About productive hours per patient day? - page 3
I'm the manager of a 20 bed ortho/neuro unit and a 29 bed medical/surgery unit. My questions is what are the productive hours per patient day alotted to various units/hospitals across the nation. ... Read More
Jan 23, '06There isn't a program per se, since each facility may define hours differently. At our facility we use only "productive" hours. We total all productive hours for the unit, (this includes the director) and divide by the number of patient days. This gives us hours worked per unit of service, or "Nursing Hours Per Patient Day".
Feb 1, '06This is my first post and unfortunately I am answering a question with a question:
I am well-versed on hppd from my years of management at an acute care facility and then a SNF. Currently I am six months into a director of nursing position at a community-based health clinic. Here we see the walking well, Mon-Fri 8-5, yet staff will be staff, and are always screaming for more help! I am searching for some kind of hppd for our clinic. Our measurable statistic is "encounters" or "visits" with providers. I went to our state organization but found they measure by nursing staff/provider. This makes no sense to me since our nursing productivity should be based on how many patients we actually process through our clinic doors each day.
Any one out there have any info on hppd for my clinic? We are a large department-I have 80 staff so we're talking lots of $ in salaries.
Feb 14, '06I did not see an answer about staffing according to acuity. Any takers? Do you have the ability to flex up and down?? What if in an ICU or telemtry unit your acuity stays very high?
What is the tool that you are benchmarking against? Is it something that can be found on line?
Aug 14, '06Mr. "RNPATL",
Dude, you're awesome. I can't count how many postings I've read from you that were soooo helpful. There was absolutely no orientation to my management postition when I started 1 1/2 year ago as the manager had quit months before and the Nurse director was filling in while doing her job. Thank you for all your advice, and for god's sake, please keep reading and posting. You are a tremendous help in explaining the basics!!
Aug 14, '06Thank you for the kind words. Unfortunately, I have not had much time to be on the board and I miss not being here a great deal. But thanks again for your nice words and I promise that I will keep posting! You keep posting too and welcome to the board!
Feb 20, '07Quote from RNPATLWhat's your ratio?I run a 40 bed unit (med-surg) and my productive hours are 7.80 ... these hours are good, but they include my hours, education as well as new graduate training. So, if you take away all these expenses each payperiod .... I am probably actually running a productive hours base of 6.8 or less and it is hard to meet patient needs with that!
Feb 20, '07Our med surg department has 85 beds spread in to 5 units. Navagant came and "suggested" we lower our hppd to 7.5. Of course we were held accountable to that number. Forget it!! By the time you enter all team members, 1 director, 2 managers, 1 charge nurse and an educator?? When we are full and running full staff, we can't hit 8.0
Feb 20, '07Quote from RNPATLUsing HPPD for staffing is unfair to nurse managers, direct care nursing staff, and patients.Actually, HPPD stands for hours per patient day.
What this means is the amount of hours permitted or allowed for a nurse to spend with a patient per day (24 hour period). Generally speaking, the HPPD is set by your unit's budget. A nurse manager and the staff nurses are required to work within the confines of these numbers as they render care for the patients. Here is a senario that might help you understand it ....
An HPPD is calculated by the census. So if your unit has a census of 25 patients, then that number is multipled by the unit's HPPD.
Census of 25 multipled by the HPPD of 7.00 equals = 175 hours. The 7.00 is the number that is given to you by upper management and the number that most nurse managers fight over with the CNO to increase.
This means that the nurse manager has 175 hours of nursing time to work with in relationship to staffing the unit. So, If I have 175 hours to work with .... all of my unit's staffing hours must come from this number .... for example:
Assuming a nurse to patient ratio of 1:6 on days and 1:7 on nights and that we are a general medical-surgical unit ... we would staff as follows for this 24 hour period:
Days Shift Staffing Hours
Nurse Managers Hours - 5.73
Charge Nurse 12 hours
(The CRN would take 2 patients)
4 Nurses all 12 hours
2 CNA - 1 for 12 hrs and 1 for 8 hrs
1 Secretary - 12 hours
Total Hours for Days = 92
Night Shift Staffing Hours
Charge Nurse 12 hours
(The CRN would take 5 patients)
3 Nurses all 12 hours
1 CNA for 12 hours
1 Secretary for 12 hours
Total Hours for Nights = 72
Total Hours Per Patient Day for this 24 hour period would be: 170 (rounded)
Sometimes, patient acuity is so high that the nurses can not handle 6 patients on days .... the nurse manager needs to be flexible to staff up if needed to accomodate the needs of the patients. This means that you might go over your allowable hours for the day. However, I usually staff by the pay period .... so, if I am off one day, I try to make it up the other days, if possible .... and always with the help of the nurses.
Hope this helps a little.
Staffing needs to be based on the needs of each patient not some budget scheme.
I am sorry you have to deal with this system.
This is just my opinion backed up by experience and research.
Sep 5, '07Quote from rrroyerGood Luck! Consultants commonly come in to bring down your WHPPD. :trout: It is very difficult to come accross that information on line. One company will sell it to you, and I did purchase it. While it's costly ($150) it does give excellent break downs regarding what facilities are utilizing for their WHPPD. The ability to be as efficient as possible is key, but the best consultants aid on how to get to that point, not just throwing down a number and walking away.I'm the manager of a 20 bed ortho/neuro unit and a 29 bed medical/surgery unit. My questions is what are the productive hours per patient day alotted to various units/hospitals across the nation. We just had consultants come and evaluate our productivity. They then suggested lowering our productivity based on "national benchmarks" so I was wanting to compare the real world numbers. Gather my ammunition. ANy help would be appreciated.
Good luck to you & your staff.
Sep 27, '07Wow RNPATL! Thanks for the detailed definition! That helps alot for a novice like myself! I appreciate you taking the time to "spell it out".