CMSA Today - Issue 4, 2021

3. PROGRAM DEVELOPMENT/ CORE COMMITTEE Taking suggestions and input helps to build self-determined, measurable criteria that translate into clinical ladder points. Building upon the organization’s mission helps align criteria into categories. This is a perfect opportunity to involve leadership in the development of the categories and application of criteria. In the IMAP pro gram, criteria used for points are grouped under Pillars (Baptist) Education, Service, Leadership and Quality Improvement. Input from the Leadership Committee helps to bring together the factors needed and organize the program elements Leadership is also needed to provide support for awards given at completion of the program. Awards for completion range from an increase in hourly pay to a lump-sum award. Also, some clinical ladders have options to obtain levels, or titles, based on the completion of the program. 4. PROGRAM LAUNCH The more information provided the better when launching a clinical ladder program. Assess what is best for your organization. Some suggestions are using the organiza tion’s intranet, having time set aside in all team meetings to discuss, having a point person in leadership to help with any questions. Also, having a frequently asked questions (FAQ) sheet available helps to start conversations and provide information in general. Make sure the clinical ladder packet is readily available and not difficult for staff to find. Clinical ladders are a great tool to pro vide recognition to care managers who go above and beyond their duties. It promotes advancement and pride in their chosen career. Involvement of staff and leadership in development provides opportunity for connections between all levels of the orga nization as well. The results can lead to a positive culture change, increased morale and highlight all that care managers con tribute to the success of an organization. ■ REFERENCES Bourgeault, R., & Newmark, J. (2012). The power of engagement: implementation of a career ladder program. Radiology management , 34 (2), 27 – 39.

ladder programs. Learning from their suc cesses and approach helped to further define the program and goals for clinical ladder development. Learning from best practices and expected outcomes allowed for setting achievable expectations. Reoccurring themes of success and missed opportunities allowed us to build upon or steer clear of similar situ ations in our new clinical ladder program. CONSIDERATIONS IN CLINICAL LADDER PROGRAM DEVELOPMENT AND IMPLEMENTATION Timelines to plan, develop and implement a clinical ladder program can range, but our program was able to be implemented in less than 2 years from the idea phase to the actual roll-out of the program. Our clini cal ladder was named IMAP-Individualized Mission Achievement Program. Below are steps that have proven successful in imple menting a clinical ladder program in our organization. Four steps to consider when starting a clinical ladder program at your organization: 1. EMPLOYEE ENGAGEMENT Success of a program involves buy in from the employees. An employee advisory committee can provide input, direction and support of the clinical lad der program. Inviting staff to participate in the structure of the program avoids it being viewed as a program that leader ship alone developed. 2. LEADERSHIP SUPPORT As you take the program from idea to development, having leadership sup port is a crucial element. Clinical ladders can positively change an organization’s culture. The return on investment is measured in both staff benefit and orga nizational benefit. Requirements are spe cific and can include quality improvement projects, research, publications and vol unteer work that all expand the organiza tion’s brand as well as the leadership skills of the employee. Staff retention, recruit ment and staff satisfaction scores are increased as well (Murphy, 2012). Overall about 5% of employees will participate, but the halo effect branches out to others that are aware there is a program option (Pierson, Liggett, & Moore, 2010).

Benefits of a Clinical Ladder Nursing Program (July 22, 2020). Health Stream https://www.health stream.com/resources/blog/blog/2020/07/22/ the-benefits-of-a-clinical-ladder-nursing-program Care Management: Implications for Medical Practice, Health Policy and Health Services Research, (publica tion 15-0018-EF), August 2018, AHRQ, https://www. ahrq.gov/ncepcr/care/coordination/mgmt.html Coleman YA, Desai R. (2019) The effects of a clinical ladder program on professional development and job satis faction of acute care nurses. Clin J Nurs Care Pract .; 3: 044-048. DOI: 10.29328/journal.cjncp.1001016 Kacik, A, (2019) Health systems redefine training to reen ergize employees, Modern Healthcare ; https://www. modernhealthcare.com/labor/health-systems redefine-training-re-energize-employees Ko, Y. K., & Yu, S. (2014). Clinical ladder program imple mentation: a project guide. The Journal of nurs ing administration , 44 (11), 612 – 616. https://doi. org/10.1097/NNA.0000000000000134 Korman, C., & Eliades, A. B. (2010). Evaluation through research of a three-track career ladder program for registered nurses. Journal for nurses in staff develop ment : JNSD : official journal of the National Nursing Staff Development Organization , 26 (6), 260 – 266. https://doi.org/10.1097/NND.0b013e31819b5c25 Moe, J. K., Lonowski, L. R., & Yancer, D. A. (1994). Combining a clinical ladder and performance appraisal system as a reward strategy: the EXCEL clinical ladder program. Seminars for nurse manag ers , 2 (3), 175 – 182. Murphy, D. (2012). Novice to Expert: Clinical Ladder Programs as a Recruitment and Retention Tool. Ohio Nurses Review, 87(5), 16-17 2p Nelson, J., Sassaman, B., & Phillips, A. (2008). Career ladder program for registered nurses in ambulatory care. Nursing economic$ , 26 (6), 393 – 398. Peña A. (2010). The Dreyfus model of clinical problem solving skills acquisition: a critical perspective. Medical education online, 15, 10.3402/meo.v15i0.4846. https://doi.org/10.3402/meo.v15i0.4846 Pierson, M.A., Liggett, C., & Moore, K.S. (2010). Twenty years of experience with a clinical ladder: A tool for professional growth, evidence-based practice, recruitment, and retention. The Journal of Continuing Education in Nursing, 41(1), 33-40. Smailes, P., Bokless, H., Blumenauer, C., (2017) Clinical Research Nurse Career Advancement Using Clinical Ladder Programs, ACRP, DOI: 10.14524/CR-17-0038 Stubblefield, A (2005) The Baptist Health care: Journey to Excellence, John Wiley and Sons, Hoboken, New Jersey.

Rebecca L. Collins, MS, RN, CCM, CHPN, CENP, is a certified nurse in care management with more than 25 years of nursing experience. Rebecca has

led teams in disease management, program development, leadership development and community outreach. Rebecca is currently the director of Care Transitions at Pure HealthCare.

13

CMSA TODAY

Issue 4 • 2021