Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-26T07:06:54.240Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of Hurricane Sandy on Hospital Emergency and Dialysis Services: A Retrospective Survey

Published online by Cambridge University Press:  28 July 2014

Chou-jui Lin ,
Lauren C. Pierce ,
Patricia M. Roblin  and
Bonnie Arquilla
Chou-jui Lin*
Affiliation:
State University of New York Downstate Medical Center, Brooklyn, New YorkUSA
Lauren C. Pierce
Affiliation:
State University of New York Downstate Medical Center, Brooklyn, New YorkUSA
Patricia M. Roblin
Affiliation:
State University of New York Downstate Medical Center, Brooklyn, New YorkUSA
Bonnie Arquilla
Affiliation:
State University of New York Downstate Medical Center, Brooklyn, New YorkUSA
*
Correspondence:Chou-jui Lin, MBChB, MPH Department of Emergency Preparedness State University of New York Downstate Medical Center 440 Lenox Road, 2M Brooklyn, NY 11203 USA E-mail linch162@gmail.com; Chou-jui.Lin@downstate.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Hurricane Sandy forced closures of many free-standing dialysis centers in New York City in 2012. Hemodialysis (HD) patients therefore sought dialysis treatments from nearby hospitals. The surge capacity of hospital dialysis services was the rate-limiting step for streamlining the emergency department flow of HD patients. The aim of this study was to determine the extent of the HD patients surge and to explore difficulties encountered by hospitals in Brooklyn, New York (USA) due to Hurricane Sandy.

Methods

A retrospective survey on hospital dialysis services was conducted by interviewing dialysis unit managers, focusing on the influx of HD patients from closed dialysis centers to hospitals, coping strategies these hospitals used, and difficulties encountered.

Results

In total, 347 HD patients presented to 15 Brooklyn hospitals for dialysis. The number of transient HD patients peaked two days after landfall and gradually decreased over a week. Hospital dialysis services reported issues with lack of dialysis documentation from transient dialysis patients (92.3%), staff shortage (50%), staff transportation (71.4%), and communication with other agencies (53.3%). Linear regression showed that factors significantly associated with enhanced surge capacity were the size of inpatient dialysis unit (P = .040), having affiliated outpatient dialysis centers (P = .032), using extra dialysis machines (P = .014), and having extra workforce (P = .007). Early emergency plan activation (P = .289) and shortening treatment time (P = .118) did not impact the surge capacity significantly in this study.

Conclusion

These findings provide potential improvement options for receiving hospitals dialysis units to prepare for future events.

LinC, PierceLC, RoblinPM, ArquillaB. Impact of Hurricane Sandy on Hospital Emergency and Dialysis Services: A Retrospective Survey. Prehosp Disaster Med. 2014;29(4):1-6.

Keywords

cyclonic stormsdisaster planningrenal dialysis
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 4 , August 2014 , pp. 374 - 379
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Redlener, I, Reilly, MJ. Lessons from Sandy-preparing health systems for future disasters. N Engl J Med. 2012;367(24):2269-2271.CrossRefGoogle ScholarPubMed
2. Davies, E. Emergency hospital evacuation as Hurricane Sandy hits New York. BMJ. 2012;345:e7357.CrossRefGoogle ScholarPubMed
3. Abdel-Kader, K, Unruh, ML. Disaster and end-stage renal disease: targeting vulnerable patients for improved outcomes. Kidney Int. 2009;75(11):1131-1133.CrossRefGoogle ScholarPubMed
4. Kleinpeter, MA, Norman, LD, Krane, NK. Dialysis services in the hurricane-affected areas in 2005: lessons learned. Am J Med Sci. 2006;332(5):259-263.CrossRefGoogle ScholarPubMed
5. Anderson, AH, Cohen, AJ, Kutner, NG, Kopp, JB, Kimmel, PL, Muntner, P. Missed dialysis sessions and hospitalization in hemodialysis patients after Hurricane Katrina. Kidney Int. 2009;75(11):1202-1208.CrossRefGoogle ScholarPubMed
6. Kutner, NG, Muntner, P, Huang, Y, et al. Effect of Hurricane Katrina on the mortality of dialysis patients. Kidney Int. 2009;76(7):760-766.CrossRefGoogle ScholarPubMed
7. Howard, D, Zhang, R, Huang, Y, Kutner, N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):325-329.CrossRefGoogle ScholarPubMed
8. Saran, R, Bragg-Gresham, JL, Rayner, HC, et al. Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int. 2003;64(1):254-262.CrossRefGoogle ScholarPubMed
9. Kidney Community Emergency Response Coalition. Hurricane Sandy After Action Report December 2012. http://www.kcercoalition.com/pdf/KCER_Hurricane_Sandy_After_Action_Report_12-28-12_508.pdf. Published 2012. Accessed July 15, 2013.Google Scholar
10. New York City Department of City Planning: Table PL-P1 NTA: Total Population New York City Neighborhood Tabulation Areas, 2010. http://www.nyc.gov/html/dcp/pdf/census/census2010/t_pl_p1_nta.pdf. Accessed July 15, 2013.Google Scholar
11. Jangi, S. Facing uncertainty-dispatch from Beth Israel Medical Center, Manhattan. N Engl J Med. 2012;367(24):2267-2269.CrossRefGoogle ScholarPubMed
12. Evans, M, Carlson, J, Barr, P, Kutscher, B, Zigmond, J. Left in the dark: seven years after Katrina, Sandy is teaching hospitals more lessons on how to survive nature's fury. Mod Healthc. 2012;42(45):6-7,12,1.Google Scholar
13. Lacson, E Jr., Brunelli, SM. Hemodialysis treatment time: a fresh perspective. Clin J Am Soc Nephrol. 2011;6(10):2522-2530.CrossRefGoogle ScholarPubMed
14. Marshall, MR, Byrne, BG, Kerr, PG, McDonald, SP. Associations of hemodialysis dose and session length with mortality risk in Australian and New Zealand patients. Kidney Int. 2006;69(7):1229-1236.CrossRefGoogle ScholarPubMed
15. Centers for Medicare & Medicaid Services. Disaster Preparedness: A Guide for Chronic Dialysis Facilities. Second Edition. http://www.kcercoalition.com/pdf/Disaster_Preparedness_-_A_Guide_for_Chronic_Dialysis_Facilities_-_Second_Edition.pdf. Accessed July 15, 2013.Google Scholar
16. Kopp, JB, Ball, LK, Cohen, A, et al. Kidney patient care in disasters: emergency planning for patients and dialysis facilities. Clin J Am Soc Nephrol. 2007;2(4):825-838.CrossRefGoogle ScholarPubMed
Supplementary material: File

Lin Supplementary Material

Questionnaire

Download Lin Supplementary Material(File)
File 55.3 KB