What is hppd hours per patient day

Touch base with charge nurses throughout the day and evening to mentor, discuss staffing plans for the following shifts, and establish guidelines for the charge nurse to contact you if he or she believes that the plan needs to change or if there's a need to staff above the acuity or grid tool. Waiting until after the shift to discuss the details of how the staffing decisions should have been implemented is too late.

Are you on the staffing bubble or did you think you were getting a new patient who never arrived? Both situations have the potential for overstaffing. Proactive discussions with charge nurses regarding these situations, along with well thought-out staffing strategies, are essential to avoiding staffing pitfalls.

When on the staffing bubble and trying to determine to staff up or down, it's advisable to staff down initially, with the option of calling in additional help if needed. It's much easier to call in a staff member than send one home after he or she is in assignment. To avoid the work of inappropriate transfers in and out of a unit, develop written guidelines that state the type of patients appropriate for the area and ensure that the charge nurse is involved in the transfer decision.

When able, avoid calling in additional staff until the patient arrives on the unit. It's often possible to absorb a new patient with current resources versus staffing up. The charge nurse may take a light assignment to get through a busy time, take over another RN's assignment so that he or she can take the admission, or give a strong clinician an additional patient with increased unlicensed or charge nurse support.

Many hospitals have house supervisors who may be able to assist with care or they may know of another area of the hospital that can send a staff member for a few hours. The consistent use of these lean staffing strategies can lead to an improvement in productivity. Productive SPPD are a result of multiplying productive hours worked by the average hourly rate.

There are many variables that affect SPPD. If an area is well staffed, requiring very little premium pay, and has low orientation expense, the SPPD may be below target, whereas the HPPD may be at or above target related to low volume or high acuity.

To keep SPPD within target, staff to core so that there are enough staff members to meet the most frequently occurring census, which leads to decreased OT use, incentive pay, and use of agency or resource team nurses who receive a higher hourly rate. Adequate core staffing is important to maintain quality and staff satisfaction, and keep costs down by ensuring staff members aren't working excessive hours above their FTE.

OT expense can be reduced by creating a balanced schedule, including weekends and holidays; maintaining a to ratio of full-time 0. Creating a balanced schedule includes a proper skill mix of licensed to unlicensed staff. Nurses should be working at the top of their license while unlicensed staff members provide care that doesn't require a license and can be done safely within their scope of practice.

Hiring nursing students in the nonlicensed role is a win-win. This provides clinical and critical-thinking experience for the student while increasing the number of nurse extenders. This can be especially helpful in the summer when many students are looking for full-time hours and many RNs are requesting PTO. During times when premium pay must be used, it's important to have clearly written guidelines that state when this pay is used and that staff members who are receiving premium pay are the last to be used and first to be released when patient needs decrease.

The current nursing shortage is projected to get worse, making turnover costly and a potential quality of care concern. Creating an environment of trust and mutual respect between nurses, physicians, and administration leads to increased engagement.

Taking the time to listen and respond to staff concerns regarding the physical work environment and conducting time trials and environmental assessments demonstrate administrative support.

For example, purchasing BP cuffs and pulse oximeters for each room, using bedside carts that contain admission and daily supplies, providing bedside computers along with a shelf to place items, and furnishing hydration stations where family members can obtain water for themselves or the patient allows staff more time at the bedside, increases organization, and improves efficiency.

Nursing or unlicensed staff turnover can be costly in loss of valued experience and dollars. Selective hiring is crucial for staff stability, and hiring the right fit for an area is important to create a positive work environment.

Encouraging high performers to refer potential hires is a great way to recruit other talented staff members. The development of a well-designed clinical orientation program, skilled preceptors, support tools, and postorientation mentorships is essential to new hire longevity. To help offset orientation costs, it's important to identity areas of concern early so that the new hire receives timely support and can complete his or her orientation on schedule.

Near the end of orientation, when trainees are taking full assignments, it may be possible for one preceptor to work with two new staff members versus training.

This helps decrease preceptor costs and encourages new hires to function in a more independent manner before coming off orientation. Lastly, all staff members should be encouraged to take personal accountability for their professional development and that of their peers. Creating a high-functioning team requires all staff members to mentor and support new hires, as well as one another. It takes a village! Meeting measurements of productivity can be both difficult to understand and frustrating.

However, it's critically important to the organization, the care team, and the delivery of quality patient care that you understand and know how to respond to fluctuations in productivity. Close monitoring of staffing and implementation of the suggestions presented in this article will equip you to provide quality care in the most efficient manner. Knowledge, attention, and action are the keys to success. Your planner will keep track of all your Lippincott Professional Development online CE activities for you.

A passing score for this test is 13 correct answers. If you pass, you can print your certificate of earned contact hours and access the answer key. If you fail, you have the option of taking the test again at no additional cost.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

American Nurses Association. Nurse staffing. Cochrane Database Syst Rev. Relationships between nurse staffing and patients' experiences, and the mediating effects of missed nursing care. J Nurs Scholarsh. Financial Management for Nurse Managers and Executives.

Philadelphia, PA: Saunders; Is it time to pull the plug on hour shifts? The evidence. Some industry leaders criticize HPPD because it can sometimes gloss over the varying needs of different patients. For example, some diagnoses will mean the patient requires much more intensive attention and care from both doctors and nurses. Other conditions will require less direct care.

Annie Sisk is a freelance writer who lives in upstate New York. She holds a B. She has written extensively for publications and websites in the business, management and legal fields. Share It. The total number of hours worked by all providers of the type being measured, for example, all nurses during a hour period. The number of patients at the medical facility for the same hour period. One measure of patient satisfaction that could reveal some potential customer service deficits is the correlation between HPPD and Hospital Compare scores over time to identify and review any patterns such as bottlenecks developing with patient discharges and cleaning.

The Hospital Compare website www. The Hospital Compare database is frequently accessed by potential patients and insurers who are seeking information regarding the best places to get health care. In addition to influencing patient choice, hospitals face potential fines or reduced reimbursement if satisfaction scores are low, because of the incentive program known as value-based purchasing VBP.

Hospital VBP programs adjust Medicare payments to reward hospitals based on the quality of care they provide to patients. In these high-stress environments, nurse satisfaction is also a significant consideration. When workloads are high, nurse satisfaction may be low.

Comparing HPPD and measures of nurse satisfaction such as turnover may also yield valuable outcome data that can be addressed as appropriate. Calculating HPPD is not the beginning or end of the description of nursing care quality and productivity.

HPPD does not allow for adjustment when caring for several patients throughout the day, or for discharges—concerns commonly expressed by clinical staff. We assert that as quality is measured, HPPD must be included in the discussion as an important correlated variable in understanding low satisfaction scores of patients and staff.

It is critical that clinical staff have access to HPPD levels and how they are calculated in a particular institution in order to inform their practice. Evidence-based care must use data and research on measures of productivity, patient satisfaction, quality, and financial accountability.

In the meantime, some hospitals are implementing a number of strategies to account for the staffing level on all units and to address bottlenecks in processing patient admissions, transfers, and discharges. At the heart of these activities is a shared desire to provide the best person-centered, timely, efficient, and effective care. Geraldine C. Nurse staffing levels and patient-reported missed nursing care.

J Nurs Care Qual. Habasevich B. Managing to HPPD. September 27, Hospital Compare datasets. Updated December 15, Hospital value-based purchasing. Centers for Medicare and Medicaid Services. Updated October Ryan A, Tompkins CP. Linking quality and cost indicators to measure efficiency in health care.

April 25, Mensik, J. What every nurse should know about staffing. Am Nurse Today. National Quality Forum. Nursing hours per patient day. NQF