URMC / Sovie Center for Advanced Practice Providers / Clinical Ladder for APP Advancement

Clinical Ladder for APP Advancement

URMC is supportive of a professional advancement model for APPs. A professional advancement model provides a formal structure to reward high performing APPs for their clinical expertise, as well as their achievements in other professional development activities. The clinical ladder for advancement is a structured system to provide NPs and PAs career advancement while remaining in the clinical setting, providing direct patient care. The formal process provides a process to elevate the role of the APPs and reward professional development.

At URMC we sought to promote professional practice by rewarding clinicians who excel in clinical practice, contribute to the education and mentoring of students, with involvement in research and professional development. The Professional Advancement Model is a voluntary program in which the APP demonstrates and maintains expertise in the following areas: 1) education, 2) clinical excellence 3) service excellence, 4) professional development, and 5) research/evidence-based practice.

Physician Assistant Executive Committee Organizational Diagram

Eligibility Criteria for Physician Assistants

Competence	Tier/Level 1 PA	Tier/Level 2 PA
Education & Certification	PA licensure in NYS NCCPA Board Certified Bachelor’s degree	In addition to Tier/Level 1: Master’s degree or doctoral degree CAQ/residency/fellowship if applicable to clinical specialty preferred
Clinical Practice	2 years PA experience in acute care setting Meets departmental productivity measures Actively participate in quality and safety measures and interventions	At least 5 years PA experience in clinical care setting Level 1 Performance rating of "exceeds" Meets/Exceeds departmental productivity measures Actively initiates and oversees in quality and safety projects and interventions (involved in Quality Improvement projects)
Service Excellence	Serves as a role model and mentor for staff and colleagues the ICare values	In addition to Tier/Level 1: Holds other staff and colleagues accountable to the ICare values Provides leadership in your service/unit through innovation, scholarship, and regular instruction
Professional Development	Presents one formal educational presentation on a service-specific topic or precept a PA-S (PA-student) within 12 months Demonstrates achievement of established goals Holds membership in a health/hospital organization/committee	In addition to Tier/Level 1: Coaches / evaluates and mentors the professional development of PAs, NPs, and residents within the service Provides at least one formal educational presentation on a service-specific topic within 12 months Presents at a national meeting or authors a publication in a peer review journal Clinical Appointment (adjunct faculty, clinical preceptor, etc. with a PA program or medical school with evidence of active engagement Clinical Instructor for a certification course (ABLS, CPR, ATLS, ACLS, PALS) preferred
Citizenship	Current member of a local/regional/national professional organization or hospital-based committee	Current officer in a local/state/national organization or hospital based committee
Maintenance	Two-year appointment	Two-year appointment

Eligibility Criteria for Nurse Practitioner and Senior Nurse Practitioner

Competence	NP (Position)	Senior NP (Advancement)
Education & Certification	RN licensure in NYS NP licensure in NYS Master's degree National certification in specialty area by recognized accrediting agency within 12 months Clinical appointment with the SON desirable	RN licensure in NYS NP licensure in NYS Master's degree, DNP or doctoral degree preferred National certification in specialty area accrediting agency Exceeds performance in previous advanced practice role Clinical Appointment with the SON with evidence of active engagement
Clinical Practice	2 years RN experience in acute care setting preferred Meets departmental productivity measures Actively participate in quality and safety measures and interventions	5 years NP experience in clinical care setting Level V Performance rating of "Meets and often exceeds" expectations or above Meets/Exceeds departmental productivity measures Actively initiates and oversees in quality and safety projects and interventions
Service Excellence	Serves as a role model and mentor for nursing staff and colleagues the ICare values Utilizes PFCC principles in the delivery of care	Serves as a role model and holds nursing and others accountable for the ICare values Utilizes PFCC principles in the delivery of care Provides leadership to service areas through innovation and scholarship
Professional Development	Presents one formal educational presentation on a service-specific topic or precept a graduate nursing student within 12 months Demonstrates achievement of established goals Holds membership in a health/hospital organization/committee	Coaches / evaluates and mentors the professional development of NPs within the service Provides at least one formal educational presentation on a service-specific topic within 12 months Precepts a graduate nursing student Presents at a national meeting or authors a publication in a peer review journal
Research & Evidence Based Practice	Practices EBP	Practices utilizing EBP research and guidelines Conducts EBP research projects Mentors others in EBP and research Participates in disseminating evidenced-based information in one of the following: Submits abstract for presentation at a regional/national conference Submits manuscript for publication in a peer review article Facilitates/coordinates planning for regional/national conference
Yearly Requirements	Contact Hours: 50 Certification achieved/Maintained Serves as a mentor to staff and colleagues "Meets" expectations or above performance rating for consistent renewal	Contact Hours: 50 Certification maintained Serves as a mentor to staff and colleagues "Meets" expectation performance rating or above for consistent renewal