Taking care of dialysis patients during an emergency means taking care of clinic staff

The floods that inundated Southeast Louisiana last month and damaged more than a 100,000 homes came with very little warning. Residents had little time to hunker down in storm shelters or evacuate to higher ground. They were going about their normal business, attending school, going to work, and for some, undergoing their regular dialysis sessions.

On August 13, employees at the Baton Rouge area dialysis clinics run by Fresenius Medical Care went to work as usual, and the patients came in for their treatments. Rivers in the area rose so rapidly that two clinics in the Baton Rouge area had to be evacuated that day. As patients were dialyzing, the staff saw the water coming up and reached out to the authorities.

“It was a controlled evacuation,” said Tim Berberovich, Fresenius Medical Care regional vice president in the Southeast Louisiana and Mississippi area. “The water wasn’t inside the clinics. Patients were able to finish their treatments. Our staff was very much on top of it.”

Even though the water rose rapidly, Fresenius staff were able to use their disaster preparedness training and responded appropriately. “They handled it amazingly,” said Berberovich. “They maintained a calm composure, put their patients first, and ensured that the patients finished their dialysis treatments. They did an excellent job.”

“I don’t think anybody realized the extent of what was about to happen,” he said. The height and quickness of the flood caught a lot of people by surprise, which is why we saw so many people stranded in their homes and on the highways.”

The floods affected 22 Fresenius dialysis clinics in the Baton Rouge area. Three clinics were closed, including one that was completely destroyed. Two of the closed clinics are being rebuilt, and Fresenius is relocating the other, which was completely flooded. Forty Fresenius employees lost their homes.

Communication is key

At the height of the flooding, communication was very difficult. Cell phone service was unreliable. Entire networks crashed. 911 was inundated.

“You could text cell phone to cell phone,” said Berberovich. “You could talk land line to land line. But it was very difficult for land lines to communicate with cell phones.”

Amidst all the chaos, Fresenius managers needed to account for their staff and their patients. This required a lot of effort “chipping away at the phone bank,” said Berberovich. They needed to communicate with hospitals, shelters, and other emergency facilities. One hospital patient services manager provided her cell phone as an emergency hotline for displaced patients needing treatment, and worked with the National Guard and U.S. Coast Guard to help more than 200 patients find safety, shelter and treatment. She put her number on Twitter, allowing patients to call her directly if they needed help.

Fresenius acted quickly to support its employees, Berberovich said. “I’ve never seen this level of outpouring of support,” he said. Fresenius provided temporary housing in the form of trailers, hotels, and eventually furnished apartments. The company provided transportation assistance to its employees and its patients and offered childcare stipends because schools and daycare facilities were closed.

“Fresenius did everything to take care of the staff so they can take care of the patients,” Berberovich said. “The company protected its staff because they are valuable. Their jobs cannot be done by just anyone.”

Despite the unexpected nature of this emergency, many dialysis professionals in this region were familiar with disaster response. Many have lived through Hurricane Katrina and Isaac, as well as a number of floods. During Katrina, Baton Rouge was an evacuation destination for New Orleans residents. But this time, people in New Orleans came together to help residents in Baton Rouge. Fresenius employees in New Orleans found an alternate 3 ½ hour route between the cities, and came to the region with staffing help and supplies.

“I, like many others in Louisiana, have now lived through a 100-year hurricane and a 1,000-year flood,” said Berberovich. And which one was worse? That really depends on where you were. “For the people whose homes and families we’re affected by the flooding, this storm was just as impactful as Hurricane Katrina was for those in its path,” he said.

Lessons learned

The renal community has become better equipped at handling disasters since Hurricane Katrina. Part of that is due to dialysis providers making it a priority to assess the response after a disaster, and identify areas that need improvement.

The greatest opportunity for improvement is in communication, Berberovich said. Fresenius communicated well with hospitals, the Kidney Community Emergency Response Coalition, dialysis patients and staff. Communication between local health care providers and federal and state agencies could have been better, he said, but he was adamant about not placing blame. There are too many unknowns in an emergency to expect everything to go smoothly.

“We are never going to be 100% prepared because every event is different. But if we improve our playbook we will always be moving in the right direction.” -by Rebecca Zumoff