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Updated: Aug 11, 2026

The Ladder Rung Walking Task: A Scoring System and its Practical Application.
Published on: June 12, 2009
Effectiveness of a clinical ladder program
Karen Drenkard1, Ellen Swartwout
1Professional Practice, Inova Health System, Falls Church, VA 22042, USA. Karen.drenkard@inova.com
Abstract:
A 5-hospital system shares results of the evaluation of a clinical ladder program. Improvements were noted in overall satisfaction with the program, nurse retention of those who participated in the program, and costs savings due to decreased turnover. The authors point out the importance of evaluating the effectiveness of advancement programs for nurses. The analysis of a clinical ladder program in relation to costs, financial impact, and benefits helps to justify the salary increments for the ladder programs. This article provides the nurse executive with appropriate justification and outcome data to effectively champion these programs.
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