A guide to the creation of a professional advancement program for advanced practice registered nurses and physician...

Professional advancement programs (PAPs) serve as structured pathways for promotion and recognition of clinical contributions among advanced practice registered nurses (APRNs) and physician associates (PAs). Despite the growth of PAPs, there is a lack of identification and standardization of these programs in the literature. This article describes the development and iterative evaluation of a PAP called Advanced Practice Provider Recognition and Incentive Structure (APPRAISE). APPRAISE was created within a large urban academic health system with a multidisciplinary committee of APRN and PA representatives. This paper presents the cycles of evolution from a tiered clinical ladder to a simplified retrospective point-based incentive structure. In addition, this paper outlines key features of APPRAISE and the benefits and challenges between clinical ladders and incentive structures. Benefits of PAPs include increased visibility of APRN and PA contributions, enhanced mentorship, and alignment with organizational goals. Identified challenges include stakeholder turnover and budget constraints. APPRAISE provides a blueprint for sustainable PAP development, emphasizing flexibility, stakeholder collaboration, and fiscal considerations. Future research should assess the impact of PAPs on retention, job satisfaction, and clinical outcomes.