HPPD Justification - Calculations

Specialties Management

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I am trying to see what other facilities use to calculate a "patient day" for their L&D department. I have been on the OB forum, and I have searched the Manager's forum clear back to 2003 and it appears that either managers have no clue, or are afraid to respond. I cannot find a single person who has provided this information, for any unit.

Finding nurse to patient ratio standards is easy, but determining what criteria is used to determine a "patient" is another. Midnight census works (somewhat) for most units. Acuity based is another method, though I've yet to see how that is being utilized effectively.

L&D is another scenario however, since during a 12 hour shift, a nurse may have 1 laboring patient, or 8 laboring patients, (not all at the same time) depending on how quickly they deliver. I know different facilities have different ways to measure. I just would like to see what is being utilized at facilities other than ours, for a comparison, and to create some sort of benchmark for us. Thank you for taking the time to respond.

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Instead of using HPPD to calculate productivity for L&D you should use hours per delivery. Take your total worked hours for the month and divide by the number of deliveries per month. That will give you the average hours spent per delivery.

Kathy

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Our current budget is based on 4.5 hours for each Labor Eval we do, 3 hours for each NST we do, and 8 hours for each delivery we do. Based on our budgeted projections, and staff, we have a budget hours worked per unit of service. Then the total actual hours worked is divided by the actual units of service. What I am looking for is how other facilities calculate their units of service in this department. At our facility, each department is held accountable for staying within their budget. Everything is based on units of service. What I have been unsuccessful in doing however, is finding other facilities that are willing to share how they calculate units of service (PD) in their L&D area. I can't believe we are the only hospital that has a budgetary accountability by department.

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My budget for L&D is based on hours per unit of service (deliveries) and we are budgeted for 9 hours per delivery. NST and Labor check are considered outpatient tests and are budgeted separately from the regular L&D budget. 3 hours per NST seems pretty generous to me.

The units of service are based on historical data from last year. We use the number of deliveries or OPD from last year and the finance department does their best to project growth for the coming year. My L&D unit has steadily increased by about 5 % every year over the past three years. Therefore finance takes the amount of deliveries we had last year and increases it by 5% for the upcoming year.

So for us in L&D the unit of service is the delivery. I hope this helps.

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Does your staff do C-sections, or is that done by Surgical Services?

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Surgical services

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