Effective approach to manage COVID-19 challenges in Hamad General Hospital dialysis facilities

Abstract

Background: Hamad Medical Corporation (HMC) is providing dialysis treatment to approximately 1050 patients. COVID-19 started from China in December 2019, and the first case in Qatar was confirmed on 27th February 2020. There were challenges to provide dialysis treatment for COVID-19 positive and negative patients during the pandemic due to severe staff shortage, staff fear and psychological distress, workload, lack of dialysis slots, prolonged working hours and staff fatigue. Some staff were even deployed to COVID-19 facilities (modular dialysis services, hotel and quarantine facilities) to provide treatment. Methods: 1) A COVID-19 management committee was established 2) An on-call team was assigned to manage new cases and review dialysis slots availability. 3) Staff performance and adherence to safety measures was monitored. 4) A hierarchy model was implemented for COVID-19. A) Elimination: – Confirmed COVID-19 patients were not to receive dialysis at Ambulatory Dialysis centres. – Unit meetings were only held online. B) Substitution: – Dialysis services were to be provided in HMC dialysis facilities, COVID-19 hospitals, and isolation/quarantine facilities (home/hotels). – Administrators with chronic disease worked from home. C) Engineering: – Reduce number of chairs in tearoom and waiting area – Rearrange offices, working spaces, and conference room to keep everyone 2 meters apart. D) Administrative: – Staff, patient and family education – Screening by using visual triaging scale – Deployment of staff – Managing staff mental health and psychosocial well-being Results: 76 dialysis patients and 30 dialysis staff were infected. 900 hemodialysis sessions were provided inside quarantine and isolation facilities (home, hotel, Bu-Sidra, and other locations) and Hazm Mebaireek General Hospital (HMGH) Modular Dialysis Unit from March to October 2020 . The number of COVID-19 positive patients reduced from 39 in May 2020 to 12 in July 2020 (p = 0002). Conclusion: Thanks to our approach, we were able to provide a high quality and safe dialysis service for in-centre dialysis and in COVID-19 facilities and quarantine centres (home/hotels).