Healthcare Providers Strive For Excellence

February 8th, 2012


By , BSN, RN

Hospitals and other healthcare facilities that earn Magnet Recognition are examples of how nurses and nursing care can influence patient outcomes. It is a great honor and it is one healthcare providers spend a lot of time and money to achieve. However, there are only about 400 Magnet hospitals around the world and thousands of fine healthcare institutions employing nurses everywhere you look.

So, is there another way to judge what it will be like to work for a healthcare provider? The answer is yes. The American Nurses Credentialing Center (ANCC) has adopted a program that recognizes hospitals for the quality of patient care and professional satisfaction of the nurses who work in them. Called the Pathway to Excellence designation, the ANCC started awarding the honor in 2007 after acquiring the program from, I’m proud to say, my home state of Texas.

How We Got On the Pathway

In 2003, the Texas Nurses Association (TNA) began working on a project to positively affect nurse retention at the state’s rural and small hospitals. They called their honor, the Nurse-Friendly designation. The program was partially funded with a five-year grant from the U.S. Health Resources and Services Administration (HRSA). The first Nurse-Friendly™ hospitals were designated in May 2005.

The TNA received inquiries from many other states about expanding the Nurse-Friendly designation. The TNA decided it wanted to transfer the program to a collegial organization that could build on the program's success, while assuring the program's integrity as it was made available to facilities nationwide.

In came the ANCC, which felt the Nurse-Friendly designation would make a perfect addition to ANCC's existing portfolio of credentialing activities, including the Magnet Recognition Program. When the ANCC acquired the Nurse-Friendly designation they renamed it and launched it to a national audience, calling it the Pathway to Excellence® Program.

How Do You Get On the Pathway?

The application process is similar to Magnet but there are few key differences. Pathway is focused on determining whether the work environment is one in which nurses can excel. The Magnet designation is aimed at how nursing excellence influences patient outcomes.

Magnet applications require two years of outcome data, which is not required for Pathway. Unlike Magnet, Pathway does not require a facility to take part in nursing research though it does require proof of evidence-based practice being used at the hospital in question. Site visits are included in the Magnet approval process but not for the Pathway to Excellence. Finally, Magnet costs a whole lot more.

What Defines the Pathway to Excellence?

Hospitals that meet 12 standards of practice deemed critical to providing a work environment in which nurses can flourish earn the Pathway to Excellence designation. The practice standards are based on research and expert input as to what makes a positive work environment for nurses and how that work environment is then reflected in the quality and safety of patient care and the satisfaction of both nurses and patients.

The 12 standards of practice are:

  1. Nurses control the practice of nursing. – Nurses have a voice in their practice, policies, and procedures.
  2. The work environment is safe and healthy. – The hospital is a secure workplace with policies in place that do not allow for harassment, bullying, or other forms of workplace bad behavior.
  3. The organization has systems in place to address patient care and practice concerns. – Patients always have the ability to speak with someone regarding their care and the Patient’s Bill of Rights is always enforced.
  4. Orientation prepares new nurses. – Mentoring and precepting programs and formal orientation programs are in place to support new graduate nurses and experienced nurses new to a specific specialty. A comprehensive orientation can impact a nurse's decision to stay at an organization and can influence the level of quality care delivered.
  5. The Chief Nursing Officer (CNO) is qualified and participates in all levels of the facility. – The CNO is the highest nursing authority within a healthcare organization. It is crucial he or she have the proper qualifications for the role and be at the executive table when decisions are made about patient care delivery.
  6. Professional development is provided and utilized. – Hospitals have comprehensive programs for staff development and opportunities for nurses to attend conferences, conduct academic work, and join professional organizations.
  7. Competitive salaries are in place. – Salaries are adjusted accordingly to the size of the organization, the market analysis in the area, cost of living, and similar organizations.
  8. Nurses are recognized for achievements. – Recognition is an important factor in nurse retention and satisfaction. It lets nurses know their contributions
 are valued.
  9. A balanced lifestyle is encouraged. – It is important that nurses care for themselves so they can provide optimal care to those in need. Examples of programs that Pathway to Excellence organizations provide to enhance work–life balance may include flexible scheduling, childcare, employee assistance, and wellness programs.
  10. Collaborative interdisciplinary relationships are valued and supported. – Staff members are encouraged to work in interdisciplinary teams and become members of interdisciplinary councils. This allows staff nurses’ voices to be heard across the organization.
  11. Nurse managers are competent and accountable. – Strong nursing leadership has long been recognized as helping to retain nursing staff. There should be programs to help and support staff nurses to become leaders, and encourages transitioning from staff roles to leadership roles through mentoring and succession planning.
  12. A quality program and evidence-based practices are used – Evidence-based practice has been identified as an essential component of improved patient outcomes. A program, in which clinical decisions are based on solid evidence translates into better patient outcomes. Nurses play a key role in quality initiatives for patient care improvements, and they lead many efforts to implement best practices in patient care.

Another cool thing about the Pathway to Excellence designation, like its predecessor it is achievable by smaller facilities. Not only hospitals can earn the honor but hospice centers, surgical centers clinics, even doctor’s offices can apply for and be recommended as employers committed to both their patients and their nursing staffs. Designation confirms to the community that the organization values its nurses and in return, nurses are more likely to recommend the organization to their peers as a great place to work.

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