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Pathway to Excellence® General FAQs

Pathway to Excellence®
General Facts and Questions

The American Nurses Credentialing Center (ANCC) Pathway to Excellence® (PTE) Program recognizes a health care organization’s commitment to creating a positive practice environment that empowers and engages staff. The evidence-based Pathway Standards provide an essential foundation for creating a culture of sustained excellence—a critical goal for organizations to thrive in this value-based industry and plays a key role in the successful recruitment and retention of high-performing nursing staff. Below are frequently asked questions (FAQ) from organizations embarking on the Pathway to Excellence journey.

Throughout this document, the following acronyms will be used:

  • PPO- Pathway Program Office
  • PPD- Pathway Program Director
  • PSD- Pathway Standards Documents
  • PLC- Pathway Learning Community
  • CNO- Chief Nursing Officer, the highest-level nurse with ultimate responsibility for all nursing practice within the organization. The title for the CNO role may vary by organization. General information

General information

What is Pathway to Excellence?

The American Nurses Credentialing Center (ANCC) believes every nurse deserves to be working in positive practice environment. The Pathway to Excellence Program® – is the premier designation for healthy work environments and recognizes health care organizations that demonstrate a commitment to establishing the foundation of a healthy workplace for staff.

Where can we learn more about Pathway to Excellence?

Visit the Pathway website to learn about Pathway and the benefits of a positive practice environment.

Is Pathway just for hospitals?

  • Pathway to Excellence is not just for hospitals; organizations across the healthcare continuum that employ nurses, are eligible to apply.
  • See eligibility criteria:

https://www.nursingworld.org/organizational-programs/pathway/apply/eligibility/

Is my organization eligible to apply? Can our entire hospital system apply for Pathway designation?

  • See Pathway to Excellence application eligibility criteria:

https://www.nursingworld.org/organizational-programs/pathway/apply/eligibility/

  • A Multi-facility healthcare system cannot apply as a whole. However, individual organizations within the system may apply. Please refer to the campus definition in the 2016 acute or 2017 LTC application manuals revised May 2018 or as stated below.

 

Topic

Eligibility Criteria

Chief Nursing Officer and Nursing Leadership

The applicant organization must designate one individual as the chief nursing officer (CNO) who is ultimately accountable for the standards of nursing practice throughout the organization.

·         The CNO is responsible for all nursing practice; therefore, all areas and campuses under the CNO's accountability where nursing is present must be included in the application, regardless of reporting relationships.

·         The CNO, as part of the organization's highest governing, decision- making, and strategic-planning body, advocates for nursing to the Board of Directors.

·         The CNO must hold, at a minimum, a baccalaureate degree in nursing at the time of application.

·         All requirements must be maintained through the application phase, the review phase, and designation as a Pathway to Excellence organization.

·         Appointees as interim CNOs and subsequent CNOs, must also comply with all requirements.

Organizational Structure

Individual organizations within the system may apply; however, a multi-facility healthcare system cannot apply as a whole.

*For those with campuses, please refer to the campus definition.

Compliance

The organization must be compliant with all state and /or federal laws as they relate to registered nurses in the workplace

Campus Definition

For Pathway purposes, campuses are remote care sites of an applicant organization. The CNO of the applicant organization is accountable for nursing practice at the remote sites. Campuses typically provide services to augment the full set of services offered at the primary site.

Can my organization include our other locations in our application?

  • Applicant organizations may include additional campuses as defined by Pathway.
  • Additional fees are incurred for additional campuses.
  • Questions? Email your questions and the organizational chart reflecting nursing service to pathwayinfo@ana.org.

Getting Started

How does my organization start our Pathway journey?

  • Conducting a Self-assessment of Organizational Culture is a good first step to evaluate your organization’s current state by comparing itself against Pathway's compulsory elements of performance. Frontline staff and leaders are involved in conducting the self- assessment and gap analysis to identify gaps for improvement and celebrate areas where the Pathway Practice Standards are active in the organization’s practices, policies and culture.

We’re anxious about how we will begin the Pathway journey and the work to be done, can you help?

  • It is not unusual to be a little anxious at the beginning, most applicants have been successful. Take time to explore the many resources designed to assist your Pathway journey before you
    • Attend the Pathway Applicant Workshop, a one day workshop that covers provides strategies and best practices for organizations across the continuum embarking on the Pathway to Excellence journey. Pathway’s expert staff will provide:
    • Guidance on how to start the journey
    • Engagement strategies
    • Resources and tools to assist in the application and appraisal process
    • Strategies for writing the narratives
    • Pragmatic exercises to enhance thought processes
    • Attend the annual Pathway to Excellence Conference. It’s a great resource and networking opportunity for organizations who are considering applying for thePathway designation. View the conference video http://www.pathwaycon.org/
    • You may also connect with Pathway-designated organizations with a similar setting. Click Find Pathway Organizations

How do I order the required Pathway application manual for my organization?

