Bookmark and Share

Practice Standards

Pathway Standards are based upon expert nurse input, nursing literature and research that supports the qualities of a positive practice environment. All 6 standards apply to health care organizations and long term care institutions. Additional standards apply to the long term care environment.

Pathway Standard 1: Shared Decision-Making 

Organizations achieving Pathway to Excellence® designation have an established shared governance structure as the foundation for involving direct care nurses in decision making.

Allowing direct care nurse input into decision making influences all aspects of care delivery.

Interprofessional collaboration is also integral within the organization, engaging staff, building teamwork, and strengthening the shared governance culture.

Nurses should:

  • Be included in organizational shared governance initiatives
  • Have input into operational decisions, including changes in practice and workflow
  • Be involved in the interdisciplinary process addressing ethical concerns
  • Be engaged in the decision-making process regarding product evaluation
  • Provide input into the hiring of nursing staff

Pathway Standard 2: Leadership 

Effective and competent leadership within Pathway to Excellence–designed organizations fosters the foundation of collaboration among staff and supports a shared governance environment.

CNOs and nurse managers actively engage direct care nurses for input in the areas of:

  • Resource allocation
  • Cost management, and
  • Staff and patient advocacy

As leadership champions within the organization, the CNO and nurse managers are accessible and effective advocates for direct care nurses and patients, especially in times of organizational change.

Leaders continuously strive to increase their core knowledge and role competency through leadership development activities along with feedback from colleagues and nursing staff. 

Pathway Standard 3: Safety

Pathway to Excellence organizations protect the safety and well-being of nurses, staff, and patients through safety policies and processes.

Developed and revised by interprofessional collaboration, the safeguards provide mechanisms for monitoring patient and staff-related events as well as professional practice behaviors.

A safe environment includes measures to prevent violent incidents within the organization against staff and patients. Leaders establish safety practices that incorporate a collaborative decision-making approach to staffing, and include consideration of safety concerns related to fluctuations in patient acuity and transitions in care.

Pathway Standard 4: Quality

Quality initiatives in Pathway to Excellence organizations are developed through interpersonal collaboration.

The organization-wide quality initiatives are evidence-based, focused on improving patient outcomes, and implemented based on internal and external benchmarking.

These initiatives include developing and revising patient care standards and policies as well as staff education.

Interprofessional teams within Pathway organizations are patient advocates driven by strong missions, visions, goals, and values.

Pathway Standard 5: Well-Being

This standard focuses on providing staff the opportunity to develop a balance between work and personal life. Work-life effectiveness is a core component of Pathway designated organizations.

Staff is actively involved in organizational initiatives that promote work-life balance. Nurses’ important contribution and participation in community service, patient advocacy, and improving population health are encouraged, supported, and recognized by Pathway organizations.

scheduling is another organizational element to assist staff achieve a balance between work and personal life. Organizations collaborate with frontline staff to create innovative strategies that foster optimal wellbeing.

Having such programs in place, as well as providing opportunities during work hours for nurses to care for themselves, supports nurses and provides organizational benefits through higher staff retention rates and more involved, motivated, and confident staff.  

Pathway Standard 6: Professional Development

 Pathway to Excellence organizations recognize the importance of staff orientation, collaboration, and development in the delivery of safe and effective patient care.

The foundation for developing competent and collaborative staff begins with a comprehensive orientation that includes individualization of learning needs and clinical experiences to allow smooth transition into practice with the support and guidance of mentors, preceptors, or other nursing experts.

Pathway to Excellence organizations value and recognize the importance of lifelong learning, ongoing education, and professional development activities.  

Research demonstrates that nurses are attracted to, and remain at, their place of employment when opportunities exist that allow them to advance professionally. 

Pathway Standards for Long Term Care Facilities
In addition to the pathway standards above, long term care institutions are required to meet standards unique to their health care setting.

  • Certified Nurse Assistants (CNAs) are included in the nursing community.
  • Educational standards are temporarily established for Directors of Nursing (DON).
  • Standards about staff education regarding zero tolerance of resident abuse and neglect; and policies/protocols on the use of restraints and prevention of falls.
  • A person-centered model of care is understood.

Learn more about Pathway to Excellence in Long Term Care®.

Learn More
References [pdf]