Perspective

Dialysis providers reopen clinics after Hurricane Florence floods the Carolinas

Dialysis companies caring for patients in North and South Carolina and Georgia have reopened most clinics after combating torrential rain and flooding from Hurricane Florence.

During the height of the storm, providers had to close more than 40 clinics across the three states. A few clinics remain closed this week. Despite preparations for the storm’s impact in Virginia, residents and health care facilities there were spared major damage, including dialysis units owned by the University of Virginia.

Preparing early for the hurricane was key for dialysis providers. However, in some situations, providers had to take evasive action.

“We’ve coordinated with emergency officials to rescue patients who were stranded across the Carolinas, whether by bus, boat or air,” said Elise Duke, DaVita Kidney Care’s group vice president, who is managing the company’s response in the southern states. “At this stage, we’ve accounted for all in-center hemodialysis patients and have a team going door to door to reach a small number of home dialysis patients. We’ve flown in teammates from across the country to help power our open clinics and have deployed generators, fuel and supplies to the area.”

DaVita spokesperson Ashley Hansen told Healio.com/Nephrology that “we have a small number of clinics that are inaccessible due to flooding and road closures. We will reopen these clinics as soon as conditions are safe and will continue to route patients to locations which can safely provide dialysis care in the meantime.” The company has about 87 clinics and 6,000 patients in North Carolina.

DaVita clinics that remained closed (all in North Carolina) due to the storm include Southport Dialysis Center, Surf City Dialysis, New River Dialysis and Leland Dialysis Center. DaVita clinics reopened in the aftermath of Florence included SEDC Burgaw Dialysis Center, SEDC Elizabethtown Dialysis Center, SEDC Kenansville Dialysis Center, Chadbourn Dialysis Center, Cape Fear Dialysis and New Hanover Dialysis Center.

At Fresenius Medical Care, company administrators from flood zone areas prepared an action plan.

“We activated our emergency disaster response plans ahead of the storm to ensure patients had emergency packets and access to advanced treatments,” said Bob Loeper, head of disaster response for Fresenius Medical Care. “Our incident command teams staged resources outside of the impact zone, which were deployed into North and South Carolina once the storm passed. We immediately conducted wellness checks to ensure all patients and staff were accounted for.”

Loeper said the company also made sure support services were available to handle the storm.

“Our command centers are equipped with generators, water, food and fuel to service the impacted areas. As of today, all patients are accounted for and all clinics are open except one, which we plan to open over the weekend,” he said.

He noted that more than 50 clinics were open on Sept. 15 to capture missed treatments, and additional shifts continue in clinics to accommodate all patients. – by Mark E. Neumann

 

Dialysis companies caring for patients in North and South Carolina and Georgia have reopened most clinics after combating torrential rain and flooding from Hurricane Florence.

During the height of the storm, providers had to close more than 40 clinics across the three states. A few clinics remain closed this week. Despite preparations for the storm’s impact in Virginia, residents and health care facilities there were spared major damage, including dialysis units owned by the University of Virginia.

Preparing early for the hurricane was key for dialysis providers. However, in some situations, providers had to take evasive action.

“We’ve coordinated with emergency officials to rescue patients who were stranded across the Carolinas, whether by bus, boat or air,” said Elise Duke, DaVita Kidney Care’s group vice president, who is managing the company’s response in the southern states. “At this stage, we’ve accounted for all in-center hemodialysis patients and have a team going door to door to reach a small number of home dialysis patients. We’ve flown in teammates from across the country to help power our open clinics and have deployed generators, fuel and supplies to the area.”

DaVita spokesperson Ashley Hansen told Healio.com/Nephrology that “we have a small number of clinics that are inaccessible due to flooding and road closures. We will reopen these clinics as soon as conditions are safe and will continue to route patients to locations which can safely provide dialysis care in the meantime.” The company has about 87 clinics and 6,000 patients in North Carolina.