What are the Pathway designation requirements?

To achieve the Pathway to Excellence or Pathway to Excellence in Long Term Care designation:

  • The presence of all the Pathway Standards must be demonstrated in the submitted PSD; and
  • Meet Pathway Survey thresholds to validate that essential elements of a positive practice environment are enculturated in the organization. See Required Threshold for Pathway

Is there a site visit for the Pathway to Excellence application?

  • There is no site visit for the Pathway to Excellence application. The Pathway validation process is through a voluntary and confidential nursing survey, which is a clear attestation of giving the frontline staff a voice. Pathway to Excellence designation can only be achieved if the nurses at the organization affirm via the Pathway Nurse survey that the Pathway Standards are integrated and alive throughout the

What are the 4 phases of Pathway to Excellence application?

Applicant Registration – approved Online Application grants official Pathway

applicant status.

Pathway Standards Document Submission and review - Upload Pathway Standards Document – No later than the date of your approved submission cycle. PSD is reviewed by a team of appraisers.

Pathway Survey- if applicant is eligible to advance to Nurse Survey, the survey is administered by Pathway Program

Recognition and Reflection- by Commission on Pathway to Excellence

What should we do before we apply?

  • Establish front line staff engagement at the very beginning
  • Conduct an organization wide Self-Assessment of Organizational Culture, it is recommended that nurses at all levels be included early in this process and establish a plan to close the gaps
  • Purchase the required application
  • Establish a timeline and realistic date/cycle for PSD submission and nurse

What are the Pathway Standards Document submission cycles?

The Pathway office accepts Pathway Standards Document on 5 cycle dates annually

  • February 1, April 1, June 1, August 1, November 1

When do we need to complete the Online Application?

  • Complete the Pathway Online Application between 8 to 12 months before your selected PSD submission cycle. Once the online application is completed and approved by the PPO, organizations are considered official Pathway

What are the benefits of being an official Pathway applicant?

Access to additional resources is granted only to official Pathway applicants. These additional resources include:

  • Pathway Learning Community (PLC)- contains discussion posts and replies from official applicants and designated organizations as well as a Resource Center with all Pathway documents and webinars
  • Pathway Program analyst- Each organization is assigned an analyst who is available to answer questions and provide guidance. The analyst contact information is provided in the welcome letter sent to all official
  • Open Forums- twice monthly open forum calls led by the Pathway Program analysts that cover timely topics related to document
  • E-newsletters
  • Recorded Welcome

What is the Pathway Online Application timeline?

Pathway Online Application is due between 8- 12 months prior to the intended submission

  • E.g., if an applicant selects the June 1, 2019 submission cycle, the online application must be completed no later than 8 months before the submission cycle (no later than October 1, 2018).
  • Applicant organizations may apply as early as 12 months before the submission cycle. (e.g. complete Online Application June 1, 2018 and select the June 1, 2019 submission cycle).

What if we are unable to meet the Pathway Standards Document submission cycle deadline?

  • It is important to correspond with your assigned Pathway analyst regarding your progress. If your organization is unable to meet your approved submission cycle deadline, you may request an extension to the next two submission cycles. Fees will be incurred.

Pathway to Excellence Logo

Does my organization have to be an official Pathway to Excellence applicant to use the Pathway on the Journey logo?

  • Applicant organizations whose Online Application has been approved, are granted access to utilize the Pathway On the Journey logo.
  • Pathway-designated organizations are granted the use of the Pathway to Excellence designated
  • The Marketing Toolkit contains program logos and trademark use guidelines, and sample press releases. Visit the Pathway Learning Community http://pathwaylearningcommunity.org to access the Online Marketing Tool

Fees

What are the Pathway to Excellence application fees?

  • Pathway application fees include: 1) Online Application fee – same amount for all applicants 2) Appraisal Process fee – based on number of licensed beds, or number of annual visits for ambulatory care, and where applicable, fees for additional campuses. There is no additional charge for the validation phase- the Pathway Survey. Pathway Learning Community membership is also
  • See website for fees table and additional information: https://www.nursingworld.org/organizational-programs/pathway/Pathway-To- Excellence-Program-Fees/
  • Additional Fees are incurred for additional campuses / branches.

