Healthcare leaders dealing with the reality that nurse turnover is expensive should be addressing the root cause: retention is a design problem, not a staffing problem.
AdventHealth’s Professional Excellence Program (PEP) offers one of the clearest examples in the industry of what happens when that design changes.
Becker’s Hospital Review reported that in a single year, PEP prevented more than 700 nurse departures and saved an estimated $47.5 million, the result of a redesigned clinical ladder that made growth visible, attainable, and meaningful at the bedside.
The financial outcome is only part of the story. The deeper shift is structural, challenging how most organizations still approach nurse engagement.
Partner success like this is the ethos behind StaffGarden’s digital clinical ladder program. Our healthcare-first platform achieves a level of clarity, engagement, and scalability that spreadsheets, binders, and generic solutions can’t.
Keep reading to learn how one of our early adoption partners transformed their program, making big impacts to their nursing workforce.
For years, AdventHealth was facing the same pressures as the rest of the industry: high turnover, rising costs, and increasing strain on care teams. At one point, system-wide RN turnover exceeded 30%.
Leaders uncovered that the issue was the lack of a path forward for nurses on the clinical floor, baked into a career architecture that defines growth as leaving the bedside.
As System Chief Nursing Executive Trish Celano explained, nurses made it clear that advancement often meant leaving the work they loved: “We were hearing from our bedside nurses quite loudly that it seemed to them that nurses, in order to advance in the organization, needed to get away from the bedside.”
That realization reframed the challenge entirely.
PEP was built to solve that exact problem: create a structured, credible path for nurses to grow without leaving patient care. StaffGarden’s healthcare-first platform achieves a level of clarity, engagement, and scalability that spreadsheets, binders, and generic solutions can’t.
Participation in the program correlates with dramatically lower attrition. As reported in Becker’s Hospital Review, “participant turnover has dropped to 4.2%, compared to 14.1% overall.”
At the facility level, the impact is even more pronounced. At AdventHealth Castle Rock, “70% of our nurses have completed the clinical ladder program… we have decreased turnover by 75% since the implementation of this program,” said the hospital’s Chief Nursing Officer.
Engagement surged alongside retention, with Celano noting the organization is now “almost at 80% engagement for our RNs, which is also industry leading.”
What makes AdventHealth’s approach different isn’t simply the idea of a clinical ladder—it’s how deliberately it was designed.
First, the program starts with a fundamental redefinition of growth. Instead of treating bedside nursing as a stepping stone, it treats it as a destination worth investing in. As Celano put it, “to have a nurse that has 10 years of experience is like having a block of gold.”
Second, the program was shaped directly by nurses themselves. In AdventHealth’s own words, PEP was “developed by nurses for nurses,” grounded in what frontline clinicians said they needed: recognition, clarity, and the ability to advance where they are.
Third — and this is where many programs quietly fail — the experience was made digital, visible, and scalable. Leaders moved away from manual processes toward a centralized platform that allows nurses to track progress, document contributions, and clearly see how to advance.
Or, as Celano summarized it: “no more binders and paper.”
This is what allowed PEP to expand across more than 50 hospitals while maintaining consistency and usability.
Perhaps the most forward-looking aspect of the program is what it chooses to measure. In addition to clinical achievement and professional development, PEP includes a dimension rarely formalized in career ladders: self-care.
That focus shows up in real-world feedback from participants: “this program is helping me to develop professionally, but also to improve my well-being.”
When growth includes sustainability, retention stops being reactive and truly becomes structural.
AdventHealth succeeded because it rebuilt the clinical ladder experience around three things most programs lack:
· Clarity, so nurses can see how to advance
· Credibility, so advancement reflects real clinical value
· Infrastructure, to create a system that can support scale
The $47.5 million in savings is simply what happens when those elements align.
AdventHealth’s success is built on the foundational truth that when nurses can see a future for themselves at the bedside — and have a system that supports it — they stay.
Many organizations already understand these principles. The challenge is operationalizing them, especially across complex systems with thousands of clinicians.
That’s where purpose-built platforms like StaffGarden come in.
StaffGarden’s healthcare-first platform achieves a level of clarity, engagement, and scalability that spreadsheets, binders, and generic solutions can’t.
For organizations ready to move beyond outdated, manual approaches to clinical ladders, the opportunity is significant.
StaffGarden helps health systems turn these principles into scalable reality — digitizing career pathways, reducing administrative burden, and creating the kind of engaging, transparent experience that keeps nurses thriving at the bedside.
If you’re rethinking your approach to retention, now is the time to design differently, and build a system that makes it sustainable.
Schedule a free consultation with our healthcare workforce development experts and learn how you can achieve clinical standards of excellence with StaffGarden by scheduling a free consultation with our healthcare workforce development experts.
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