A lot of people want to put the long tx on first, but I think it works better to put short pts on first- for example- say on your first & second shifts a single pod has one 3 hr pt, two 3.5 hr pts and one 4 hr, and your you can do it like this:
(Each of the dash marks "-" represents a 7.5 minute increment of time)
1st shift ______________________________________________2nd shift
Chair 1) 0600 3.0 hr pt on- off @ 0900---- 0930 4.0 hr pt on- off @ 1330
chair 2) 0615 3.5 hr pt on- off @ 0945---- 1015 3.5 hr pt on- off @ 1345
chair 3) 0630 3.5 hr pt on- off @ 1000---- 1030 3.5 hr pt on- off @ 1400
chair 4) 0645 4.0 hr pt on- off @ 1045---- 1115 3.0 hr pt on- off@ 1425
If you have a third shift, do it the same way- allow 30 mins from the time you take a 2nd shift pt out of a chair before you put a 3rd shift pt in it.
By putting a short tx pt on first in chair #1, you can have that pt off, machine stripped re-set up and the 4 hr second shift pt on before the next first shift pt comes off. Then, take off pt in chair 2, then 3. Set up those machines for the nerxt pts- but if you have some time left over do not put the 2nd shift pts on early
- that will mess everything up. Then take the pt in chair 4 off, reset up, and put the second shift chair 4 pt on.
If you have a nurse who is doing assessments, verifying bath/dialyzer/machine settings, making tx decisions and giving meds, but not putting pts on in the morning, a schedule like this will give her time to give a few meds between pre-assessments.
For example, if you have four pods of four pts each, each pod will have an 0600 pt, and 0615 pt and so on. It also helps a lot if you do not let the pts on the floor until their put on time. For instance- @ 0550, let in the four 0600 pts- and not anyone else- close the lobby door. When those pts are on, let the 0615 pts in- but no one else, and so on.
Also- it helps to use the pts' behaviors in the schedule. If you have a pt who is always late for his tx and throws the schedule off, change your schedule with this in mind- change the pt's time to the next later time on- but do not tell the pt.
This way, when the pt shows up "late" he will really be on time.
Same thing goes for if you have a pt who always shows up early, and is pressuring staff to put him on early- change his time to an earlier time.