Workforce shortages in health and health care are reaching crisis levels, prompting many employers to adopt creative approaches for recruiting and retaining workers. Employers are turning to “grow your own” strategies that help lower-skilled, frontline workers advance to higher-skilled, higher-paying jobs. One overarching strategy that integrates these various approaches uses the framework of career ladders, a strategy that has the potential to benefit employers and workers alike, both now and in the future.

This issue brief, drawing on the experience of the Baltimore Alliance for Careers in Healthcare, illustrates how one such career ladder system could work, as well as some important considerations when designing and implementing such a system. The alliance is a grantee of Jobs to Careers: Promoting Work-Based Learning for Quality Care, a national initiative focused on establishing systems that train, develop, reward, and advance current frontline health and health care workers in order to improve the quality of care and services provided to patients and communities.