1. Pabico, Christine PhD, RN, NE-BC, FAAN
  2. Graystone, Rebecca MBA, MS, RN, NE-BC

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The American Nurses Credentialing Center's (ANCC) Pathway to Excellence(R) Program (Pathway) and The Leapfrog Group (Leapfrog) are pleased to share that the Pathway program is now included in the Leapfrog Hospital Survey-an annual assessment of hospital safety, quality, and efficiency performance measures. Incorporating Pathway's commitment to workplace excellence in the Leapfrog survey will not only raise the bar for nursing practice in hospitals across the country, but also advance nurses' involvement in critical workforce areas, such as nurse staffing and leadership.

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About the Pathway to Excellence Program

The Pathway to Excellence Program recognizes any healthcare organization, regardless of size or setting, for their commitment to achieving and sustaining positive practice environments where nurses excel. To qualify, organizations meet Pathway Standards essential to an ideal nursing practice environment. Nurses trust that Pathway-designated organizations respect their contributions, support professional development, and nurture optimal work settings.


About The Leapfrog Group

The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American healthcare by providing data consumers need to make informed decisions. The flagship Leapfrog Hospital Survey and new Leapfrog Ambulatory Surgery Center (ASC) Survey collect and transparently report hospital and ASC performance. The Leapfrog Hospital Safety Grade, Leapfrog's other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.


A natural alignment

Effective this year, ANCC Pathway-designated hospitals participating in the Leapfrog Hospital Survey will have the opportunity to earn full credit for the National Quality Forum (NQF)-endorsed Safe Practice #9: Nursing Workforce. Safe Practice #9 is used to assess hospitals on their dedication to providing safe patient care across all settings and specialties by ensuring that nurses at every level, including senior administrative and unit levels, are highly skilled professionals. It also verifies that organizations are placing nurses in leadership positions with decision-making roles in nursing practice and patient safety issues. Hospital performance on Safe Practice #9 is counted among other measures in the Leapfrog Hospital Safety Grade, a letter grade of A, B, C, D, or F issued to eligible general hospitals twice annually.


According to Leapfrog President and CEO Leah Binder, Leapfrog's team of experts agree that concepts in Safe Practice #9 align directly with the six Pathway Standards of safety, quality, leadership, professional development, and shared decision-making, as well as elements in Pathway's Organizational Overview. These concepts include clinical nurse involvement in reporting, reviewing, and identifying safety events; nurse leadership of quality improvement initiatives to improve outcomes; nursing leadership performance evaluations; adequate and competent staffing requirements; transition-to-practice programs; and a culture of interprofessional decision-making.


Uniting to elevate quality and safety

Pathway and Leapfrog share an overarching goal to improve safe, high-quality patient care, and the Pathway program aligns with nursing workforce elements in the Leapfrog survey, including awareness, accountability, ability, and action to ensure adequate and competent nursing staff and leadership at all levels. As the premier designation for positive practice environments, Pathway recognizes organizations that establish the foundations of a healthy workplace. To achieve the credential, organizations must first successfully demonstrate the presence and full integration of the six Pathway Standards in their policies and practices. Nurses at all levels are then invited to complete a confidential Pathway Survey to validate that the Pathway Standards have been enculturated and become the lived culture in their organization. The Pathway Survey ensures that nurses at all levels are empowered, engaged, and have a strong voice in their practice. The Pathway Framework for Positive Practice Environments (Figure 1) guides organizations in their workplace culture transformation, shapes workforce development programs, safeguards clinician well-being, and influences healthcare system and national policies.

Figure 1:. Pathway t... - Click to enlarge in new windowFigure 1:. Pathway to Excellence

For more than 20 years, Leapfrog has worked to promote transparency in healthcare, collecting, analyzing, and disseminating data to inform value-based purchasing and improve decision-making. Open to every acute care hospital in the country, the Leapfrog survey measures quality standards across areas that include medication safety, surgical outcomes, infection rates, and other patient priorities. These standards align with those of the NQF and the National Database of Nursing Quality Indicators(R). Data are publicly reported, empowering consumers with easy access to compare healthcare providers.


Elevating nursing's role

ANCC believes every nurse deserves to work in an environment that's safe and supportive and promotes the highest level of excellence in nursing practice and patient care, and Leapfrog is a trusted and long-standing voice for patient safety, quality, and transparency. As such, ANCC's credentialing programs are a natural fit for the Leapfrog Hospital Survey and its efforts to improve these elements in hospitals nationwide. "Leapfrog looks to recognize hospitals where nurses, nursing leadership, and nursing values are respected and central to all operations, and our experts agree that ANCC Pathway designation was a reliable resource for identifying those hospitals. Abundant evidence suggests nurses are critical to safer, higher quality care for patients, as well as a more engaged workforce," said Binder. "Inclusion in the survey underscores the growing importance, and undisputable role, of nursing practice in the nation's ever-changing healthcare system, especially in the wake of extraordinary challenges related to the COVID-19 pandemic."


Dr. Valerie Morrison, the chair of the Commission on Pathway to Excellence, agrees. "A partnership with Leapfrog brings synergy to the work nurses and nurse leaders are completing to ensure their patients receive high quality, safe patient care," said Morrison. "When organizations are recognized by these two premier organizations, patients and families can trust that they are receiving top-notch care by a dedicated healthcare team."