A Roadmap for Disaster Risk Reduction and Management in Kidney Care: A Scoping Review and Content Analysis.

Abstract

Background: Natural, technological and other disasters cause significant human suffering, and kidney patients are uniquely vulnerable. The safe provision of kidney replacement therapies necessitates the consistent provision of resources. Robust disaster risk reduction and management (DRRM) can mitigate risks associated with resource disruption. Individual kidney care programs may benefit from an organized approach to developing context-specific protocols. We aimed to synthesize contemporary literature in kidney care to create a roadmap in DRRM.

Methods: We conducted a scoping review followed by a content analysis using the Framework Method. Literature that focused on lessons learned and proposed strategies or recommendations in DRRM was eligible. We contextualized this roadmap within the domains of disaster preparedness, response, and recovery.

Results: Of 3,973 titles and abstracts screened, 52 articles were included. We developed the following roadmap: 1) the 'ABC4s' of disaster preparedness: Assess needs, risks, and vulnerabilities (regional risks, patients at risk); Build a task force network; Capacity building (tangible resources, intangible resources, monetary considerations, transportation); Communication (network and protocol, patients' medical and dialysis information, contact information of all stakeholders, inclusive approach, reliable medium); Coaching (patients, caregivers, healthcare personnel, reinforce and repeat); Contingency planning (surge capacity, rationing care, resource distribution); and Strategic partnerships. 2) the 'DIAL' response: Damage and scope assessment; Initiate action plan (choose the plan, apply preparedness tenets, implications for receiving facilities); Appraise the action plan regularly (reassess, maintain ethical standards, address psychosocial needs); and Liaise, engage and update. 3) the 'ARC' to recovery: Assess damage; Return to the (new) norm; and Collect data to evaluate, improve, and share.

Conclusions: We propose a roadmap to disaster preparedness, response and recovery that can guide individual kidney care programs globally to develop context-specific protocols aimed at building capacities and facilitating processes toward DRRM.