Clinical career ladders: St. Vincent Hospital and Health Care Center.

The career ladder program developed for pharmacists at St. Vincent Hospital and Health Care Center (SVH), a 625-bed community hospital, is described. Before 1986 the only advancement program for pharmacists at SVH was a traditional managerial one. The need for a system that would reward outstanding pharmacists both professionally and financially and prevent increases in turnover led to the development of a three-tiered ladder system in which clinical expertise and participation in elective professional activities are important keys to advancement. All baccalaureate-level pharmacists are hired at level I. Level II represents the standard of pharmacy practice at SVH. Pharmacists promoted to level III have made a major contribution. Advancement is contingent upon the accumulation of points awarded for performance evaluations, elective activities, and tenure. In addition to distributive and clinical duties, level II and III pharmacists must participate in special projects or on committees. Promoted pharmacists must accumulate additional points annually to remain at the higher level. The program was objected to by some staff members who believed that it would cut into personal time and give certain pharmacists preferred work schedules. Nevertheless, several promotions have quickened interest in the program, and participation in advancement-related activities has increased. The career ladder program has stimulated employees' professional and financial growth, enhanced the quality and quantity of pharmaceutical services, and averted potential increases in staff turnover.