What Is the Synergy Model for Patient Care?

Each patient is unique and has dynamic needs. Meanwhile, no two nurses bring the exact same skill set to their practice. Enter: the synergy model for patient care. Theorist Dr. Martha Curley developed this framework in 1998 to guide certification for the American Association of Critical-Care Nurses (AACN). Today, it provides a high-level framework to help operational leaders guide care and promote the best outcomes for patients.

The model focuses on the needs of the patient and the nurse competencies that can help meet those needs. When competencies and needs are matched, patients experience the best outcomes. And while conceptual models like this one might seem abstract in the day-to-day life of a nurse, they offer an essential perspective on the nurse-patient relationship.

What Is The AACN Synergy Model for Patient Care?

This nursing framework was designed to guide practice by matching a nurse’s competency level with the complexity of a patient’s needs. Synergy model theory states that, while patients experience similar needs, they exist on a continuum. The more severe or complex their needs are, the more compromised a patient’s status is. While you might not see this model referenced in clinical practice, there’s mounting research to support the model being used by nurses, unit leaders, and senior leadership.

These assumptions guide the synergy model for patient care:

• Patients are social, spiritual, biological, and psychological beings that present at a specific developmental stage. The whole patient must be considered when delivering care.
• The context for the nurse-patient relationships is provided by the patient, family, and community.
• Patient characteristics are interconnected, and cannot be viewed in isolation.
• Nurses can be described in several ways, and a nurses’ interrelated qualities create their identity.
• A nursing goal is to restore a patient to optimal wellness, as defined by the patient themselves. In this context, death can be an acceptable outcome, and it is the nurse’s goal to assist in moving the patient towards a peaceful death.

The Synergy Model: Patient Characteristics

While these assumptions lay the foundation for synergy model theory, specific patient qualities drive needs. Patient characteristics include eight criteria:

• Resiliency: A patient’s ability to return to a baseline level of functioning, or how they can bounce back quickly after an insult.
• Vulnerability: How susceptible the patient is to actual or potential stressors that can adversely affect their outcomes.
• Stability: A patient’s ability to maintain their own equilibrium.
• Complexity: The entanglement of systems that impact patient care, such as therapies, body systems, and family dynamics.
• Resource availability: The extent of personal, financial, social, psychological, and technical resources that a patient has access to.
• Care participation: The extent that the patient and the family engages in care.
• Decision-making participation: The extent that the patient and the family engages in care decisions.
• Predictability: How possible it is to accurately predict the course of a patient’s illness.

In each of these domains, the model uses this rating scale:

• Level 1: Minimally possessing the quality
• Level 3: Moderately possessing the quality
• Level 5: Highly possessing the quality

The Synergy Model: Nurse Characteristics

The synergy model of nursing defines patient needs, but it also acknowledges that nurses aren’t carbon copies of one another. Each clinician brings specific skills and competencies to care, and certain patients may require more of some skills than others. Nursing characteristics can be defined in these eight dimensions:

• Clinical judgment: The ability to assess, analyze, and interpret patient data to make informed decisions and provide safe and effective care.
• Advocacy and moral agency: Working on another person’s behalf to represent the concerns of the patient, family, and nursing staff, and helping resolve ethical concerns.
• Caring practices: Creating a compassionate, supporting, and therapeutic environment for patients and staff.
• Collaboration: Working with others in a way that promotes each person’s contributions towards achieving optimal and realistic patient goals.
• Systems thinking: A body of knowledge that the nurse uses to manage environmental and system resources that exist for the patient and their family.
• Response to diversity: The ability to recognize, appreciate and incorporate differences into care provisions.
• Facilitation of learning: Encouraging learning for patients, families, nursing staff, other healthcare teams, and the community.
• Clinical inquiry: Questioning and evaluating practice and using evidence to guide practice changes.

In each nursing domain, the synergy model uses this rating scale:

• Level 1: A baseline level of competence
• Level 3: A moderate level of competence
• Level 5: A strong level of competence

Synergy Model for Patient Care Examples

Looking for a more concrete understanding of how this model applies to patient care? Check out our application of the synergy model for a patient and a nurse.

Patient Synergy Model Example

An 87-year-old woman is admitted to a cardiac unit after having a cardiac catheterization for chest pain. The procedure went well, but she is waiting for her cardiologist to arrive with a plan of care. Her daughter is at her bedside and has brought her home medications. The patient has diabetes and usually walks with a cane, but is in good health otherwise and is insured. Currently, she is groggy from her procedure, but oriented and hungry.

Resiliency: moderate to low
Vulnerability: high
Stability: moderate to high
Complexity: moderate
Resource availability: high
Care participation: high
Decision-making participation: high
Predictability: moderate

Nurse Synergy Model Example

Justin has been a nurse for just over a year, and works in the pediatric intensive care unit at a major hospital. Today he’s caring for an 8-year-old girl with a congenital deformity who was admitted for pneumonia. The patient’s father is at the bedside, and as Justin hangs up new IV antibiotics, he tells the father and patient what he is doing. He asks the father if he has any questions and gets in touch with the medical team to clarify a new order. At lunchtime, he sets up the TV so that the patient can watch her favorite show.

Clinical judgment: moderate
Advocacy and moral agency: high
Caring practices: high
Collaboration: high
Systems thinking: moderate to high
Response to diversity: high
Facilitation of learning: moderate to high
Clinical inquiry: moderate to high

While the synergy model might seem abstract, it creates a nonjudgmental way to categorize the needs of patients and the strengths of nurses. The next time you’re assigned a patient, think about the ways that your unique skills align with their needs.

Find a Role That Fits Your Needs

The synergy model for patient care offers a unique lens for clinicians to look at patient care. If you’re a nursing professional looking for a new opportunity, sign up for nursing job notifications with IntelyCare.