AdventHealth Saves $47.5M With Redesigned Nurse Career Ladder

By Mariah Taylor

AdventHealth’s redesigned career ladder has prevented the departure of more than 700 nurses and saved the system an estimated $47.5 million in 2024.

The Professional Excellence Program launched in 2022 to keep nurses at the bedside and counter the notion that they had to migrate into leadership, quality or safety roles to progress in their career.

“Historically, to advance, nurses often felt they had to step away from the bedside because those roles didn’t fully recognize the specialized competencies they bring,” said Trish Celano, RN, system chief nurse executive for the Altamonte Springs, Fla.-based system. “The clinical ladder changes that.”

Leaders worked closely with nurse unit practice councils to revamp how the program was administered — rehousing its creed from a bulky paper binder to a digital tool that enables participants to document their experience, engagement, expertise and value to the organization with more ease. The platform allows nurses to identify their skills, which are assigned points. Those points move them through four levels of the ladder.

The ladder also incorporates principles from American nurse theorist and professor Jean Watson’s theory of human caring, emphasizing both the interpersonal relationship between caregiver and patient and self-care.

The Professional Excellence Program has been standardized across all 56 of AdventHealth’s facilities — and with big results. About half of 23,000 eligible nurses have enrolled. Participant turnover has dropped to 4.2%, compared to 14.1% overall. The vacancy rate has dipped to under 5% and agency usage to under 0.5%.

Nurse satisfaction, engagement and the quality of nurse-physician relationships have also all improved, alongside, leaders found.

Altogether, the program’s victories have amounted to an estimated cost savings of $47.5 million in 2024.

“We’ll keep tracking outcomes to see what’s next,” Ms. Celano said. “Retention is first; next, we’ll watch for quality impacts. If we retain our most experienced nurses, what does that mean for outcomes in 2026 and 2027?”