About productive hours per patient day? - page 4

by rrroyer 71,776 Views | 47 Comments

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... Read More


  1. 0
    anyone have any info on staffing and nurseatient ratios for psych?
  2. 0
    Mr. "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!!
  3. 0
    Thank 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!
  4. 0
    what about staffing in er? do you use HPPD for your ER?
  5. 0
    Quote from RNPATL
    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!
    What's your ratio?
  6. 0
    Our 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
  7. 0
    Quote from RNPATL
    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.
    Using HPPD for staffing is unfair to nurse managers, direct care nursing staff, and patients.
    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.
  8. 0
    Quote from rrroyer
    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! 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.

    Good luck to you & your staff.
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    Wow RNPATL! Thanks for the detailed definition! That helps alot for a novice like myself! I appreciate you taking the time to "spell it out".
    RNPATL likes this.
  10. 0
    Quote from mothertucker
    Wow RNPATL! Thanks for the detailed definition! That helps alot for a novice like myself! I appreciate you taking the time to "spell it out".
    Not a problem at all. I am glad we still have people that are willing to be nurse leaders in this day and age of numbers crunching and reimbursement issues. I think many hospital administrators have forgotten the reason we exist is because we care for sick patients. Oh well ....

    Love your name by the way! Patrick
    Last edit by RNPATL on Sep 27, '07 : Reason: spelling - as usual!


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