How a Clinical Ladder is Structured

Zoe Reid

No one wants to roll a stone up a hill for the hundredth time, only to watch it roll back down. But, most clinical ladder programs’ analog nature makes applying to and managing these programs arduous work that can feel like it doesn’t pay off. 

Clinical ladder programs are essential to both nurse professional growth and quality of care at any hospital. 

Small clinical ladder incentives can generate a lasting, rippling change throughout your hospital. 

Peter Drucker once said, “if you can’t measure it, you can’t improve it.”

When you have to rifle through thousands of pages of individual applications and comb through years’ worth of binders, you’re not storing information in a way where you can look at it, making it impossible to extract value from all that hard work. Even more difficult are those data driven decisions you’d like to be making. 

It becomes difficult to tell which programs produced results and which were less successful.

That’s why we decided to make it easier. At StaffGarden we created GROW, we’ve stripped the structure of the ladder down to its most crucial elements, simplifying it so that it’s mobile, modern, and user-friendly. 

We built our ladder structure based on the myriad programs we’ve seen at hospitals across the country. 

We know one size does not fit all. That’s why our software is configurable so administrators can tailor it to meet your hospital’s unique needs. 

The GROW structure looks like this:

It starts with a program.

Within the program, there are levels.

A level describes the experience of the nurse – years of professional experience, education, specializations – and outlines the tasks required to maintain their current level or advance to the next level. In that way, the tasks or requirements necessary for level maintenance or advancement are level-specific.

For example, a level 3 nurse might require 20 “points” of elective activities, a BSN, and an evidence based project, versus a Level 2 nurse who wouldn’t need a BSN nor an evidence-based project. These tasks/requirements are labelled as activities and can be grouped into two different types: prerequisites and requirements.  

Prerequisites are items the individual needs to apply for that ladder level. The GROW platform lays out the prerequisites for each level so applicants and choose the level that is appropriate for them.

For example, Level 2 prerequisites might be 1 year of RN experience and a BSN, while Level 3 prerequisites are 2 years of RN experience, a BSN, and National Nursing Certification. These prerequisites are customizable to match your hospital’s program.

Requirements are activities the applicant does throughout the program. The requirements outlined on the application the nurse starts, allowing the nurse to understand what is expected from them. These also can vary from level to level. For example a Level 2 might be required to do an Evidence Based Project and earn 20 “points” of elective activities, while a Level 3 is required to do an Evidence Based Project and earn 30 “points” of elective activities. 

Applicants are able to start filling working on their requirements right away and can save and return to those items anytime. This is helpful for applicants to plan out their elective activities and make sure they are earning enough points. This allows our users to strike a healthy balance in their programs between rigor and choice. For example, all nurses may need to be on a committee, but they have a choice of which committees they’d like to join and which elective/supplemental tasks they’d like to complete in order to advance to the next ladder level. 

For each of these requirements, we allow you to categorize them with which initiative these items belong to and, more importantly, what improvement aim it is designed to accomplish. One of our search tools lets you pull up all items associated with an initiative. Want to see what people are working on related to quality improvement? Then simply select that initiative in the search and see all the items categorized under quality improvement. Capturing this type of information garners measurable results and assists you in meeting improvement goals. Plus, it’s easier to compare your program from year to year and makes changes to better meet your hospital’s goals.

Our configurable and user-friendly interface allows for better management of ladder nurses’ applications. When ladder programs are analog, the way information is disseminated to nurses about their applications/requirements can be filled with discrepancies. The result is that nurses complete their applications according to their own interpretation. With the advent of an organized, online database, the dissemination of important information regarding how to complete ladder applications is streamlined. Hospital administrators are better able to structure and order how a nurse completes the required tasks for level advancement, meaning it’s much easier to interpret results.  Plus managers and administrators are able to see applications in real-time, making it easier to keep people on the right track.

At StaffGarden, we know how important it is to get the most out of your hard work. What you do as essential workers is critically important work that we know can feel overwhelming. When we were designing this program we knew it was crucial to design a platform that was flexible for both administrators and nurse participants. 

With our system, everyone wins: nurses have autonomy while also being held to enough structure that they meet rigorous institutional guidelines. 

Now’s the time to make the change to a digital platform that you’ve been wanting to do, but keep waiting for the right time. Give your administration, managers, and nurses a user-friendly, digital platform in which to take part in your hospital’s clinical ladder program.

Put down that figurative stone and stop rolling it up that hill, instead advance to the age of technology and you’ll never look back.

Interested in learning  more? We’d be happy to answer any questions and show you how we can help. Schedule a demo below!