From a management perspective the situation is not chaotic, since there are clear targets: keep the patient in good condition and maximize the ratio of HHD to all dialysis. Most exceptions can be handled with pre-established routines linked to specific competencies and equipment. Second, dialysis is time-critical. It must be performed within a given time-bracket not to cause harm to patients. Third, patient monitoring to some extent allows the use of control limits to prompt action. Fourth, on a general level the number of exceptions can partially be estimated and resources allocated accordingly. Fifth, typical handovers, both within and beyond the HHD unit, can be identified and routinized. Sixth, the HHD unit is the process owner with the overall responsibility for its patients having the authority to request renal therapy related inputs from the supply network.