Danguilan, R. A. (2014). Management case: Outbreak of chills in the hemodialysis center at the National Kidney and Transplant Institute (NKTI) (Unpublished master's thesis). Public Management Development Program, Development Academy of the Philippines.

Public Management Development Program Batch 3 Senior Executives Class Senior Executives Class

Kidney failure or end stage renal disease (ESRD) is the 10th leading cause of death in the Philippines today. Once diagnosed, the patient needs lifetime dialysis to replace kidney function or a kidney transplant. There are about 20,000 patients on chronic hemodialysis (HD) in the Philippines today. HD in a highly technical procedure, requiring advanced methods to ensure the highest purity of water. The NKTI is the lead agency under the Department of Health for kidney disease management and runs one of the largest HD Centers in the country, dialyzing more than 120 patients daily, 24 hours a day, 6 days a week. On May 28, 2014 the HD Centers of the NKTI experiences an increasing number of HD patients developing chills. In the interest of patients safety, the NKTI Administration decided to shut down operations of its HD Centers while investigating the cause of the chills. More than 100 patients were displaced, who were scheduled for regular HD that day, and more than 300 patients for the rest of the week. All posible causes for the chills were looked into from dialysis access infections, contamination of the water treatment facility, dialyzer re-processing, HD machine dialysate ports, chemical water tests, and heparin. After the problem wa solved, the HD Centers were back to normal operations after 9 days. A total of 21 patients required hospital admission, 49 ptients were given intravenous antibiotics for 10 to 14 days, and there was no death associated with this outbreak. This is an example of the proper handling of an important complication that HD Center should be equipped to handle.