CMSA Today - Issue 4, 2021

PROFESSIONAL DEVELOPMENT

CLINICAL LADDER: REACHING PROFESSIONAL HEIGHTS IN CARE MANAGEMENT BY REBECCA L. COLLINS, MS, RN, CCM, CHPN, CENP

GTS/SHUTTERSTOCK.COM

C are management has proven to be an integral part of patient centered care mod els throughout the healthcare continuum. (AHRQ, 2018) Building an effective care management team is key to program growth and staff retention. One way to achieve a cohesive team is to highlight successes and provide opportuni ties for professional growth. A clinical ladder is a tool that can be designed to inspire and reward staff by honoring their contributions to the organization. Clinical ladders help to feature the skill set of the individual staff member as well as promote the care man agement team overall. An added benefit is that clinical ladders have a halo effect that extends outside of the team (Coleman, Desai, 2019). In this article, I would like to share my organization’s implementation of a clinical ladder to encourage the use of this approach in the care management setting. The steps involved in this innovative model benefit programs and elevate leaders in care man agement teams. We found that utilizing a clinical ladder also fosters a higher level of

interprofessional collaboration within the entire organization.

mentorship, enhance morale and empower our care managers and staff. We recognized the need for an option that would increase retention rates, staff satisfaction and provide a hiring benefit to compete in the field with other medical organizations. Our next step was to explore the use of clinical ladders to achieve organizational goals. A clinical ladder was a sensible solution to increase workforce engagement, thus allowing for star employees to be recognized and pro vide a needed opportunity for disengaged employees to engage again. We started with a foundation of Benner Theory of Expert to Novice and included the Dreyfus model of skill acquisition (Peña, 2010). Dividing skills into pillars or categories allowed for focusing on the specific skillsets (Stubblefield, 2005). The development of the program was built around these foundational elements. FIRST STEPS After having the foundational guidelines and researching evidence-based practice articles, we sought real world experience. We reached out to other organizations that had experience with implementing clinical

WHAT ARE CLINICAL LADDERS? Clinical ladders have been utilized in differ ent forms since the 1970s, and most models are based off the Benner Theory of Expert to Novice approach to obtaining skills (Smalies, Bookless & Blumenauer, 2017). Clinical lad ders have a history of being used in the nurs ing profession to increase job satisfaction and honor the nurses working at the bedside (Kacik, 2019). Even though the clinical ladder had its beginnings in nursing, the clinical ladder program can translate very easily to other disciplines. The best use of clinical lad der programs is when it is reflective of the organization’s priorities and values (Nelson, Sassaman & Phillips, 2008). Clinical ladders can be implemented for those involved in healthcare systems ranging from ambula tory settings, hospital systems to that of post-acute care workplaces (Ko, & Yu,2014). WHY A CLINICAL LADDER Our organization wanted a way to fos ter professional development, increase

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CMSA TODAY

Issue 4 • 2021