Table 6.

Questions for the future of nephrology disaster response

AreaQuestion
Patient plansCan we identify and overcome barriers to early and complete evacuation of dialysis patients?
Can providers motivate patients to develop and rehearse individual evacuation plans?
Should the resuscitation status be included in each patient's disaster packet?
Will kidney patient organizations take a leading role in the effort to educate dialysis patients about disaster response?
Facility plansWill dialysis units procure redundant communications tools?
Are web-based portals, such as the DMIS FEMA eGOV platform, a practical step toward a truly interoperable communications system?
Will dialysis units procure appropriately sized generators and store sufficient fuel?
Will dialysis units develop plans to back up medical records, with the ability to disseminate medical information after the unit is forced to close?
Will dialysis units develop affiliation agreements with other units outside the likely disaster area?
Will facilities be able to gather useful data on dialysis patient care in future disasters to facilitate future disaster planning?
Community plansIs the timeline to safety a useful tool to focus planning for all organizations that cooperate in ensuring the swift resumption of regular dialysis treatments for patients?
Will a detailed and resourced community transportation plan improve evacuation?
Will medical personnel in evacuee shelters have dialysis patient evaluation protocols, communications resources, and appropriate laboratory support? Will they be aware of resources to facilitate dialysis referral, including the KCERC emergency telephone number (888-33kidney)?
Will careful planning and early evacuation for dialysis patients reduce burdens on the general disaster response effort?
Should particular shelters be predesignated for kidney patients, and what particular resources should these shelters be provided?
Are we doing enough for kidney patient subgroups with particular needs: Pediatric dialysis patients, peritoneal dialysis patients, hepatitis B–seropositive dialysis patients, and transplant patients?
Federal plansShould there be plans for emergency dialysis clinics to be set up and staffed by federal kidney medicine emergency response teams to augment the capacity of existing dialysis facilities?
Will the newly available sorbent and closed-loop dialysis systems become readily available for disaster response?
Will the federal government develop and deploy an emergency health records system?
All-hazards planningIs the kidney community ready for a large-scale disaster involving widespread crush injury or pandemic influenza?
The kidney community is now focused on disaster planning; will this focus be lost in the years ahead if we are spared another domestic disaster?