Effectiveness of a clinical pathway for dialysis patients affected by the Great East Japan Earthquake

The Great East Japan Earthquake (March 11, 2011), which caused unprecedented damage, also greatly affected dialysis facilities in Miyagi Prefecture. In particular, the coastal areas were devastated, affecting numerous chronic dialysis patients. The Supply of electricity and water was unstable, and communication links were paralyzed. The living conditions of the people were miserable. We requested dialysis facilities outside the disaster areas to provide treatment for chronic dialysis patients, because the quality of dialysis could not be maintained under the conditions. In regard to dialysis treatment, requesting the afflicted dialysis facilities to provide usual medical information about chronic dialysis patients does not fit into the basic philosophy of disaster relief. On the other hand, we had to treat many chronic dialysis patients who were admitted to our hospital for the first time. Issues related to the medical treatment of patients who were evacuated from the disaster-afflicted areas were quite different from those in ordinary situations. Therefore, we formulated a “clinical pathway for the hospitalization of chronic dialysis patients” as a tool to visualize information and allow it to be shared among different professionals and institutions. The clinical pathway allowed the standardization and understanding of patients conditions during hospitalization and was also helpful for the handover of patients to dialysis facilities in Hokkaido. The findings suggested that the clinical pathway would be a useful tool for chronic dialysis patients. We report the details in this article.