IAEM Bulletin September 2007 Online Edition
Florida Kidney Disaster Coalition Pioneers Community Preparedness
By Sherilyn Burris, Sally Gore, MBA, MSW, and Deuzimar Kulawik, BSN, RN, MSN
Chronic kidney disease (CKD) is a growing epidemic. Many people with CKD will progress to end stage renal disease (ESRD), or kidney failure. Kidneys remove waste from the body, regulate electrolyte balance and blood pressure, and stimulate red blood cell production. End-stage renal disease occurs when the kidneys cannot function well enough to sustain life. ESRD is fatal unless treated with dialysis or a kidney transplant, both of which can have serious risks and consequences.
Florida has approximately 19,000 ESRD patients, 312 dialysis centers and nine transplant facilities. Three renal replacement therapy options are available: renal transplantation, hemodialysis (HD) and peritoneal dialysis (PD). Most patients choose hemodialysis for their treatments, which requires them to visit a dialysis center three times per week. Without dialysis, the patient may require hospitalization or die from fluid overload and other complications.
Need for the Coalition
Disasters, both natural and manmade, can cause major disruptions in life-sustaining dialysis services. After a disaster, the needs of the patients require that caregivers and service providers assist dialysis facilities, with little or no notice. The Florida Kidney Disaster Coalition (FKDC) emerged to establish and facilitate partnerships that provide a framework for disaster readiness and continuity of care for the renal community. Florida represents a unique but difficult opportunity for the ESRD community and emergency management stakeholders to share information and resources. The coalition aims to align with state emergency management objectives to ensure all-hazards preparedness; continuity of operations of dialysis clinics and transplant centers; and the provision of basic human needs for all ESRD patients, families, stakeholders and staff.
Although Florida is home to a variety of dangerous hazards, the Atlantic Hurricane Seasons of
2004 and 2005 revealed an important need for the state’s renal community. Based on these experiences, dialysis stakeholders recognized the need to improve planning and preparation for ESRD and transplant patients in emergencies. In late 2005, these concerned stakeholders met to form a Florida dialysis disaster preparedness and response coalition. Twenty-eight participants representing 18 organizations attended the first meeting. They included large dialysis organizations, independent dialysis facilities, transplant facilities, professional organizations, the Florida Department of Health, the State Survey Agency, emergency management, patient organizations, a utility company, and other key stakeholders.
Mission and Vision
The coalition’s mission and vision further facilitates buy-in and engages stakeholders. The FKDC mission is to establish and facilitate partnerships that provide a framework for disaster readiness and continuity of care for the renal community. The vision states: “The Florida Kidney Disaster Coalition is the model disaster planning and readiness organization for kidney patients by collaborating with community partners to ensure timely access to quality care.” Coalition members worked together to identify key priorities, including communication, coordination, education and emergency operations center (EOC) involvement. Based on these priorities, workgroups were formed to create relevant resources and materials.
Creation of Resource Toolkits
For example, the education committee created and distributed several resource toolkits to all
Florida dialysis providers. These included information on best practices and lessons learned from
2004 and 2005, a disaster drill instructional guide, and an emergency communications kit. Evaluations were included in each toolkit, and recipients indicated a high satisfaction level with the materials.
Evaluating Activities
Identifying gaps, reprioritizing tasks, monitoring progress, and evaluating coalition structure and participation are important aspects of evaluation. When evaluating current or future activities, FKDC strives to relate the tasks to the coalition mission and vision. A SWOT (strengths, weaknesses, opportunities, threats) analysis is also a useful tool for evaluating
activities or progress. A quality evaluation is as easy as answering three questions: (1) Where are we? (2) Where do we want to be? (3) And how do we get there?
FKDC’s Accomplishments
Since its inception, FKDC’s accomplishments have been remarkable.
Active coalition membership has more than doubled and now stands at 66 members representing 40 agencies.
The coalition created a logo, brochure, and traveling tabletop display to raise public awareness of the coalition and the needs of renal patients during disasters.
Members routinely attend patient and professional conferences to market the coalition and its materials.
Diligent workgroups developed quality programs and materials. The EOC (emergency operations center) involvement committee made significant headway in its efforts to conduct “community collaborative” meetings with dialysis providers, local emergency management officials, and other community stakeholders involved in disaster preparedness and response.
What Happens Next
Next, FKDC is compiling resources for “community partner packets” specific to Florida
hazards. These packets will outline the number of dialysis patients per zip code and the number and the location of dialysis providers, so that emergency management can incorporate renal stakeholders into their existing plans. Finally, the coalition also aims to establish an online portal and listserv for members to share information and resources from their areas of expertise.
