The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

THE CLINICAL LADDER, A KEY ELEMENT IN RECRUITMENT, PROFESSIONAL DEVELOPMENT, RETENTION AND WORK FORCE PLANNING

Tim Frymyer, BS, RRT, Mike Trevino, MS, RRT, Gary Weinstein, MD, FCCP, Presbyterian Hospital of Dallas, Dallas, Texas

Background: Acquiring and retaining qualified employees is critical to meeting current and future service needs of our Respiratory Care Department where nearly 95% of all adult respiratory care is directed under a Therapist-Driven Protocol program. A staff of 73 therapists serves this 903-bed acute-care facility. The average tenure is 12 years, staff mix reflects a 65% RRT to CRT ratio. Employee turnover holds consistent at 5% and about 40% of the department staff were either at or would reach the maximum of their designated pay range. In 2001, the Dallas/Ft. Worth hospital council identified a vacancy rate of 12.9% for Registered Therapists. Finally, an employee survey conducted the same year identified compensation and benefits, recognition, and employee treatment as priorities. As the department began to look at a systematic approach to meeting personnel projections, a Clinical Ladder program was identified as a critical component. 

Method: Goals for the Clinical Ladder (CL) were as follows: support behaviors which promote professional development and the goals of the organization, offer opportunities for individuals to reach career goals, improve employee satisfaction and generate interest in education and research. The CL identified 7 key areas of participation: professional development (PD), process improvement (PI), staffing, clinical growth, educational development, research and community service (CS). Each category is made up of several line item activities that can earn the employee points. The CL is 2 tiered with an increasing financial differential applied as the therapist moves from Level 1 to 2. A year-end analysis of the program was performed. 

Results: Approximately 38% of our department participated in CL activities, while 29% of our staff reached the first achievement level; no one reached Level 2. When evaluating the results of the successful Level 1 staff member it was found that those therapists capitalized on 4 categories, with process improvement and professional development outpacing the others (Chart 1). They also had most of their points contributed by these same 4 categories (Chart 2).

 




Conclusion
: Our Clinical Ladder demonstrates a useful strategy for promoting professional development and improving the processes that govern Respiratory Therapy administration. The CL permits and encourages employees to assume greater responsibility and enables them to set and achieve goals, while at the same time assigning accountability for performance. Success of a CL program cannot be measured simply by how much financial reward is recognized by the employee, but rather, are the inherent goals of the program being met. A Clinical Ladder should be considered a principal factor when developing a model for meeting employee and department goals.

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