DaVita Medical Insights

Story: Continuing Dialysis with a Limited Water Supply after Hurricane Harvey

How can kidney patients continue dialysis when a natural disaster renders a city without running water?

This question arose abruptly in August when Hurricane Harvey landed in East Texas with a vengeance and devastated Houston, Beaumont and several other regions along the Gulf Coast. Due to flooding of their pumps, the city of Beaumont was left without running water. Regardless, one hospital in Beaumont—Christus Southeast Texas-St. Elizabeth—continued to provide care to its citizens, and DaVita Hospital Services Group committed to helping ensure dialysis continued to be available for the hospital’s kidney patients.

Without a fresh water source, however, traditional intermittent hemodialysis was not an option. Making matters more challenging, Christus Southeast Texas-St. Elizabeth did not offer continuous renal replacement therapy (CRRT) services, leaving the hospital and acute dialysis teams with limited options for low-water solutions. To address this challenge, a large interdisciplinary team (including nurses, local dialysis leaders, biomedical experts, the hospital’s acute dialysis medical director and our colleagues at NxStage) worked together to design a strategy and implement a solution.

The dialysis team considered several options, which included trucking in water, transferring patients to other hospitals or using a hybrid therapy with home dialysis/CRRT machines. On a Saturday afternoon, the team settled on the most viable option, which was low-water utilization dialysis. By Sunday, with significant help from our partners at NxStage, the team delivered 10 NxStage CRRT machines to the hospital, brought in two trainers, wrote a protocol and organized a boot-camp-style training session.  Dialysis of ESRD patients with CRRT equipment began Monday morning, with an expectation to last 48 to 72 hours. The plan was a success and ultimately continued for a week while the city and the hospital restored water.

Out of necessity came innovation. The interdisciplinary team of experts from DaVita, the hospital and NxStage collaborated to implement the solution and provide care without an external water source.  Ultimately, the tremendous physicians in Beaumont triaged patients, carried out the modified dialysis plans, monitored patients closely and prevailed against Mother Nature.

There have been countless stories from Texas, Florida and Georgia in the recent weeks recounting amazing innovations, heroic efforts and unflinching human spirit that kept communities moving forward during these disasters. Every one of them shared the same theme: teamwork. This story from Beaumont is no different and highlights to me the very best in our teams, teammates and partners.

Jeffrey Giullian, MD, MBA

Jeffrey Giullian, MD, MBA

Jeffrey Giullian, MD, serves as chief medical officer of hospital services, vice president of medical affairs and national group medical director at DaVita Kidney Care. He leads the clinical quality and safety efforts for hospital services, helps lead the group medical directors and plays an active role in improving physician experience. Dr. Giullian relies on his past experiences in private practice and hospital leadership to advocate for physicians and medical directors. Dr. Giullian is active with the Renal Physicians Association (RPA) as a member of the Board of Directors, chairman of the Healthcare Payment Committee and member of the RPA’s team of advisors to the American Medical Association Relative Value Units Utilization Committee. Dr. Giullian trained in nephrology and transplantation at Vanderbilt University and received his MBA from the University of Colorado at Denver. Twitter: @Dr_Giullian_MD