Synergy in the ER: Emergency Department Care and Provider and Patient Outcomes

Summary of Research

Joan Wagner RN PhD, Faculty of Nursing, University of Regina

Sonia Udod RN PhD, College of Nursing, Rady Faculty of Health Sciences,
University of Manitoba

Maura MacPhee RN PhD, School of Nursing, University of British Columbia

Lois Berry RN PhD, College of Nursing, University of Saskatchewan

In Canada, emergency departments are often congested, which can lead to increased patient morbidity and mortality.  Emergency department congestion is also associated with health care provider dissatisfaction and high turnover.  Nurses can experience moral distress as a result of their inability to provide safe, quality care.  In 2016, the Saskatchewan Ministry of Health put forth a goal to reduce emergency department patient wait times by 60 percent and improve patient flow within the department to decrease patient’s length of stay.

The purpose of the synergy research study is to investigate the impact of a patient needs-assessment tool, the synergy tool, on emergency department (ED) care delivery and nurses’ workloads within two busy EDs in Regina. The synergy tool, a real-time staffing tool on patient care delivery and nurse workload management, has been implemented in a variety of practice settings such as acute care, community health care, residential care and mental health care settings across North America but has yet to be implemented in the ED.

We are evaluating the impact of the synergy tool in the following areas: patient outcomes, organizational outcomes (including human resources utilization such as overtime, absenteeism and turnover), quantifying patient care requirements (including determining alternate services that can be provided in a more appropriate and less costly environment), and identifying nurse perceptions of quality, safe care delivery and team work.

This innovative research has yet to be used in a Canadian ED context. This research utilizes a patient-centered model of care and findings will be disseminated to advance healthy workplaces, and improve patient wait times and patient flow in other EDs across Canada.