Surveys conducted pre‐ and post‐implementation of a synergy tool: Giving voice to emergency teams

Abstract

Aim To investigate the impact of a patients’ needs assessment (synergy tool) on emergency department nurses’ perceptions of quality, safe care delivery and morale. Background The synergy tool provides real‐time data on types of patients, their arrival, management and discharge. This tool was introduced to two urban emergency departments in response to government priorities to reduce emergency department wait times and improve patient flow. Method This survey, a component of participatory action research, measures perceptions of 158 nurses pre‐introduction and 91 nurses post‐introduction of the synergy tool. Result Responses were consistent regarding intent to leave, workload/staffing, spirit at work and quality/safety. One question describing staff as working in ‘crisis mode’ indicated a significant improvement. Conclusion Critical patient care may be missed during periods of overload, placing patients and staff at risk, leading to an increase in intent to leave. The synergy tool provides an objective means in real time for staff to identify their patients’ care needs, assisting management with staffing decisions. Ongoing staff and management communication using tools such as the synergy tool may reduce perceptions of working in ‘crisis mode’. Implications for Nursing Management This research suggests that when managers employ a collaborative process and use evidence‐based tools and approaches to addressing nurses’ workload concerns, nurses’ perceptions of working in ‘crisis mode’ diminish.

Implementing the Synergy Model: A Qualitative Descriptive Study

“…The findings of this study support similar research with the Synergy Model: participants valued the nurse-driven patient-centered approach to this care model [5,[9][10][11]13,14]. This study further demonstrated how one tertiary care healthcare organization was able to successfully standardize the synergy patient needs assessment tool across 12 different clinical programs while adapting the synergy scoring indicators for specific patient populations, such as cardiology and neurology.…”

“…This model was originally developed for use in critical care settings in the United States, but it has since been used in a variety of healthcare sectors in the United States and other countries [5][6][7]. In Canada, the Synergy Model has been successfully used in acute care and inpatient specialty areas [8,9] and in emergency services [10,11]. The premise of this model is that synergy or best possible outcomes arise from a 'fit' between patients' needs and nursing competencies [4].…”

“…Scores can also be averaged and graphed to look for trends in patient population care needs over different lengths of time, such as over a shift, a week, a month, or seasonally. Because the Synergy Model is nurse driven, use of this model has been associated with nurse empowerment and more effective relational practice [9][10][11][12][13][14] while the patient-centered approach to patient needs assessment has been linked to more effective patient outcomes [5].…”

Nurse perspectives in the emergency department: The synergy tool in workload management and work engagement

“…A paper by Wagner et al. (2021) outlines the quantitative descriptive findings from a survey administered to ED nurses at two sites at Times 1 and 2, and details of the overall study are described in another paper (MacPhee, Wagner, et al., 2020). The premise of our study was that engagement of direct care nurses and their leadership would enable us to more effectively meet the goals of the Quadruple Aim (Sikka et al., 2015).…”

A Mixed Methods Study to Implement the Synergy Tool and Evaluate Its Impact on Long-Term Care Residents

“…Psychometric evaluation of the Synergy tool for acute care and specialty settings was carried out in the US where the tool was widely adopted over the last 20 years [19]. Subsequently, the conceptual model and tool spread internationally, including in Canadian jurisdictions [20][21][22].…”