Optimizing Kidney Replacement Therapy During the COVID-19 Pandemic Across a Complex Healthcare System.

Area of Science:

• Nephrology
• Critical Care Medicine
• Healthcare Management

Background:

• The COVID-19 pandemic caused an unprecedented surge in hospitalizations for patients requiring kidney replacement therapy (KRT).
• This surge placed significant strain on healthcare systems, particularly in managing essential resources for KRT.
• Existing protocols were challenged by the rapid increase in demand for KRT services.

Purpose of the Study:

• To describe the formation and strategies of a multidisciplinary task force established to address the KRT surge during the COVID-19 pandemic.
• To detail innovative approaches implemented to ensure the continuity and equitable distribution of KRT resources.
• To highlight the successful adaptation of healthcare systems to an unanticipated demand for critical nephrology services.

Main Methods:

• Formation of a cross-campus "New-York Presbyterian COVID-19 Kidney Replacement Therapy Task Force" with representation from physicians, nursing, and supply chain professionals.
• Development of novel dashboards for real-time tracking of KRT resource supply and demand.
• Implementation of strategies including urgent start peritoneal dialysis, in-house preparation of KRT fluids, and utilization of unconventional personnel.

Main Results:

• The task force successfully managed the surge in KRT inpatients, mitigating extreme stress on hospital systems.
• Novel dashboards enabled effective monitoring and management of critical KRT resources.
• The implemented strategies facilitated equitable resource sharing across a complex healthcare system.
• Standardized KRT protocols were rapidly deployed across all hospitals.

Conclusions:

• A proactive, multidisciplinary task force approach is crucial for managing surges in KRT demand during public health crises.
• Innovative strategies, including resource tracking and flexible staffing, can ensure the continuity of essential KRT services.
• Effective resource management and protocol standardization are key to maintaining equitable patient care in complex healthcare systems facing unprecedented challenges.