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Department: Pathway To Excellence®

Partnering for maximum impact

Pabico, Christine PhD, RN, NE-BC, FAAN; Abel, Sarah DNP, RN, CEN, FAEN

Author Information
Nursing Management (Springhouse): April 2021 - Volume 52 - Issue 4 - p 9-11
doi: 10.1097/01.NUMA.0000737788.76775.e8
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The American Nurses Credentialing Center (ANCC) Pathway to Excellence® Program (Pathway) and the Sigma Theta Tau International Honor Society of Nursing (Sigma) have harnessed the synergy between both organizations for an initiative to create positive practice environments where nurses can thrive. This partnership draws on the experience and expertise of two of the most respected entities in the nursing community with like-minded goals. Leveraging these resources will enhance both organizations' collective impact to grow in value and benefit nurses around the world.

Two organizations aligned in purpose

Sigma and Pathway share a natural affinity. Their respective missions and goals align, especially around leadership, professional development, and advocating for positive practice environments. (See Pathway and Sigma alignment.)

As the international honor society for nursing, Sigma works to connect and empower nurse leaders to transform healthcare around the world. Founded in 1922, Sigma has grown to include more than 135,000 active members in 100 countries. Its mission—developing nurse leaders anywhere to improve healthcare everywhere—reflects its commitment to the value of scholarship and excellence in nursing practice. Sigma was the first US organization to fund nursing research and continues to support nursing professional development to advance education and learning among the world's nurses.1

The Pathway to Excellence Program—the premier global credential for positive practice environments—recognizes healthcare organizations that demonstrate a commitment to establishing the foundation of a healthy workplace for nurses and other healthcare professionals.2 It provides an evidence-based framework comprised of Pathway standards that promote shared decision-making, leadership (both at the organization and unit level), quality, safety, well-being, and professional development.3 There are now 197 Pathway-designated organizations in seven countries.

Both Sigma and Pathway advocate for and provide tools to develop competent and empowered staff—the foundation of every successful high-reliability organization. Their partnership will enable both organizations to reach and give voice to more nurses at all levels.

An evidence-based focus on work environments

Sigma and Pathway share the common goal of making work environments the best they can be for both patients and staff. In the wake of the COVID-19 pandemic, nurse well-being has emerged as a critical concern. Even before the pandemic, the clinical workforce in the US was already reporting increasing levels of stress and burnout.

In a 2019 survey conducted by the American Nurses Association, almost 80% of nurses rated themselves at high risk for stress.4 COVID-19 added worry about risks to personal health, family safety, and personal protective equipment (PPE) shortages.5 Now these professionals face a surge of physical and emotional harm that amounts to a parallel pandemic.6 Subsequent surveys on health and safety hazards show that an overwhelming majority of nurses believe they're most at risk for stress in their work environment. Based on these alarming trends, investing in strategies to optimize the well-being of nurses should be a priority among healthcare leaders.7

In 2016, Pathway added well-being as an essential component of a positive practice environment. Sigma shares this evidence-based commitment and focus. Among other factors, studies show that strong staff engagement is associated with better patient care, quality, satisfaction, and safety outcomes, as well as nurse satisfaction and retention.8 Preventing and treating nurse burnout significantly improves patient care and safety.9 In addition, improving patient care and safety significantly boosts clinician well-being.9 Therefore, positive practice environments are just as essential as PPE in safeguarding our care providers. The “other PPE” is the invisible structure for improving quality and safety and protecting our clinicians.

Sigma vision/mission/strategic goals Pathway to Excellence® vision/mission/standards
  1. Vision

  2. Connected, empowered nurse leaders transforming global healthcare

  1. Vision

  2. Pathway to Excellence is valued as the premier healthcare practice environment credential in the world

  1. Mission

  2. Developing nurse leaders anywhere to improve healthcare everywhere

  1. Mission

  2. Pathway to Excellence guides the positive transformation of practice environments in multiple settings to build global community healthcare organizations committed to nursing workplace excellence