DaVita clinics that remained closed (all in North Carolina) due to the storm include Southport Dialysis Center, Surf City Dialysis, New River Dialysis and Leland Dialysis Center. DaVita clinics reopened in the aftermath of Florence included SEDC Burgaw Dialysis Center, SEDC Elizabethtown Dialysis Center, SEDC Kenansville Dialysis Center, Chadbourn Dialysis Center, Cape Fear Dialysis and New Hanover Dialysis Center.

At Fresenius Medical Care, company administrators from flood zone areas prepared an action plan.

“We activated our emergency disaster response plans ahead of the storm to ensure patients had emergency packets and access to advanced treatments,” said Bob Loeper, head of disaster response for Fresenius Medical Care. “Our incident command teams staged resources outside of the impact zone, which were deployed into North and South Carolina once the storm passed. We immediately conducted wellness checks to ensure all patients and staff were accounted for.”

Loeper said the company also made sure support services were available to handle the storm.

“Our command centers are equipped with generators, water, food and fuel to service the impacted areas. As of today, all patients are accounted for and all clinics are open except one, which we plan to open over the weekend,” he said.

He noted that more than 50 clinics were open on Sept. 15 to capture missed treatments, and additional shifts continue in clinics to accommodate all patients. – by Mark E. Neumann

 

    Perspective
    Debbie Cote

    Debbie Cote

    As of Sept. 10, Virginia was in the direct path of Hurricane Florence. Staff began reviewing emergency plans and a 3-day diet with patients. Patients were notified to think about alternate plans to reach treatment facilities depending on where they lived. Social workers identified shelters in the area and provided that information to our patients.

    Home training nurses reached out to home dialysis patients. For PD patients, we wanted to make sure anyone on a cycler was prepared to do continuous ambulatory peritoneal dialysis. Home hemodialysis patients were given options to change treatment schedules to reduce the demand for power needs at the peak of the storm.

    Facilities reprinted patient orders to have the most accurate ones in case there was a disruption in our information technology. We planned to review clinic downtime procedures. We also thought about the lab courier services that pick-up specimens and bring these to the hospital laboratory.

    Staff were told to prepare their own emergency plans and “go bags” in anticipation of the need to stay overnight at the clinic. We offered the facilities as a safe place to stay to eliminate travelling if needed. We also discussed the need to be operational on Sunday for patients if needed and started to prepare team members. We discussed any potential schedule changes in the clinic, but with the geographic diversity of the facilities and the unpredictable path of Hurricane Florence, we opted to leave that to the local leadership to make that decision as appropriate for their areas and conditions.

    Generators were checked for fuel and to ensure function. The biomed team made sure the machines were plugged into the emergency outlets. We were prepared to provide oxygen to patients who required it, without the use of oxygen concentrators. In one facility where the medication refrigerator is not on a generator, plans were made to move the drugs to another facility for storage.  

    The biomed team reached out to our water vendor in case potable water was need at a facility. We were disappointed but understood that most of the trucks were already committed to FEMA under contract. We asked the units to stock water bottles and ice for upcoming power outages and/or useable water sources. Clinics were asked to check for flashlights and batteries for use as back up if needed and to ensure emergency radios were in the unit where they could be heard and that these functioned.

    The question was raised if we had a contact with the National Guard in case we needed emergency transportation. As we are hospital based, we have an active emergency management team who, in the event of a declared emergency, would open the command center and we would reach out for assistance. 

    We had some concerns with supply delivery later in the week to the units, so we contacted our two main vendors for weekly deliveries to be delivered before the storm. We made plans to have windows boarded in the three facilities that have a wall of windows in the treatment area.

    We were prepared for the worst, but we got lucky when Hurricane Florence took a turn to the south and the hurricane threat was gone.

    Our next step is to make this a table top exercise: review with the staff to get input into things that we might not have thought of or things that we might have over-reacted to, and do an after-action review. We want to take advantage of the planning that was not needed and learn from it.

    • Debbie Cote, MSN, RN, CNN, NE-BC
    • Administrator, dialysis program
      University of Virginia Health System
      Charlottesville, Viriginia
      Nephrology News & Issues Editorial Advisory Board Member