Dialysis is a life-saving treatment for people who have lost their kidney function.

Behind that life-saving treatment is a ton of technology. From dialysis machines and water treatment to replacement parts and diagnostic tools – equipment is a key component in units and patients’ homes across Manitoba.

Dialysis technologists are the people deploying, installing, maintaining, and servicing that equipment. When a patient’s home dialysis machine needs urgent repairs or a unit’s reverse osmosis (RO) system is failing, technologists quickly mobilize – sometimes by vehicle or plane – to get repairs done. It is vital to get equipment up and running as fast as possible, to ensure patients continue getting the life-saving treatment they need.

Technologists are based out of Seven Oaks General Hospital, St. Boniface Hospital, Brandon Regional Health Centre, and Health Sciences Centre Winnipeg. HSC Winnipeg technologists service rural units in addition to the hospital’s own units.

“A lot of our true emergencies are related to the water treatment systems. Something happens to the central RO system in centres that warrants us to have to go out there right away,” explains Doug Franklin, manager of technology for the Manitoba Renal Program.

Newer technology installed in recent years allows dialysis technologists to remote analyze water system issues and rapidly develop a repair action plan. Whether it’s initiating a temporary bypass or getting on site, the goal is to minimize any downtown and disruption to the dialysis unit.

Technologists often work with community and regional health authority staff to diagnose and repair issues, some of which can be complicated or far-reaching.

“If there are issues in Boundary Trails or Portage le Prairie, we typically have electricians on standby there,” says Franklin. “The challenge is in a lot of the remote areas.”

Over one year there were about 250 service calls for rural units and home hemodialysis machines in patients’ homes.

One of the more extreme repairs to take place in the past was in a remote dialysis unit when diesel fuel had contaminated the unit’s water supply. The fuel affected equipment leading to the reverse osmosis system and much of the equipment had to be replaced. The issue was identified early and led to a temporary unit shutdown with patients and staff safely relocating for treatment for two weeks.

Another recent example is when a RO system blew out its power supply and stopped working completely, needing immediate on-site repair.

While technologists manage and service water systems and dialysis machines in rural units, all types of equipment are coordinated and maintained in Winnipeg dialysis units.

Apart from nearly 400 in-centre hemodialysis machines and seven central RO systems, there are beds, recliners, infusion pumps, ultrasound machines and glucometers to coordinate and maintain. When it is time to introduce a new piece of equipment to multiple units, that undertaking can be a large project.

 “We have a provincial standard for dialysis equipment so that all sites use the same piece of equipment,” says Franklin.

Franklin says patient safety is always at the forefront. He says having standardized equipment at all the sites ensures safe, consistent operation and repair.

“We try our best to pick the best machine and the most reliable machine – it actually helps us to reduce the amount of calls or problems we have with them,” he explains. When consistent issues are identified with a product, he implements steps to manage and fix the situation such as working with the vendor on an improvement plan or starting the process of sourcing new equipment.

After a request for proposal (RFP) process takes place to select new equipment, vendor experts help train educators and other renal staff at the start of a phased-in approach to establish the new equipment.

One of the largest examples of introducing a new machine was when all in-unit hemodialysis machines were replaced with newer models because the older model was becoming obsolete.

Technologists are not always behind-the scenes. Many technologists meet and work with patients directly in their homes because of the need to maintain and repair home hemodialysis equipment. There are two different types of home hemodialysis machines utilized by patients who live throughout the province, sometimes in very remote areas.

Franklin says he appreciates the hard work of the technologists at the sites because they are critical in keeping units and machines operating smoothly.

“Overall, I have a very great technical team at all the sites that provide a really good support for everyone.”