ANCC’s Pathway to Excellence: Commitment to Good Nursing Environments

  • Print Page

By Debra Wood, RN, contributor

Health care facilities that want to demonstrate their excellent nursing environments have a new option — the American Nurses Credentialing Center’s (ANCC) Pathway to Excellence® designation.

Ellen Swartwout, RN, MSN, NEA-BC
Ellen Swartwout, RN, MSN, NEA-BC, directs the Pathway to Excellence program for ANCC.

“The Pathway to Excellence program recognizes the essential elements of an ideal nursing practice environment,” said Ellen Swartwout, RN, MSN, NEA-BC, director of Pathway to Excellence for ANCC. “The focus is on the workplace, balanced lifestyle, whether there is a collaborative atmosphere, positive nurse job satisfaction and retention, and that nurses feel their contributions are valued.”

Most nurses are familiar with the ANCC Magnet Recognition Program®. Pathway to Excellence differs from Magnet, Swartwout explained, in that Magnet also recognizes excellence in patient care, with standards that encompass leadership, professional practice and development, innovation and research, and outcomes.

“Magnet has much more emphasis on nursing research,” said Ruthie Robinson, RN, PhD, CEN, FAEN, director for the Center for Nursing Innovation at CHRISTUS Hospital-St. Elizabeth in Beaumont, Texas, and CHRISTUS Hospital-St. Mary in Port Arthur, Texas, which hold both Pathway to Excellence and Magnet status.

The difference in research abilities may sway some hospitals to pursue Pathway to Excellence rather than Magnet. Although Tahoe Forest Hospital in Truckee, Calif., has now affiliated with the University of California, Davis to conduct nursing research, at the time it sought Pathway to Excellence designation in the spring of 2008, Sandra Golonka, RN, MSN, chief nursing officer, considered research a weak area for the facility. Pathway to Excellence gave the hospital another option to show nurses its commitment to providing a quality nursing work environment.

Pathway to Excellence evolved from the former Texas Nurses Association’s Texas Nurse Friendly Hospital initiative, which launched in 2003. Fifty-one hospitals earned that distinction, meeting 12 practice standards to improve the work environment and, in turn, retention. Those hospitals were grandfathered into the new program, when ANCC assumed ownership of the program in 2007.

“You know if a hospital has Pathway to Excellence, you can expect certain things from that facility,” Robinson said.

ANCC has spent 2008 and 2009 transitioning to the new program. It made minor revisions to the original standards so they would apply to a national audience. The current practice standards include:

1. Control of nursing practice
2. Safety of the work environment
3. Systems in place to address patient care concerns
4. A solid nurse orientation
5. A chief nursing officer involved at all levels of the organization
6. Professional development opportunities
7. Competitive wages
8. Nurse recognition
9. Balanced lifestyle
10. Exemplary interdisciplinary collaboration
11. Leadership accountability
12. Quality initiatives

A self-assessment, available at the ANCC Web site, can assist nursing leaders in evaluating whether their organization is ready to participate in the program and what they still need to build upon to meet the standards. ANCC offers Pathway to Excellence workshops to help organizations prepare to apply.

When applying for the Pathway to Excellence designation, hospitals must submit a written description of how they are meeting the 12 standards. A three-nurse review panel evaluates the application. Swartwout estimates it takes facilities between six months to a year to complete the application.

If the facility’s written application passes muster, ANCC conducts an online nurse survey to validate that the information in the documentation accurately reflects nurses’ perceptions. At least 51 percent of the facility’s nurses must fill out the form, and 75 percent of the results must be favorable.

Since ANCC took the program over, 19 hospitals have achieved Pathway to Excellence designation.

The program is suitable to all size facilities. Facilities can hold both Magnet and Pathway designations, but Swartwout indicated many organizations use Pathway as a bridge or first step toward Magnet.

“It is ideal for small and medium health-care organizations, such as clinics or critical access organizations,” Swartwout said.

Golonka indicated Pathway to Excellence is well suited to rural hospitals that may not have the resources of a large, urban center.

“[Pathway to Excellence] has a lot of the qualities of Magnet status, but it focuses on establishing a professional work environment and achieving the best nurse outcomes that we can,” said Golonka, adding that nurses look for organizations that value nurses, and the designation by a national organization signals a sense of quality in the work environment.

“Pathway to Excellence shows a commitment by the organization to nursing and the nursing staff,” Robinson said. “That is very positive.”

For information about how your facility can participate, visit the ANCC Pathway to Excellence site.

© 2009. AMN Healthcare, Inc. All Rights Reserved.