title: The impact of a large-scale power outage on hemodialysis center operations.
abstract: BACKGROUND
  On June 29, 2012, mid-Atlantic storms resulted in a large-scale power outage affecting up to three million people across multiple (US) states. Hemodialysis centers are dependent on electricity to provide dialysis care to end-stage renal disease patients. The objective of this study was to determine how the power outage impacted operations in a sample of hemodialysis centers in the impacted regions.
  
  
  METHODS
  The sample consisted of all hemodialysis centers located in the District of Columbia and a total of five counties with the largest power losses in West Virginia, Virginia, and Maryland. A semi-structured interview guide was developed, and the charge nurse or supervisor in each facility was interviewed. The survey questions addressed whether their centers lost power, if so, for how long, where their patients received dialysis, whether their centers had backup generators, and if so, whether they had any problems operating them, and whether their center received patients from other centers if they had power.
  
  
  RESULTS
  Calls were placed to 90 dialysis centers in the sampled areas and a 90% response rate was achieved. Overall, hemodialysis operations at approximately 30% (n = 24) of the centers queried were impacted by the power outage. Of the 36 centers that lost power, 31% (n = 11) referred their patients to other dialysis centers, 22% (n = 8) accommodated their patients during a later shift or on a different day; the rest of the centers either experienced brief power outages that did not affect operations or experienced a power outage on days that the center is usually closed. Some centers in the study cohort reported receiving patients from other centers for dialysis 33% (n = 27). Thirty-two percent (n = 26) of the centers queried had backup generators on site. Eleven percent (n = 4) of the centers experiencing power outages reported that backup generators were brought in by their parent companies.
  
  
  CONCLUSIONS
  Comprehensive emergency planning for dialysis centers should include provisions for having backup generators on site, having plans in place for the timely delivery of a generator during a power outage, or having predesignated backup dialysis centers for patients to receive dialysis during emergencies. Most dialysis centers surveyed in this study were able to sustain continuity of care by implementing such pre-existing emergency plans.
authors: 1 George Washington University, Department of Emergency Medicine, Washington, DC USA and RAND Corporation, Arlington, Virginia USA.
authors: Mahshid
authors: M
authors: Abir
authors: Sophia
authors: S
authors: Jan
authors: Lindsay
authors: L
authors: Jubelt
authors: Raina M
authors: RM
authors: Merchant
authors: Nicole
authors: N
authors: Lurie
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D004189:Disaster Planning; D004560:Electricity; D004630:Emergencies; D006801:Humans; D009874:Operations Research; D006435:Renal Dialysis