title: Building a nursing productivity measure based on the synergy model: first steps.
abstract: BACKGROUND
  The Synergy Model describes nurses' work on the basis of the individual needs of patients and their families.
  
  
  OBJECTIVE
  To generate data necessary to develop a nursing productivity system by using the Synergy Model as a conceptual framework.
  
  
  METHODS
  Nurses from 3 different intensive care units participated. In phase 1, charge nurses in focus groups described patient and family indicators considered when making nurse-patient assignments. In phase 2, charge nurse data were used to construct a survey for experienced staff nurses, asking them to link the indicators to 3 levels of nursing workload.
  
  
  RESULTS
  Thirty charge nurses considered all 8 patient dimensions of the Synergy Model when making nurse-patient assignments. Thirty-two experienced staff nurses completed 79 surveys ranking patients' stability as the most important dimension in patient care followed by complexity and predictability. Respondents linked a common set of unique indicators to each of the patient dimensions of the Synergy Model: fluctuation in vital signs was linked to stability; number and severity of diagnoses, to complexity; trajectory of illness, to predictability; lack of reserve, to resiliency; invasiveness of procedures, to vulnerability; family educational level and participation style, to family participation in decision making/care; and home environment, to resources. Sets of indicators were common across units and clustered around level of workload.
  
  
  CONCLUSIONS
  The Synergy Model shows promise as a conceptual framework for a nursing productivity system. Using a model that centers nursing work on patients' needs may better capture what nurses do and enhance our capacity to quantify nursing resource allocation.
authors.affiliation: School of Nursing, University of Pennsylvania, Philadelphia, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kohr
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Hickey
authors.forename: Martha A Q
authors.initials: MA
authors.lastname: Curley
mesh_terms: D017598:Efficiency, Organizational; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D016294:Models, Nursing; D017146:Models, Organizational; D009511:New England; D009732:Nursing Care; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010561:Personnel Staffing and Scheduling; D016526:Workload