After we apply

What are the requirements to be an official applicant? How does my organization know that our application has been approved and that we were accepted into our requested document submission cycle?

  • After the completed application is received: reviewed by the Pathway Program Office, a Pathway Senior Analyst will be assigned to the organization. The analyst will send a ‘Welcome’ email correspondence to the CNO and Pathway Program Director (PPD) as designated on the Online Application.
  • This email contains your organizations unique application number, and serves as notification of official applicant status, and confirmation of the approved document submission cycle.

Pathway Standards Document Preparation and review

How do we format and submit our Pathway Standards Document (PSD)?

  • The PSD required for the appraisal process is composed of 3 major parts: the organizational demographic form (ODF), Organizational Overview (OO), and responses to each element of performance (EOP) from Pathway Standards 1 to 6. Both initial and re-designating applicants are required to upload the PSD via the online Pathway portal. Organizations are also required to upload a table of contents and glossery.
  • Official applicants can find requirements for formatting the PSD and directions for uploading files into the portal in the Document Submission Guide. This guide, located both in the Pathway Portal and Learning Community (PLC), further describes formatting requirements for page numbering and PDF bookmarking.

When can I expect to be notified by the Pathway office on the outcome of my document review?

  • The document review is performed by the appraiser team to determine whether the applicant organization’s written documentation confirms the presence of the ALL Pathway standards. There are 3 possible outcomes for the first document review:
    1. The document has met all six standards set forth in the Pathway manual and the organization is advanced to the Pathway Survey phase. The organization will receive a congratulatory email from the program office along with further instructions regarding the nurse survey
    2. A set percentage of EOPs within the document have met criteria, but not all, and thus additional information is required to address the unmet The CNO and PPD will receive an email correspondence from their analyst regarding this outcome. This email states that additional information must be provided and that the “application is temporarily suspended” until the identified EOPs undergo a second review. All 6 Pathway standards must be met with the 2nd review for the organization to advance to Pathway survey.
    3. The organization’s document did not meet the set percentage of EOPs required for additional information and thus the review is concluded and the organization is denied designation. A call will be scheduled with the program office to discuss this outcome.
      • Organizations can expect to be notified of the first review outcome approximately 6-8 weeks of the document submission date. The second review will take an additional 4-8 weeks to complete.

Pathway Survey

What is the purpose of the Pathway Survey?

  • The Pathway Survey is an integral part of the appraisal process for organizations applying for American Nurses Credentialing Center (ANCC) Pathway to Excellence designation. The survey invites nurses working at all levels of the organization to share their perceptions of the workplace environment. Responses from the survey play a key part in the decision on whether to award Pathway to Excellence designation.

When do we start the Pathway Survey?

  • Organizations that successfully pass the PSD review phase will be notified by the PPO to advance to the Pathway survey phase.
  • Applicants organizations can expect to be notified of the first review outcome within approximately 6-8 weeks of the document submission date. If applicable, applicants will be notified after the second review, which takes an additional 4-8 weeks to complete.
  • Once notified, applicants are then offered several dates, within a 6 week window, to launch their Pathway Survey.

What is the required threshold for the Pathway Survey?

Pathway Survey Threshold

The minimum performance outcomes required for a successful Pathway Nurse Survey:

  • 60% of all eligible respondents must finish the survey.
  • 50% of respondents must respond strongly agree or agree on ALL 28 survey questions.
  • 75% of respondents must respond strongly agree or agree on at least 21 out of the 28 survey questions.

Important: A score of less than 50% on any of the 28 survey questions on the Pathway Survey will result in an unsuccessful Pathway application.

Who administers the Pathway survey?

  • The Pathway survey is a voluntary and confidential web-based survey, administered by the ANCC Pathway to Excellence program.

Where can we find the questions on the nurse survey?

  • Visit Pathway website or PLC to access Pathway Survey FAQ, frequently asked questions and the topics of each of the 28 survey items on the Pathway to Excellence Nurse Survey https://www.nursingworld.org/organizational-programs/pathway/apply/pathway- survey/
  • The survey questions relate to the presence of essential elements of a positive work environment as defined by the Pathway to Excellence criteria. 
  • Select the appropriate Survey FAQs corresponding to the Pathway application manual for your setting:
    • Acute care- Pathway Survey FAQs
    • LTC - Nursing Survey FAQs

How is the Pathway Survey FAQs used?

