Productivity in the dialysis setting explained and multiple ways to control productivity costs outlined

1. Understanding and Achieving Productivity
Mary Kay Hamilton, RN, MHI
Building your foundation for the evolution of kidney care

2. Different metrics for Productivity
$/Treatment
Salary & Wages
Overtime
Differential labor costs
(paying RN to do PCT job)
Cost of Agency staff
Productivity
Number of hours worked per treatment

3. The Productivity Formula used in Outpatient
Hemodialysis Clinics
Productivity =
Hours worked
Treatments provided

4. Calculating Productivity for an average 3.5 hr/tx
10.00 hours
8 tx
= 1.25 hours/tx
Productivity =
Hours worked
Treatments provided
Bob
Sue
Ann
Ted
3.5
3.5
3.5
3.5
HOUR
0600-0930
0615-0945
0630-1000
0645-1015
TIME INTERVALNAME
Carrie
James
Allison
William
1045-1415
1100-1430
1115-1445
1130-1500
3.5
3.5
3.5
3.5
HOUR TIME INTERVALNAME
To accomplish this, the staff would need to work from 0500-1530=10.5hours-a 30minutes lunch break=10.0hours
1-hour set up time:0500 arrival
30minutes clean up: 1530 depart

5. Average 3.5 hour treatment
(30.0 hr)
10.0 hr X 3 Pods
( 24 tx)
8 tx X 3 Pods
(12 hr)
12 hr RN
(24 tx)
8 tx X 3 Pods = 0.5 hrs./tx
PCT: ÷
÷RN:
= 1.25hrs/tx
Sally, RN (0500-1730)

6. Pulling it all together
1.25 hr/tx + 0.5 hr/tx = 1.75 hr/tx
Total Productivity Number:
(30.00hr)
12.0 hr X 3 Pods
( 24 tx)
8 tx X 3 Pods
(12 hr)
12 hr x 2RN
(24 tx)
8 tx X 3 Pods= 0.5 hr/tx
PCT: ÷
÷RN:
= 1.25hrs/tx
PCT RN PRODUCTIVITY
NUMBER

7. A Rule of Thumb when Determining Productivity
= 1.75 hr/tx
3.5
2
Average treatment duration of 3.5 hours
Take your average treatment duration and divide it in half.
This is a productivity guideline allowing for enough time for safe and effective care.
= 2.0 hr/tx
4.0
2
Average treatment duration of 4.0 hours

8. Three Reasons to be More Productive
Company viability
Allocation of funds
Controllable costs - Labor
01
02
03

9. Takeaways:
• Potential for payment reduction – up to 2%
• Outcomes to reporting ratio changing in 2018
• From 75%:25%  90%:10%
• Adding in Blood Stream Infections in 2018
What this means to you:
• Time to provide quality care is vital!
• Infection Control Practices
• RN time to provide oversight
• RN time for outcome management
Company Viability
QIP and Productivity

10. Allocation of funds
Staffing large cost for a company
 Support roles (outcome mgrs., survey readiness)
 Education
 New/updated equipment
 Conferences
If we can decrease these dollars going to one area, the dollars could become available
for other areas like:

11. The Dollar and Cents Reason to understand Productivity
(Using a $25.00 blended rate)
For every 0.1 hour/tx savings it saves $2.50/tx
No big deal right…..
WRONG!
If your current productivity number is 2.5 hrs./tx,
getting to 2.2 hrs/tx would be a 0.3 savings

12. The Dollars and Cents Reason
Hours/treatment
Hours/treatment
savings
$/treatment
savings
0.1 $2.50 $750.00 $3,000.00 $36,000.00
Weekly savings
(using a 300tx week)
Monthly savings Annual savings
0.5 $12.50 $3,750.00 $15,000.00 $180,000.00

13. Steps that can be taken to improve productivity
What is your current productivity?
What is your company goal for productivity?
How does it compare to your current?
Look at the factors that impact productivity
Missed treatments
Training hours
Extra RN hours – to get all the paperwork done!
Staff added to cover peaks
Workflow that does not allow for independents
1
2
3
4
What is your current productivity?
What is your company goal for productivity
How does it compare to your current?
Look at the factors that impact productivity
Missed treatments

14. The patient treatment schedule is the scheduled workflow of the clinic
Patient Safety
• Appropriate amount of time to complete tasks
• Appropriate amount of staff for scheduled events
• Unencumbered nurses available for emergencies
Quality of Care
• Adequate time to initiate, terminate, and complete treatments
• Nurses that are not required to be on the floor supporting
turnover have more time to manage clinical outcomes
Patient Satisfaction
• Focused attention from staff
• Reliable treatment start and stop times
• Tone and pace of the treatment floor
Impact of Workflow
Staff Satisfaction
• Manageable work assignments
• Sense of a job well done and accomplishment
• Professional satisfaction for nurses
Productivity and Costs
• Effective use of human and financial resources

15. To hear more about how ScheduleWise can support your
organizations productivity and workflow goals contact us at
info@getschedulewise.com or via the information below
Mary Kay Hamilton
marykay@getschedulewise.com
877-753-3947 Ext. 1
877-753-3947 Ext. 1