In 2003, the Texas Nurses Association (TNA) began work to positively affect nurse retention by improving the workplace for nurses and established the Nurse-Friendly™ designation of Texas Nurses Association . The program was partially funded with a five-year grant from the U.S. Health Resources and Services Administration (HRSA). The goal of this program was to improve both the quality of patient care and professional satisfaction of nurses working in rural and small hospitals in Texas. The first Nurse-Friendly™ hospitals were designated in May 2005.

TNA received many inquiries from other states about expansion of Nurse-Friendly hospital designation. TNA sought to transfer the program to a robust, collegial organization that could build on the program’s success, while assuring the program’s integrity as it was made available to facilities nationwide. From ANCC’s perspective, the high quality and superb reputation of the Texas Nurses Association Nurse-Friendly hospital designation program made it a perfect addition to ANCC’s existing portfolio of credentialing activities. Thus, a true “win-win” was born and in 2007 ANCC acquired Nurse-Friendly designation of the Texas Nurses Association.

In re-launching the Nurse-Friendly hospital designation to a national audience, ANCC renamed the program, now known as the Pathway to Excellence® Program;.