  • Applicant organizations use the Survey FAQs in innovative meaningful ways to educate and engage staff. The survey topics can be used to create internal surveys or focus group discussions to help determine gaps that need to be addressed.

What survey results are shared with the applicant organization? Pathway Survey responses?

  • Individual survey results are completely confidential
  • Applicant organizations will only receive participation rate and the final Survey Summary Report listing the percent of favorable responses for each item in aggregate.

What are the responses on the Pathway survey?

  • The survey responses are on a 4-point Likert scale, disagree to agree.

Is it okay for our organization to offer incentives for the Pathway survey?

  • Yes, incentives at a nominal value and provided to all nurses are allowed. Ensure that confidentiality is maintained; the survey is voluntary and confidential, organizations must never require staff to disclose their participation in the survey.
  • See list of Pathway Survey Do / Don’t below.

We are an LTC facility, are nursing assistants invited to participate in the Pathway survey?

  • Yes, a key difference in Pathway to Excellence and Pathway to Excellence in Long Term Care is unlicensed assistive personnel (UAP, e.g. Nurse Assistants, CNAs) are invited to participate in the Pathway Nursing Survey for LTC.

Who is eligible to participate in the Pathway Survey?

Nurse Survey Eligibility

All eligible nurses must be invited by the CNO to participate in the Pathway to Excellence® Survey. Any nurse (RN, LPN, APRN) in the organization, whose nursing practice is under the CNO's oversight is eligible to take the survey, regardless of the nurse’s reporting relationships, except as noted in the chart below.

  • Full-time
  • Part-time
  • Internal : Per diem/prn/float pool
  • Agency
    • Per diem/prn/float pool Long term/ Contract
    • Long term/ Contract
  • Nurses in the above Agency categories are eligible to take the survey if they:

(a)  are contracted to your organization to work more than half-time

AND

b)  have worked at your organization (as an agency nurse) for more than 90 days

AND

c)  The contracted agency nurse is evaluated by your organization

Nurses who work in outsourced services are ineligible to take the survey.

The following considerations for APRNs also apply:

APRNs (Advanced Practice Registered Nurses) include certified registered nurse anesthetists, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners. Eligible

APRNs’ nursing practice must be under the CNO's oversight.

  • Upon successful Pathway Standards Document review, and in preparation for the Pathway Survey, applicant organizations are required to provide a count of their eligible nurses for each category listed below. The Eligible Respondents report (ERR) count must be entered in the Pathway Portal within 5 business days after the organization receives the Nurse Survey Stage
  • Pathway to Excellence in LTC: the above eligibility applies, and unlicensed assistive Personnel (UAP) in nursing service, are included in the LTC Nursing Survey.

Pathway to Excellence Nurse Survey Guide for applicant organizations

DO:

Ensure nurses understand the importance of the Pathway Nurse Survey

  • Do Incorporate the Pathway nurse survey during all phases of the Pathway journey
  • Do Include all areas of nursing in Pathway Events
  • Do Kick Off Events: Intro Team / Theme
  • Do Discuss the Pathway Survey FAQ with Managers and frontline nurse, and provide them copy
  • Do ensure leaders and champions are compliant with Pathway survey guide
  • Do Give ample opportunity for Q&A prior to survey launch
  • Do Include Frontline nurses in planning the roll out of the survey

Create an appropriate environment for nurses to take the survey

  • Do Create a fun atmosphere for the survey
  • Do Share your weekly response updates with staff to encourage participation
  • Do Ensure Pathway survey is voluntary
  • Do Assure nurses confidentiality will be maintained
  • Do Assure incentives are at a nominal value and provided to every nurses
  • Do Have training for staff who will support nurses taking the survey

Ensure logistics of the Pathway survey are addressed

  • Do Work with your IT department in testing and roll out of survey
  • Do provide your organization’s Survey FAQs and “Instructions for Pathway Survey Participants” to ALL nurses
  • Do Ensure opportunity for staff to take the survey during work hours
  • Do promote survey launch and close dates, where they can go to take survey on all shifts.
  • Do inform nurses that they have the option to access the organization’s unique survey link and take the survey on their personal devices, e.g. I-Pad or smart phone.
  • Do ensure Pathway Survey does not overlap with other organizational surveys.
  • Do, if possible, provide survey icon on your organization’s intranet for easy accessibility to the Survey FAQs and instructions.

