We're very pleased to announce an exciting new partnership between Nursing Management and the American Nurses Credentialing Center's (ANCC) Pathway to Excellence® Program. Nursing Management has been selected as the official leadership journal of the Pathway to Excellence Program. Recognizing the essential role that nurse leaders play in creating and sustaining a positive practice environment, we felt the journal made the best fit to lend our expertise in this area to readers. Throughout the year, you'll find relevant, practical, and evidence-based information from the team at the ANCC with one goal in mind—to help you transform your work culture.
ANCC recognizes healthcare organizations that promote nursing excellence and quality patient outcomes, while providing safe, positive practice environments. Healthcare organizations that are Magnet® recognized or Pathway designated demonstrate the presence of professional development opportunities, shared-governance structures, more autonomy in practice, greater interprofessional collaboration, and overall better workforce outcomes.1,2
Positive practice environments
Originally founded as the Texas Nurse-Friendly Program in 2003 by the Texas Nurses Association, the program was acquired by the ANCC in 2007 and renamed the Pathway to Excellence Program. In 2010, the program expanded to include international applicants, and the Pathway to Excellence in Long Term Care® Program was launched. One of the fastest growing programs at the ANCC, Pathway organizations can be found in 34 states; Washington, D.C.; and four other countries (Australia, Mexico, Switzerland, and Thailand), ranging from 13 to 1,000 beds, with many more on the journey. As a global recognition program, Pathway distinguishes organizations that demonstrate six essential elements of a positive practice environment that lead to high levels of nurse job satisfaction and retention: shared decision making, leadership, safety, quality, well-being, and professional development.
Pathway standards foster the development of leaders who continually support and empower nurses to perform at their highest capacity. Pathway promotes giving clinical nurses a voice in everyday decisions, especially those decisions that affect their clinical practice and well-being. One of the biggest decisions that nurses are involved in during the organization's journey to excellence is the final validation phase of the Pathway application process, which requires inviting all nurses to participate in a confidential survey. No organization can achieve the Pathway designation unless nurses validate that the six essential elements are truly present and practiced throughout their organization. The Pathway designation is a marker for nurses looking for an organization that's genuinely invested in its nursing workforce. Nurses in Pathway organizations know that their individual contributions are valued—a crucial factor to consider when looking for an optimal place to work.
A closer look at the standards
Shared decision making is the cornerstone of a Pathway organization. Nurses must have a voice in decision-making processes that affect how care is delivered. In addition to being involved in care decisions, organizations must demonstrate clinical nurse involvement in staff hiring and the evaluation of new clinical products. The culture must also foster interprofessional collaboration, building teamwork to further strengthen the effectiveness of shared governance.
Leadership team members in Pathway organizations foster collaboration among staff and support the shared governance environment. The CNO and nurse managers actively engage staff for input into resource allocation and cost management throughout the organization. Nurse leaders are accessible, visible, and effective advocates, especially during times of organizational change.
The safety standard ensures that the organization protects nurses, staff, and patients through safety policies and practices. Organizations must monitor patient and staff safety-related events, and include nurses in addressing any unfavorable trends. The standard also requires applicants to demonstrate how safety issues are ultimately resolved. In addition, clinical nurses must have input into daily staffing decisions and consider fluctuations in patient acuity as an element of ensuring a safe culture.
The next Pathway standard is organization-wide quality initiatives. These initiatives must be evidence-based, focused on improving patient outcomes, and grounded in internal and external benchmarks. Staff members in Pathway organizations also have a clear alignment with the mission, vision, and values, and understand how these attributes contribute to the overall quality program.
One of the unique standards within the Pathway to Excellence Program is the well-being standard. Pathway organizations demonstrate that staff members have the opportunity to develop a balance between their work and personal lives. This includes nurse involvement in organizational initiatives that promote work-life effectiveness, such as flexible scheduling and an assessment of employee wellness. Achievements for community service, patient advocacy, and contributions to improving population health are also encouraged, supported, and recognized by the organization.
The final Pathway standard is centered on professional development. The organization recognizes the importance of solid onboarding, transitions in practice beyond orientation, and continued professional development. Professional growth activities should support lifelong learning in the delivery of safe and effective patient care. Pathway organizations understand and plan for the individualized learning needs and unique clinical experiences of each team member, and support activities such as certification, career ladders, and attending conferences.
Not just for acute care hospitals
With the increasing complexity of care, the Pathway to Excellence Program aims to recognize organizations across the care continuum that demonstrate a positive practice environment for nurses. Current Pathway organizations include acute care hospitals, ambulatory settings, hospice, home healthcare agencies, and long-term-care providers. The standards for the Pathway to Excellence Program and Pathway to Excellence in Long Term Care Program vary slightly and recognize the unique attributes of the care delivery model in the long-term-care setting. As of February 2018, there are a total of 150 Pathway organizations representing various practice settings.
Pathway organizations report more collegial relationships, which has been linked to patient safety and better patient outcomes. Nurses reported better quality of care, higher job satisfaction, and lower intent to leave on units with better collaboration among healthcare providers.3 In addition to improved collaboration, Pathway organizations ensure an individualized and comprehensive orientation for staff members new to the organization and/or transitioning to a new practice environment.
A recent study of the National Council of State Boards of Nursing's Transition to Practice Model reported fewer negative safety practices, higher overall competence, less stress, more job satisfaction, and higher intent to stay in organizations using established transition to practice programs.4 With the national trend of increased nursing turnover and vacancy rates, transition to practice was one of the new standards added to the 2016 revision of the Pathway to Excellence Program application manual. Nurses who are more satisfied with their training and professional development opportunities also report being more engaged, experiencing less burnout, and having higher job satisfaction.5 Creating this level of engagement is one of the primary goals of the Pathway to Excellence Program.
Synergy and partnership
Our exciting new relationship with Nursing Management promises to bring an increased focus on ways you can improve your practice environment. Using real-life stories and examples, we hope to spur your thinking and creativity as you look for new ways to deal with the day-to-day challenges you face. Nursing Management has a long history of bringing real issues to the forefront while providing provocative and innovative dialogue for nurse leaders across the continuum, and we couldn't be more proud to be part of that continued legacy.
1. Jarrín OF, Kang Y, Aiken LH. Pathway to better patient care and nurse workforce outcomes in home care. Nurs Outlook
2. Laschinger H, Shamian J, Thomson D. Impact of Magnet hospital characteristics on nurses' perceptions of trust, burnout, quality of care, and work satisfaction. Nurs Econ
3. Ma C, Shang J, Bott MJ. Linking unit collaboration and nursing leadership to nurse outcomes and quality of care. J Nurs Adm
4. Spector N, Blegen MA, Silvestre J, et al. Transition to practice study in hospital settings. J Nurs Reg
5. Carter MR, Tourangeau AE. Staying in nursing: what factors determine whether nurses intend to remain employed. J Adv Nurs