We present a framework system dynamics (simulation) model that evaluates the effect of dialysis policies on session performance, quantifying, optimizing dialysis efficiency and monitoring dialysis performance online. The model focuses on analyzing and highlights factors which may alter the delivered dose and may lead to session degradation This will help increase the achievement of adequate Hemodialysis to a level consistent with or higher than National Adequacy Statistics, in order to reduce the Morbidity rate of the Hemodialysis patient. Five blood samples were drawn from 134 dialysis patient; arterial sample at the inlet of the dialyzer, venous sample at the outlet of the dialyzer, peripheral sample, pre blood urea sample and post blood urea sample. The simulation results and the statistical analysis revealed that there is no statistically significant difference between the calculated results and the measured results. This system dynamics model is considered the first system that calculates the dialysis session performance as a function of not only dialysis adequacy but also as a function of the intradialytic complications and overall equipment effectiveness.