DON’T

  • Do not coerce nurses to take the survey. Survey participation is strictly voluntary.
  • Do not inquire in any way whether a nurse has or has not taken the The nurse’s participation or non-participation is strictly confidential.
  • Do not exclude nurses from participating in Pathway Standards Fairs or Events

What resources are available to help our organization prepare the Pathway Standards Document?

  • Pathway Learning Community (PLC) - contains discussion posts and replies from official applicants and designated organizations as well as a Resource Center with all Pathway documents and webinars. (See question below for more details on the PLC)
  • Pathway Program analyst- Each organization is assigned an analyst who is available to answer questions and provide guidance. The analyst contact information is provided in the welcome letter sent to all official applicants.
  • Open Forums- twice monthly open forum calls led by the Pathway Program analysts that cover timely topics related to document preparation.
  • Workshops- The Pathway Program Office (PPO) puts on multiple workshops each year for organizations reviewing each phase of the Pathway journey, including the Pathway Standards Document.

What is the Pathway Learning Community (PLC)? Why should we join?

The Pathway Learning Community™ (PLC) is an exclusive online community for nurses committed to creating positive practice environments and promoting excellence in nursing practice. The PLC provides an opportunity for nurses to connect and share best practices, resources, research, experiences, and strategies that have led to positive practice environments, quality patient care, and excellence in professional nursing practice.

The PLC features:

  • Downloadable documents and resources to help you on your Pathway journey
  • Pathway to Excellence resource modules and webinars
  • Networking opportunities with designated and applicant organizations
  • A discussion board where you can ask questions, share best practices with other Pathway organizations, and get questions answered to assist you on your journey
  • Get the latest news and information from the Pathway Program Office
  • Find information about upcoming events related to ANCC & Pathway

Who is eligible to join the PLC and is there a fee?

A Pathway Learning Communities (PLC) membership is available to healthcare organizations that are: currently Pathway-designated, or official applicants who have paid their application fee and received a Welcome Email from the office, or part of our pre-intent program. You may join at any time during the year and subscriptions are managed on an annual cycle.

  • Pathway-designated organizations receive two memberships in the community, one for the CNO and one for the PPD. Designated organizations can purchase an additional 25 memberships for $750.
  • Applicant organizations receive up to 25 memberships in the community included with their application fee.
  • PLC Public page is accessible to organizations who have yet to apply.

My organization is eligible to join the PLC – How do we get access?

As part of the application fee, applicant organizations receive up to 25 memberships in the Pathway Learning Community. Once all application materials are received, approved by the Pathway Program Office, and a Welcome Email is sent to the organization- a Docusign agreement will be sent to the CNO via email. Once that is signed, the organization will receive an email from a community specialist pathwaycommunity@ana.org regarding completion of the PLC’s staff enrollment form. Completion of this form is required for access to the community.

To request more information or join, please provide your contact information and details about your organization via email to pathwaycommunity@ana.org or call 1.800.284.2378, x5193.

What is the benefit of using Pathway Flashcards used?

  • Applicant organizations use the Pathway Flashcards in innovative meaningful ways to educate and engage staff on how they are living the Pathway standards.
  • This fun engagement tool can be used in any forum to discuss the EOPs from the vantage point of the individual staff, the unit, and the organization. Staff can discover stories to help formulate narratives to meet the intent of EOPs.
  • Order Pathway Flashcards via email to pathwayinfo@ana.org.

How do we apply for Pathway to Excellence® redesignation

https://www.nursingworld.org/organizational-programs/pathway/pte-renewal/

We are applying for our Pathway redesignation, what is the redesignation timeline?

  • Pathway-designated organizations must submit the PSD on a submission cycle no later than the first day of the month the designation
    • E.g. an organization designated in April expires the first day of April, and must submit the PSD for redesignation by the April 1st submission cycle.
    • Pathway-designated organizations whose expiration month does not fall on an established submission cycle, may submit the Pathway Standards Document on the next submission cycle.
    • E.g. An organization designated in March, designation expires in March, the Pathway Standards Document may be submitted in April.
    • The current Pathway designation status should remain in good standing while the appraisal process is underway.
  • Pathway Online Application and non-refundable application fee is completed 8 to 12 months prior to the intended submission cycle. Click here to view the five Pathway Standards Document submission cycles https://www.nursingworld.org/organizational- programs/pathway/apply/
  • Notify the Pathway office of your intention to apply for redesignation one year before your current designation expires. https://www.nursingworld.org/organizational-programs/pathway/pte-renewal/

Please Note: When an organization’s designation expires and if the organization fails to designate, the next time that organization applies will be considered an initial

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