Dialysis providers collaborate on offering isolation shifts, clinics for COVID-19 patients
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Fresenius Medical Care North America and DaVita Inc. are collaborating with U.S. Renal Care, American Renal Associates, Satellite Health and other providers by sharing isolation capacity around the country for dialysis patients who are or may be positive for the coronavirus.
“We are doing our part to not overwhelm hospitals as the prevalence rate surges in the coming days and weeks,” Robert Kossman, MD, executive vice president and chief medical officer of Fresenius Medical Care North America, said in a statement to Healio Nephrology. “As part of this strategy, we have been identifying isolation shifts and designated isolation clinics for all patients receiving dialysis. Patients who are COVID-19 positive and mildly symptomatic will receive their dialysis at one of these locations and be referred for testing without an emergency room referral. Isolation would remain in effect until an absence of infection is documented. More severely symptomatic patients will still be sent to the emergency room for treatment.
“Our first priority has been to convert an entire dialysis center to handle symptomatic patients only, especially in regions hardest hit to date,” Kossman said. “The second-best option is to designate a full shift for symptomatic patients so that we can do a deep clean before and after those shifts. We are trying to avoid symptomatic patients being treated in our dialysis centers alongside healthy patients, given the high risk to our patient population.”
The two largest dialysis companies in the world said in a joint statement that they are “creating a nationwide contingency plan” to treat patients in clinics or shifts that can be accessed by other dialysis providers. “This collaboration will help safeguard caregivers, will conserve personal protective equipment and other important supplies, and will create an environment that provides excess capacity for providers that may be overwhelmed with larger COVID-19 clusters,” the companies said. “There is strong evidence that diligent isolation will mitigate the potential of cross-spread due to close contact among patients and staff.”
Javier Rodriguez, CEO for DaVita Inc., said in the statement, “Dialysis is not optional, it is life-sustaining. In these trying times, we think that by working collaboratively, we can combine resources, clinical expertise, and physical space to help ensure all patients across the kidney care community have access to life-sustaining care in the safest environment possible.”
A critical aim of the collaboration, the companies said, is to keep dialysis patients out of the hospital whenever possible, freeing up limited hospital resources and ensuring there are enough nurses, social workers, dietitians, care technicians and available space to treat all dialysis patients, including those who are or may be infected with COVID-19.
“U.S. Renal Care is proud to be working closely with other national providers to create a safety net ensuring that all 500,000 kidney disease patients will have access to safe, effective treatment every day,” Mary Dittrich, MD, chief medical officer and interim CEO of U.S. Renal Care, said in the statement.
Further instructions on how to refer patients to designated isolation shifts and clinics will be published through the Kidney Community Emergency Response (KCER) Program, under contract with CMS. – by Mark E. Neumann
Disclosures: Kossmann, Rodriguez, and Dittrich report no relevant financial disclosures.
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