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

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.