Clinical Ladder

Nursing excellence is a top priority in meeting Hoag’s mission to provide the highest quality of health care services to the communities we serve.  For more than 65 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers.



Professional Growth in a Renowned Hospital

Recognizing highly-skilled ladder and compassionate health care professionals who positively transform the experience of health care.  The Clinical Ladder program supports the growth, education, and development of our Hoag nurses. We pride ourselves in our commitment to investing in our people.


We Believe in Investing in Your Future

The Clinical Ladder program is designed for nurses to take initiative for their own professional growth and development within their clinical field. Thus, enhancing quality of care, improvement in patient outcomes, and providing excellent nursing results.


Hoag Misson

Our mission as a nonprofit, faith-based hospital is to provide the highest quality health care services to the communities we serve.

Our Patients

Create an environment that promotes high-quality patient care and clinical outcomes.

Provide Recognition

Provide recognition and reward associated with the individual Registered Nurse’s level of professional practice and clinical expertise.

Build Community

Provide a network of resources for clinical expertise, collaboration, research/evidence based practice, peer review, and consultation for members of the health care team.

Growth & Development

Promote clinical excellence in patient care and professional nursing practice through the encouragement, promotion, and support of professional development and engagement.


What is the application process?

Hoag is the first hospital in the entire country to offer a complete end-to-end digital clinical ladder program for our nurses.  The entire ladder experience from initial application to managing innovation projects and reporting outcomes is completely automated and paperless.

Interview Process

In most cases, if you’re on the ladder program at another institution, you could be eligible to transfer into our ladder program, presuming you meet our minimum requirements.  If you are a new nurse without ladder experience, you must wait until the next enrollment period to apply which typically starts November and runs through mid-December.

Why is our Nurse Clinical Ladder model formatted this way?

  • We sought to create more flexibility and encourage nurses to creatively manage their own development.
  • Promote nurses practicing at their full scope of licensure as promoted in the Institute of Medicine’s (IOM) Future of Nursing Report.
  • Promote transparency, empowerment, and engagement.
  • Encourage individual accountability.
  • Adaptability to deal with rapid change.

Where is the Nurse Clinical Ladder located?

Our ladder program is offered on both of our hospital campuses in Newport Beach and Irvine.

How is participation tracked?

Currently, participation is tracked in a few different ways. When a nurse agrees to take on a new role such as designated unit preceptor or charge nurse, or becomes a super user, this is tracked by the unit committees and leadership on an individual basis.  Nursing committees, specifically our Unit Practice Council, Education, Quality, and Safety Committee, will now have the ability to track participation in evidence-based practice research and changes that are made across units and departments.

Finally, all staff roles and accomplishments are documented in portfolios and reviewed during performance appraisal, as well as at frequent check-ins.  Anecdotally, nurse managers and directors report that staff are more proactive in seeking out opportunities that interest them across each of the three pathways as a result of the portfolios.

How will you measure the success of the new framework?

We intend to measure success through both patient and staff satisfaction criteria. To gauge the impact on patient care, we will analyze performance on core measures including hand washing, falls, noise, and central line infections. 

To assess success from a professional development standpoint, we will review certification and educational advancement rates, in addition to employee engagement survey results.

What is the duration of the Nurse Clinical Ladder program?

Nurses have to reapply each year to maintain their clinical ladder status.

What happens after I successfully complete the Nurse Clinical Ladder Program?

Individuals can earn 5, 10, and 15% extra in pay depending on their eligibility/level. The goal is to develop all of our nurses on the clinical ladder program using Patricia Benner’s Novice to Expert model. 


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We are hiring experienced physicians for our hospitals, clinics, and home care across multiple locations throughout Orange County, California. Join us in delivering world-class health to our patients and making an impact in our community. If you don’t see a job opening in your specialty, click the button to be contacted for future opportunities.