The LEAD Program: Forging a Path for Self-Directed Clinical Advancement

Purpose: The objective of the presentation is to describe the structure, the implementation process, and outcomes of a clinical advancement program in the ambulatory care setting. In addition, we will highlight the organizational challenges and lessons learned.

Description: LEAD (lead, excel, and develop) is a system-wide multidisciplinary clinical advancement program that improves clinical practice through local projects and research. Literature illustrates the positive influences of this type of program in the inpatient setting: advancing nursing, improving retention and engagement, and generating better patient outcomes (Hossli, Start, & Murphy, 2018). Internal data collated from LEAD implementation at various inpatient settings throughout our medical system has shown that LEAD advances local and organizational goals, increases nurse engagement, and enhances the patient or staff experience. For participants, LEAD empowers clinicians to identify opportunities to drive change and positively impact relationships, reliability, efficiency, and growth. Upon successfully completing the program, participants receive a compensation bonus.

Through anonymous engagement surveys, ambulatory care nurses at our organization have consistently voiced a concern regarding the lack of career development opportunities and a desire for a clinical advancement program. Hossli, Start, and Murphy (2018) found that this type of program in the ambulatory care setting led to an increase in nurse engagement and an increase in percentage of staff who obtain certification.

In FY22, our organization is implementing LEAD in the ambulatory care setting. In order to be accepted into the program, LEAD projects must fit specific criteria such as aligning with clinic/programmatic goals, collecting measurable data pre-/post-intervention, and staying within the span of control of the clinician. Participants can choose to either lead a project or be a supporting team member of a project. Additionally, each participant is required to complete level-specific training and mid- and end-year presentations within a designated timeframe to be eligible for the compensation bonus. The eligibility criteria reflect the attributes of a nurse and include education, certification, and role-specific requirements.

This presentation will highlight the program’s impact on nurse engagement, retention, and opportunities for professional growth. It will also include an overview of the infrastructure required to manage the program, anticipated direct and indirect costs, and challenges to program success.

Evaluation/outcome: A clinical advancement program for ambulatory care nurses will enhance professional development, improve staff engagement, and recognize clinicians for going above and beyond to advance clinical practice. Benefits to the organization include optimized care delivery, process improvement, and better patient outcomes.

References
1) Hossli, S., Start, R., & Murphy, M. (2018). Implementation and evaluation of an ambulatory care nurse clinical advancement system. Journal of Nursing Economics, 36(3), 149-155.