by Gary Peterson
Weather professionals are calling hurricane Sandy an unprecedented storm. In terms of disasters, we will be in uncharted territory. Millions could be without their usual supplies of power, fuel, and food for many days. Many unanticipated things will likely happen. Civil disorder is a possibility.
While trying to meet the needs of dialysis patients in such a complex environment, problems and mistakes are to be expected. One of them, however, should not be the withholding of information from patients and the medical professionals trying to help them. While withholding some information about food and fuel may be necessary during disasters for security reasons, it should not be used as a blanket excuse that limits dialysis patients’ choices and -- conveniently in the end -- ensures patient hoarding and corporate profiteering during disasters.
During natural disasters, everyone seeks as much information as possible to either protect themselves and their families or to help others. This is not the time for KCER (web site) to withhold information and limit access to their conference calls. This is not the time for focusing on managing the positive and negative publicity about KCER, the largest dialysis providers, and their joint planning and activities.
For the benefit of the patients and to maximize the assistance from the medical community, KCER should open its daily conference calls to all interested parties, not on a “by invitation only” basis. (They began this practice during hurricane Issac two months ago after RenalWEB reported that patient tracking through CROWNWeb wasn't working.) KCER should also make information about dialysis clinic closures available to multiple nephrology news web sites, not just to one web site that has been maintained on a part-time basis.
Dialysis patients should get the hell out of there!
They should travel west, southwest, south, and possibly north and go as far as they can go now so that their schedules are interrupted the least.
The longer patients hang around thinking that their clinics will be open, the more danger they risk to themselves.
Infrastructure problems will not only adversely affect their dialysis schedules, but also the many support services that are required to meet the medical needs of dialysis patients.
The creep of transportation through disaster areas such as metropolis NYC is likely to be 48 hours, if allowed at all in some areas.
The emergency response gurus should call for meeting places for dialysis patients at fire stations and other public locales so that they can be safely extracted and delivered to distant staging sites that can appropriately handle the needs of this vulnerable and medically needy population.
The KCER should coordinate with emergency response officials and CMS for a plan to disperse the volumes of patients to areas that can line up schedules now and not wait for shelter establishment.
The mistakes of the past should have gained us enough wisdom to take a proactive approach that emphasizes patient health first, rather than providers’ bottom lines.
Realtime asset mapping to handle patient surges are critical to the success of this plan. Patients need to understand which facilities are truly open for business.
Therefore, provider and patient input regarding waiting times, true chair availability, and staffing capabilities are information that must be honestly shared with the coordinators of emergency referral.
Patients need to know that they should call networks and KCER with important updates to help other patients.
Information sharing not only helps others now, it helps the experts study what works, what doesn't, and what needs work.
This is the time to test the plans that were designed by those who noted the mistakes of the past.
Established dialysis units that can dedicate an entire day to transient patients alone should be identified and mapped for patient and emergency personnel referral. In this manner patients can be staged with confidence that they will get lifesaving therapy without showing up to facilities repeatedly where they get bumped around like a pin ball machine. The map of such dedicated units should be broadcasted on KCER, ESRD networks, radio, and television as well as posted for website information retrieval at key DIPP (disaster information public posts) along the disaster exit routes.
Will we get it right this time around?
Posted by: anonymous | 10/30/2012 at 08:21 AM
While some may not believe the previous posting is appropriate, I believe it will do more good than harm.
With thousands of dialysis patients in the disaster area, this is going to be the biggest challenge the U.S. dialysis community has ever faced. At this time during this unprecedented disaster, it is best that patients do as much for themselves as possible.
Posted by: Gary Peterson | 10/30/2012 at 08:41 AM