1. Murray, Kathleen MSN, RN, CNA

Article Content

Pathway to Excellence or Magnet(R) recognition?

Q I'm a director at a rural 100-bed facility, which is currently pursuing Pathway to Excellence. Staff members have asked why we aren't going for Magnet(R) recognition. Can you provide the key differences between these programs?


According to the American Nurses Credentialing Center's (ANCC) Pathway to Excellence program requirements, the organization is to submit a written description of how it's meeting the following 12 standards:

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

* nurses control the practice of nursing


* the work environment is safe and healthy


* systems are in place to address patient care and practice concerns


* orientation prepares nurses for the work environment


* the CNO is qualified and participates in all levels of the organization


* professional development is provided and used


* equitable compensation is provided


* nurses are recognized for achievements


* a balanced lifestyle is encouraged


* collaborative relationships are valued and supported


* nurse managers are competent and accountable


* a quality program and evidence-based practice are used.1



The Pathway to Excellence designation is granted for 3 years. An organization receives designation thorough the following review process:


* A self-assessment for nurses at all levels is conducted regarding how the 12 practice standards are active in its practices, policies, and culture.


* The organization is required to submit demographics and supporting evidence.


* The submitted documents are reviewed by at least three ANCC nursing experts.


* After completion of a successful document review, the organization's nurses participate in a confidential ANCC online survey to validate the integration of practice standards.


* The final decision is made by the Commission on Pathway to Excellence, which grants official designation and re-designation after a final review.



The estimated minimal financial implications for a 50- to 100-bed facility are: application fee, $1,500; document submission fee, $14,160; and if additional documentation is required, $700, for a total of $16,360.


The new 2014 Magnet(R) requirements have transitioned to a focus on empirical outcomes.2 Of the 49 sources of evidence, 50% are based on empirical outcomes. For example, organizations must submit nurse-sensitive clinical outcomes, patient satisfaction, and nurse satisfaction for all units with a comparison to national median/mean benchmarks. In addition, the organization is required to engage in nursing research. The Magnet designation is granted for 4 years.


For re-designation, the organization is required to submit interim reports before resubmission of the Magnet document, which include data for the number of RNs with BSNs and specialty certifications, patient satisfaction, nurse satisfaction, and nurse-sensitive clinical indicators. The organization is also required to submit a document providing examples and outcome data for the 49 sources of evidence.


The estimated minimal financial implications for a 50- to 100-bed facility, excluding costs for research, certification, academic requirements, clinical ladders, and shared governance, are: application fee, $4,200; appraisal fees, $13,750; and site visit fees, $5,500, for a total of $23,500.


Your hospital's executive team most likely completed a gap analysis comparing the necessary infrastructure for Magnet and may not have all of the required resources to pursue Magnet recognition at this time. Clearly, they've strategically chosen to pursue the Pathway to Excellence program as a first potential milestone in pursuing Magnet recognition.




1. American Nurses Credentialing Center. ANCC Pathway to Excellence program. [Context Link]


2. American Nurses Credentialing Center. ANCC Magnet Recognition program. [Context Link]