doi.org/10.1097/NNA.0000000000001228
Sigma Membership
Delta Theta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Interprofessional initiatives, DEI/BIPOC, Workforce
Recommended Citation
Do, Shelby; Holland, Julie; and Foglia, Dorothy, "Climbing Collectively: Clinical Ladder Modernization Leveraging Shared Decision-Making" (2025). Creating Healthy Work Environments (CHWE). 14.
https://www.sigmarepository.org/chwe/2025/presentations_2025/14
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Phoenix, Arizona, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Climbing Collectively: Clinical Ladder Modernization Leveraging Shared Decision-Making
Phoenix, Arizona, USA
The clinical ladder program (CLP) at a large Texas healthcare system is a strategy for enhancing professional well-being through fostering a culture of professional development. An opportunity to evaluate and enhance the CLP arose with an impending change to the workforce management solution that would no longer support the current compensation model. Intentional inclusion of direct care nurses (DCN) allowed for shared decision making (SDM) on the CLP changes.
In addition to compensation changes, inclusion of diverse generational needs, diversity/equity/inclusion, and well-being considerations enhanced the CLP. With direct input from DCN groups, the CLP enhancements correlate more contemporary professional/organizational needs of time reduction, increased activities, leveraging technology, support through the process, and clear guidance.
The impact of the CLP transformation is evident through: improved communication between nursing, human resources (HR), and compensation teams; increased participation in the CLP; and enhanced employee engagement. The interprofessional partnership with HR and compensation required overcoming barriers in place due to siloed work. Frequent communication and open dialogue strengthened relationships that will further benefit future work. Utilizing SDM throughout the process was lengthy, but necessary. Often DCN are overlooked as participants in conversations of compensation or program change but provide vital expertise that led to overall enhancement of the CLP.
The work was done through rapid change cycles, meeting to enhance and refine the CLP with DCN. The DCN elevated current needs that would lead to improved satisfaction of the CLP and provide opportunity for increased participation. The HR partners participating directly in conversation with DCN stakeholders removed barriers of relayed communication and delayed responses. Leveraging the CLP digital platform, reduced timeframe, and improved peer support, give the program appeal to a wider group of DCNs. With the primary goal of the CLP modernization being program sustainability, this engagement ensures that the CLP remains relevant and effective.
As a large healthcare organization, each entity holds its own culture, but the CLP is scalable across all entities. It is important to revise and modernize CLP with significant input from DCN to provide program sustainability and desirability. The CLP showcases tools that can be adopted by different organizations and widely applied.
Description
Explore the transformative efforts made to modernize the clinical ladder at a large healthcare organization. This session will delve into enhancements made to the clinical ladder program, driven by direct care nurses’ input and focused on professional development, diversity, equity, inclusion, and well-being. Discover how improved communication and strategic interprofessional partnerships have rejuvenated the CL program, ensuring sustainability across the healthcare system.