Abstract
AIMS: To understand how nurses perceived the contributions of the Dutch Excellent Care Program, the development of nurses' leadership, and their ability to positively influence their work environment. BACKGROUND: Research shows that the nursing work environment influences job satisfaction, retention, and quality of care. Many countries have created programs such as the Excellent Care Program to improve nurses' leadership and facilitate a positive work environment. METHODS: A descriptive qualitative study based on 17 semistructured group interviews (participants N = 52) and directed content analysis using thematic coding. RESULTS: Four program processes contribute to leadership development: (1) nurses taking responsibility for their knowledge and skills development; (2) strengthening organizational structures to improve nursing governance; (3) challenging the status quo with quality-enhancing projects; and (4) enhancing awareness of the supportive role of the nurse manager. CONCLUSIONS: The program supported nurses' leadership development for a positive work environment. The interrelatedness of the four processes enhanced the nurses' ability to solve day-to-day problems and challenge the status quo that influenced working practices. Implications for Nursing Management. The findings support making improvements to healthcare organizational strategies to encourage nurses to show leadership in their work environment.