  1. Strategic goals

    1. Grow in value for nurses globally

    2. Recognize and promote nursing scholarship, leadership, and service

    3. Expand and develop strategic relationships globally

    4. Advance innovative and customized resources to develop nurse leaders

  1. Standards

    • Shared decision-making

    • Leadership

    • Safety

    • Quality

    • Well-being

    • Professional development

(Sigma, 2020) (ANCC, 2020)

Amplifying awareness at nursing events

In February, more than 400 nurse leaders attended Sigma's 2021 Creating Healthy Work Environments virtual conference. They explored the essential components of a healthy workplace and identified strategies they could implement within their healthcare organizations. As part of the conference, Pathway presented “Positive Practice Environments: The Other PPE.” This campaign outlines the growing risk of burnout among nurses and demonstrates how creating a positive work environment can improve mental well-being and resilience among frontline staff.

In November 2021, Sigma will have a presence at the ANCC's colocated Magnet® and Pathway to Excellence Conference® in Atlanta, Ga., and will provide a special guest speaker at the Pathway Leadership Luncheon. Sigma will present evidence for the development and empowerment of frontline nurses as current and future leaders of healthcare. Sigma recognizes that these leaders are indispensable to cultivating and sustaining positive practice environments.

Disseminating nursing knowledge

Enhanced nursing scholarship is another intended benefit of the Sigma-Pathway partnership. To disseminate nursing knowledge to a global audience, Sigma will create an ANCC page in its open-access repository. The Sigma Repository (formerly the Virginia Henderson Global Nursing e-Repository) is the only repository solely dedicated to sharing works created by nurses around the world.10 It freely collects, preserves, and disseminates full-text nursing research, educational, and evidence-based practice (EBP) materials in a variety of formats and item types. Any nurse, anywhere, can submit a scholarly article, which will be peer reviewed and added to the collection. Likewise, anyone can access the repository and find a trove of unique and relevant research, EBP resources, and educational materials across an unrestricted timespan.

Creating a dedicated ANCC page means that all ANCC-authored articles and studies pertinent to ANCC programs (Pathway to Excellence, Magnet, accreditation, and certification) will be housed in one location for nurses to access. At the same time, nurses in Pathway-designated hospitals can search the repository for resources as they implement EBP as part of the quality and safety practice standards.

Helping nurses prioritize options

Nurses face many competing priorities with little guidance on what matters most. Through their partnership, Sigma and Pathway send a clear, collective message about healthy work environments, leadership, professional development, and more. Together, they aim to impact frontline nurses and help them better understand their role in creating a positive workplace.

Strong relationships are the glue that holds healthcare together, and building these relationships is critical in our interconnected world. It isn't just imperative that nursing entities work together, but it's also essential that we share resources to help nurses focus on what's truly important. Sigma and Pathway are united in the common cause to help nurses live the standards that will build a culture of wellness and a caring environment.


1. Sigma.
2. American Nurses Credentialing Center. ANCC Pathway to Excellence Program.
3. American Nurses Credentialing Center. 2020 Pathway to Excellence and Pathway to Excellence in Long-Term Care Application Manual. Silver Spring, MD: American Nurses Credentialing Center; 2020.
4. American Nurses Association. Healthy Nurse, Healthy Nation: year two highlights 2018-2019. 2019.
5. American Nurses Association. COVID-19 survey results. 2020.
6. Dzau VJ, Kirch D, Nasca T. Preventing a parallel pandemic—a national strategy to protect clinicians' well-being. N Engl J Med. 2020;383(6):513–515.
7. Hume L. An investment in staff well-being. Nurs Manage. 2018;49(12):9–11.
8. American Nurses Credentialing Center. Pathway to Excellence: testimonials and case studies.
9. Health Policy Institute of Ohio. A call to action: improving clinician wellbeing and patient care and safety. 2020.
10. Sigma Repository.

Sigma and Pathway invite organizations and individuals to unite with the common goal of building a healthier workplace by submitting abstracts or award nominations or attending future conferences. Sigma's Creating Healthy Work Environments event is designed to help leaders in both academic and clinical settings develop, implement, and maintain strategies to improve their organization's work environment. Find more information at The ANCC Pathway to Excellence Conference unites 1,000+ nurses from around the world for workshops, exhibits, and presentations focused on best practices and the essential elements of developing a positive practice environment for nursing. Learn more at

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