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tracking patient IV charges

We are a full IV Therapy team in a 450-500 bed teaching facility (though we don't do infusion - we're thinking of changing our name to reflect the majority of what we do, which is vascular access).  As is probably true in many other facilities, our department purchases the non-chargeable items such as peripheral IV start supplies.  We try to collect as many of these supplies as possible from the units themselves, but still stock a significant amount of stuff on our carts at the beginning of every shift.

Periodically, the administration likes to remind us that we spend more than we take in, and we get into a tiresome debate with them about how non-reality based our budget appears, because the income from the non-chargeables doesn't make it directly back into our budget as revenue (it's part of the patient's room rate).

I've seen references to Pyxis machines on this forum - is that how other facilities are managing this accounting problem?  Any other suggestions about how we could more accurately track expenses and revenue specifically for our department? 

Another problem - our acuity tool.  Right now they're relying heavily on our acuity tool, but disregarding tasks like "problem solving" which we spend a significant amount of time on.  We're being used as consultants, without being paid for it.  We've considered marking ALL of what we do as IV starts just we can get credit for it!


When we get an IV request we
When we get an IV request we always remind them to have supplies ready when we get there.  If they aren't there we won't do it until they get supplies.  I have a tackle box that I fill with extra stuff from the floors.  We do 700 IV's a month so imagine what supplies would cost our dept. if we supplied them.
Hmmm... We do


We do 2700-3000/month.  Having to wait on the floor for the supplies would be a big problem for our efficiency, but - we may be able to have IV carts on each unit where we could easily get stock.  That's where my pyxis question was heading....anyone use Pyxis for IV supplies?  How does it work in your facility? 

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

I have a "chargemaster" for

I have a "chargemaster" for my team.  I have defined each function (IV Start/restart, tPa, Central Line Dressing Change, Consultation, Lab Draw via Central Line, etc.)  each is associated with an "RVU" in (1RVU=15 minutes), a service code, a CPT-code and a cost associated with the service.  If it is not a billable item (bundled), then it is just a statistic, however, some insurance companies will accept certain charges, so if it can be billable it has the charge associated with it- and it is billed.  We have an automated system of billing at the bedside.  In this way, I am able to track time and units of service as well as revenue generated by the team.  Recently, this data came in very handy, when Navigant Consultants came and wanted the hospital to disolve the team.  I was able to present the data, in combination with Press Ganey results and we still have a team!  The team takes their supplies from the floor stock, so we do not have any chargebacks against the team other than salary.


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