A professional recognition system using peer review.

The concept of a Professional Recognition System or a Clinical Ladder is not new. In fact, many models appear in the literature and have been implemented in hospitals across the country. However, few models contain the element of peer review. This article describes the development process, structure, and function of a Clinical Ladder program at a pediatric tertiary level hospital. The program grew out of a desire and recognized need on the part of the professional nursing staff to reward outstanding nursing care. Based on the concept of peer review, it underwent many revisions and revealed many lessons that can be put to use by other persons attempting to implement such a program.