Nurses at Clarian Health have embarked on an exciting journey that promises to transform patient care and the nursing profession as we know it. Clarian is the first hospital system in the nation to implement the Synergy Model for Patient Care, commissioned by the American Association of Critical-Care Nurses.

This model well represents the varied roles that nurses play within the health care delivery system. At its core, the Synergy Model identifies eight patient needs or characteristics and eight nursing competencies. When these patient needs and nursing competencies are aligned, better outcomes can occur.

We've developed this web page to introduce you to the Synergy Model and how Clarian Health is incorporating it into every aspect of nursing care and development. We believe that once you understand this revolutionary approach to nursing care, you'll be confident in your decision to align yourself as a Clarian Health nurse.

Aligning patient needs with nursing competencies
The patient is at the heart of everything we do at Clarian Health. Decisions are made based on how they help our patients heal in the best possible environment. Because the Synergy Model is so patient-driven, the decision to adopt it at Clarian Health was an easy one. The eight patient characteristics that are evaluated by nurses include:

• Participation in decision making: Evaluates how involved a patient or family member wishes or is able to be in making decisions about treatment options.
• Participation in care: Predicts how involved patients or family members wish or are able to be involved in their own care. For example, one day a mother in the PICU may want to bathe and dress her child. Another day, she may wish for the nurses to care completely for her child.
• Stability: Refers to the ability of the body to maintain itself in a steady-state. We typically identify how stable a patient is by the designation given to patients describing their condition: stable, critical, etc.
• Complexity: Evaluates whether the illness or injury involves multiple body systems. For example, a patient who has both COPD and diabetes might be considered more complex.
• Resiliency: Assesses the ability to return to the original state of being before illness. For example, a 15-year-old boy in car accident who breaks his leg is likely to be more resilient than an 80-year-old woman who falls and breaks a hip.
• Vulnerability: Considers the patient's susceptibility to stressors such as noise, lights, temperature and psychological stressors. For example, in the NICU, we try to reduce the noise and lights around the infants' isolettes.
• Resource Availability: Monitors the support systems in place for the patient such as family and friends, financial resources, etc.
• Predictability: Assesses how likely an illness will follow an established path; for example, a simple cold vs. pneumonia.

Nurses then use eight nursing competencies to respond to these patient needs in such a way as to enhance outcomes. These competencies include:

• Clinical Judgment: Include a nurse's clinical decision making, critical thinking and global grasp of the situation coupled with nursing skills. Examples might run the gamut from checking a patient's pupils for dilation to noticing a particular pallor of a patient's skin when first walking into the patient's room.
• Caring Practices: Refers to those nursing activities that are responsive to the uniqueness of the patient and family, such a nurse holding a patient's hand or practicing active listening skills.
• Advocacy: Involves working on another's behalf; serving as a moral agent in identifying and helping resolve ethical and clinical concerns. One example might be a nurse talking to a doctor about a family's request that a feeding tube be removed.
• Collaboration: Entails working with others (e.g., patients, families, healthcare providers) to promote and encourage each person's contributions toward achieving optimal and realistic patient goals. For example, a nurse would speak with a physical therapist about a patient who refuses to get out of bed after hip surgery.
• Response to diversity: Requires the sensitivity to recognize, appreciate, and incorporate differences into the provision of care. One example might involve a nurse making arrangements to have a prayer rug brought in so a Muslim family can pray by the patient's bedside.
• Facilitator of Learning: Calls for the ability to facilitate patient and family learning, such as a nurse explaining to a patient how to use an incentive spirometer.
• Clinical Inquiry: Necessitates a nurse questioning and evaluating his or her nursing practice, providing informed practice, and soliciting innovation through research and experiential learning. Nurses participate in continuing education classes in order to find out new ways of providing care to a specific patient population.
• Systems Thinking: Refers to the body of knowledge and tools that allows the nurse to recognize the holistic interrelationship that exists within and across healthcare systems. A nurse might practice systems thinking by talking to a food service worker to discover ways to get a food tray to a diabetic patient quicker.
  
  

By understanding our patients' needs in a more complete manner, we are better able to match nurses with the most appropriate level of experience. New patient acuity tools are being developed based on the Synergy Model for Patient Care and will encompass all these patient needs, allowing more refined staffing decisions to be made that best meet the needs of patients.

A career advancement program ensures nurses' continued professional development
Clarian Health built a career advancement program on the differentiated practice principles espoused in the Synergy Model. Three levels exist:

• Associate Partner: All nurses who come into the Clarian system are hired as an Associate Partner
• Partner: Nurses with 3-5 years of experience typically are ready to advance to Partner
• Senior Partner: Nurses with 5-8 years of experience are usually ready to advance to Senior Partner
  
  

Compensation for our nurses is competitive in our market, and nurses who choose to advance their careers at Clarian by becoming Partner and Senior Partner nurses can expect up to a 15 percent increase in their salaries.

Workforce development options provide nurses the tools to advance
One of the most exciting aspects of the Synergy Model is the creation of innovative options for nurses' continuing education. Clarian has partnered with respected nursing schools to bring educational advancement opportunities right to our nurses. Onsite and online education options are available to help nurses move from ASN/diploma to BSN and BSN to MSN.

Shared leadership model gives a voice to bedside nurses' concerns
A network of nursing councils has been established which bring the concerns of bedside nurses to the attention of nursing leadership. From the nursing unit to the board room, these councils ensure that needed changes take place.

For more information about how the Synergy Model for Patient Care is making the journey more exciting for Clarian nurses, please contact the Clarian Health office for Nurse Recruitment, Retention and Workforce Development at 317-962-2600 or toll free at 877-354-2996.