As the cost of health care continues to rise, hospital administrators and other health care professionals are more concerned than ever with the efficiency of their care providers. This process means the administrator or manager needs a reliable, objective metric by which to measure the amount of time spent on each patient by the care provider. For both nurses and doctors, the industry standard metric is hours per patient day or HPPD.

## Use of Hours Per Patient Day As a Metric

Hospitals, clinics and in-home health care providers use the hours per patient day metric to evaluate both the level of patient care and the ratio of staff to patients. Generally, health care providers will calculate HPPD separately for different classes of healthcare providers. For example, doctors will have one HPPD calculation and nurses a separate calculation.

You can manually calculate this figure if you know some basic information about the number of patients and hours worked by the specific medical staff.

## How to Calculate Hours Per Patient Day

To calculate the hours per patient day metric, you’ll need to have access to two specific figures:

1. The total number of hours worked by all providers of the type being measured, for example, all nurses during a 24-hour period.
2. The number of patients at the medical facility for the same 24-hour period.

It is crucial that both figures reflect the same 24-hour period, in order to provide the most accurate information for the hospital or clinic. Once you have these two figures, divide the total nursing hours by the total number of patients.

To illustrate this calculation, consider this example. Assume the hospital performing the HPPD calculation discovered for the 24-hour period in question that nursing staff provided a total of 1,000 nursing hours. Further, assume there were 500 patients at the hospital during the same 24-hour period.

To calculate the hours per patient day metric, divide 1,000 (total nursing hours) by 500 (total number of patients). Thus, for this 24-hour period at this hypothetical hospital, the hours per patient day is two.

## Debate About the Hours Per Patient Day Metric

Hours per patient day is a well-understood and easily calculated metric. It helps administrators compare staffing needs and practices between departments and organizations, which in turn helps clinics, hospitals and health care companies stay competitive.

The metric also helps departments and businesses ensure they’re meeting their financial goals. The reality of the health care industry requires providers and entities to stay financially healthy and competitive in order to remain viable as businesses and employers.

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. It’s important to make sure that HPPD metrics are truly being used to compare “apples to apples” and that the criteria being evaluated takes into consideration all relevant factors.