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  1. Winslow, Susan A. MSN, RN, NEA-BC
  2. Fickley, Sharon BSN, RNC-OB, Clin IV
  3. Knight, Diane BSN, RN, CPN, Clin IV
  4. Richards, Kimberley BSN, RN, ONC, Clin V
  5. Rosson, Joy RN, CPN, Clin IV
  6. Rumbley, Nancy BSN, RN, HCS-D, Clin V


After 20 years of a static clinical ladder program at our institution, the clinical ladder program was completely redesigned using a staff nurse-led shared governance structure to re-envision the program as an innovative, staff leadership model to meet our organizational nursing mission and vision strategic plans around retention and professional development. The literature demonstrated a lack of outcome-driven findings on the sustainability of hospital-based clinical ladder programs. The authors cover the rationale for our clinical ladder model, the process used for revision, the implementation strategies, and the specific outcomes tracked regarding nurse satisfaction, affiliation, retention, and participation of staff nurses advancing to the optional upper levels of the ladder.