MossRehab has rolled out a newly developed Clinical Ladder Program that supports and promotes speech, occupational, physical, and recreation therapists who want to develop professionally.

A Clinical Ladder that recognized years of experience had existed previously, but it did not adequately recognize therapists’ accomplishments, areas of expertise or specialization, or their work in the larger professional communities. The new Clinical Ladder now has five levels, all of which have requirements for patient care, continuing education, knowledge sharing and responsibility within the department or program. Although experience is one component of the levels, the emphasis has been shifted to what individual therapists are accomplishing professionally and how they are growing in their careers.

Distinguished on a National Level

“The development committee decided to expand the Ladder to five levels, with the highest level challenging even the most experienced clinicians in the network,” said Mary McLaughlin, PT, MS, Therapy Coordinator for Rehab Services at Albert Einstein Healthcare Network. “MossRehab is consistently rated among the top rehabilitation hospitals in the country, and as such, all staff should be challenged to achieve the highest level of professional expertise possible.”

In developing the new Clinical Ladder, the committee recognized the need to support staff as they make their way up. Numerous support systems have now been put in place to achieve this, such as an electronic Therapy Resource Center, regular workshops and presentations for assisting therapists in achieving their professional goals, and a Network Clinical Education Committee that helps address the educational needs of staff at all of MossRehab’s sites. In addition, team leaders, managers and supervisors also are undergoing training to provide support to their staff. “This is yet another way MossRehab distinguishes itself on a national level,” added McLaughlin.

An Innovative Program

According to Marcia Moore, PT, ATP, Clinical Manager of Inpatient Therapies at MossRehab, the committee looked at several Clinical Ladder Programs at different entities during the development process. “Most facilities have some kind of Clinical Ladder in place. However, many have limitations similar to the ones in our previous Clinical Ladder, and do not recognize accomplishments and support professional development as our new Clinical Ladder does,” she said.

Under the new Clinical Ladder program, staff beginning at Levels I and II are required to supervise a student therapist. Level II therapists are further required to oversee some aspect of the department, such as an in-service program, with the approval of a supervisor. Therapists at Level III must, among several other requirements, make professional presentations and develop an educational program to support positive patient outcomes. Staff at Level IV have an increased presentation quota and are expected to become experts in a target clinical area.

Staff at Level V would be responsible for a distinct service or program, and would serve as a principal investigator on a research project, teach a university-level course, author a paper in a peer-reviewed journal, serve as chair of a committee for a professional organization, or develop and implement a Moss-sponsored continuing education course.

“The committee is hoping the program will have a positive impact on the level of care we provide our patients,” stated Moore, “and on our therapists’ professional development, retention and recognition in the professional community.”

Recognition and Rewards

Stephanie Dunn, MS, CCC-SLP, a speech pathologist, was the first MossRehab therapist to reach Level V. At Einstein, the focus for speech pathologists is the management of dysphagia, or difficulty swallowing. Speech therapists can prevent further pulmonary complications by determining the safest means of nutrition and hydration for an acutely ill patient. Speech and swallowing services have been promoted through lectures, printed resources, and in quality improvement projects.

“Through the Clinical Ladder, I was awarded a title advancement and monetary gain for time and effort I have spent outside of work hours on projects that promote speech and swallowing services,” explained Dunn. “There are ongoing advances in speech pathology, and it takes effort to effect change and provide the best quality of care for our patients.”

The Clinical Ladder also recognized the value of Dunn’s research project with George Newman, MD, PhD, Chairman of the Division of Neurosensory Sciences. The project, which has funding from an AES grant, compares the acoustic signal of swallowing and breathing with the presence or absence of aspiration in acute stroke patients in order to find objective means for screening for swallowing disorders.

“Stephanie had been doing an extraordinary job as a staff level IV in our previous Clinical Ladder,” explained Moore. “She had worked with physicians and other clinical staff to develop new assessment tools and is planning a network swallowing center. Now, with the new Clinical Ladder, her efforts are being recognized, and she is getting additional support for these activities. Her work also serves as an example and inspiration for other therapists who may see needs for our patients in other areas.”