Abstract
Objectives: This qualitative study explored factors promoting disaster preparedness (DP) in dialysis facilities by investigating facilities with relatively advanced preparedness.
Methods: (1) Choice of advanced facilities: A quantitative survey on DP in dialysis facilities was conducted on all the facilities operated by members of the Japanese Association of Dialysis Physicians. Questionnaires inquired about their accomplishment of five DP targets: Patients, Staff, Equipment/Infrastructure, Cooperation with community organizations (Cooperation), and General management. Results indicated that DP accomplishment in facilities participating in the survey regarding Patients and Cooperation was lower than for the other targets. We selected 30 facilities in the descending order of accomplishing each target (15 facilities for Patients and 15 facilities for Cooperation) with five facilities being selected for both targets. We finally conducted interviews in 25 facilities. (2) Survey methods: Semi-structured interviews were conducted with the staff in charge of DP. Interview items included methods of advancing DP for each target, DP for the staff (a target of relatively low accomplishment scores), and DP for the entire facility. Twenty facilities (8 facilities for Patients, 8 facilities for Corporation, 4 facilities for Patients and Corporation) participated in the interviews. (3) Analytical method: A qualitative descriptive analysis of verbatim interview records.
Results: Facilities with high DP accomplishment for Patients (1) developed methods showing practical benefits in communicating with patients, (2) disseminated DF information according to patients’ demands, and (3) conducted practical evaluation drills. Facilities with high DF performance by Staff (1) conducted measures from the staff’s perspectives, (2) conducted drills utilizing daily tasks, and (3) conducted education for promoting spontaneity. Facilities with high DF accomplishment for Cooperation (1) developed practical cooperation, (2) established Cooperation with a clear purpose and meaning, and (3) developed face-to-face relationships with the staff of other organizations. DP promotive factors in an organization as a whole included (1) awareness of DP needs, (2) maintaining awareness of DP’s crucial role, and (3) increasing the momentum for DP through experiences of large natural disasters.
Conclusion: It is suggested that developing the spontaneity of patients and staff, incorporating DP into daily tasks, and nurturing key DP personnel in facilities are essential for developing DP in dialysis facilities.
