Clinical Ladder Program (CLP) Redesign


The Clinical Ladder Program (CLP) at Atrium Health Wake Forest Baptist saw decreased participation and project completion by those participating over the last five calendar years. From 2015 to 2020, there was a 78.33% decline in letters of intent (LOIs) and a 57.14% decline in project completion. The purpose and value of the CLP is the professional development of the direct, sharp edge bedside caregivers. The CLP promotes and rewards participants who optimize quality care and outcomes – these contributions foster and empower expert practitioners at the bedside.


A decision was made to redesign the CLP and align all existing CLPs across the region to a single regional program. The authors reviewed CLPs at other organizations and discussed options with stakeholders in conjunction with key leaders. The authors decided that the redesign would be a points-based system with two tiers for registered nurses and a single tier for licensed practical nurses. The points-based system allows flexibility for the program participants to choose their pathway. To promote well-rounded professional development, the points were divided over five categories with a required minimum in four of the five categories. The categories are built around the acronym CLIMB: Clinical practice, Learning, Innovation, Model, and Benevolence.


The new CLP roll-out occurred during the ANA recognized Nurses Month 2021. Utilizing highly visible, multimodal regional marketing strategies was critical to promote the redesigned program and reach all levels of potential participants. Regional committee representatives joined the project owners at their respective practice sites to tailor the communication to their teams. In-person, advertising ranged from stationary tables in shared areas with flyers to rounding on the nursing units. These sessions occurred daily for one week and were beneficial in prospective participant question and answer sessions.


As the nursing shortage continues to expand, taxing nurse leaders and healthcare administrators, the authors have shared this work encouraging others to join their efforts in applying best practices through evidence-based research. The impact of this CLP redesign is yet to be fully determined; however, through application consistent with other CLPs and strong leader involvement, the authors hope to promote positive engagement and retention outcomes in nursing. Continuing to build and disseminate knowledge of nursing CLPs is warranted and only stands to strengthen the nursing profession, enabling us to retain talent while optimizing our patients' care.