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I am reading this conversation and the reality of our actual work is. It reflected here. These metrics are great if we are dialyzing a Robot with kidney failure that we can basically just put on and take off. 

I believe this is where the difficulty is encountered with nurses. We care for people (I understand that we also run a business but it is in the “business of caring”) and these people are sicker than their Chronic Dialysis counterpart. I think we should consider the minutes spent on basic “rapport establishment”, the challenges of the hospital system in transporting patients to a multi station dialysis room, the staffing mix of floor RNs and dialysis staff (you know that an experience staff can easily send their patient for HD vs am inexperienced one); the time when treatments are being done (we currently start our day at 7 am (as if. I can get a report from a floor nurse a 7 am! Which is change of shift).  I believe the productivity rate of 6 for a 4 hour patient is more realistic for a hemodialysis treatment with ZERO delays. 

Another area to consider is the size of the hospital and the distance of the machines and supplies. The bigger the hospital - it will take a little longer to get to the patient and even longer to get to the next one depending on situations. 

OH - we added a 15 minute huddle with our team and that eats up 7.5 minutes per patient on top of that. 

I think - the Acute community MUST take a look at this and create our own matrix calculator.

Is this discussion still Open?

I am also trying to figure out how calculate productivity per staff. We recently shut down our treatment room with a 2:1 ratio, now we had been doing HD at bedside 1:1. We have technicians most of the time to set up our machines.  We are trying to fine tune our allotted time due to concerns of patient and staff safety and quality of care. we trialed 1.25hrs with our first pt and take off time of  0.75hrs and 0.75 hours to start our 2nd pt then we have 1.0hrs post tx for our last patient either 2nd pt or to our 3rd pt if we have so it would look like theses

1.25hrs + 4hrs tx + 0.75hrs post= 6hours for 1 pt

but when we have 2 patients it would look like theses

1.25hrs + 4hrs tx + 0.75hrs post + 0.75hrs to start 2nd pt + 4 hrs tx + 1hr = 11.75 hrs (excluding the 30 mins meal break in between 1st and 2nd pt.

How do you guys do your calculations and allotted time for the pt tx?

I have now a small to med acute program of about 1200 rxs per year. Previously i covered covered a larger regional prgram. 2:1 should be the standard except for ICU/CCU 1:1 patients. If your nurses also also do all the cleaning 4.5 hours rx is a good productivity number. If some one else is cleaning monthly disinfection etc 4.0 hours per unit of servive

I am a pediatric dialysis nurse in a small hospital based program. We have 17 PD patients and 7 hemodialysis patients. They just started flexing my budget. We get 1.5 caregiver hours per hemo pt on the day they are here. 1.5 caregiver hours on each PD pt every day. If we have an acute hemo we only get 1.5 caregiver hours.We are having a difficult time making this happen and feel it is unsafe to our patients and nursing does not feel that they are providing safe patient care. I would like to know how other pediatric units staff. How can I make a case for more staffing? How can I keep my nurses happy and want to stay in the unit?

I manage a 6 hospital program. We measure productivity by taking the hours that the person worked and divide it by the number of patients that were treated by that RN. So if the RN worked 7 hours and dialyzed 2 patients, their hrs/tx productivity is 3.5. You would have to compare it to what is your budgeted hours/tx. If you have a large unit with many patients to a few RNs, add up all the RN time and divide by the number of patients that were done. So if 7 RNs worked a total of 42.1 hours and dialyzed 10 patients, the days hours/tx (productivity) is 4.21. Hope that helps!

I also manage an inpatient unit. Our ratio is two patients to one nurse unless they are highly unstable then it is one to one. It is difficult to capture the productivity. I just use overtime hours and the number of treatements done in a day. If the acuity and number of treatements is high, then I can justify the overtime. I hope this helps.