think kidneys uk kidney week

Acute Kidney Injury (AKI)

The Think Kidneys programmeDr Richard Fluckrichard.fluck@nhs.net,Chair, Think Kidneys

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An ‘intermediate’ health stateAssociated with other serious illness

Important marker of illness severity

“Force multiplier” for poor outcomes

Potential to improve care

Reduce avoidable harm - death and morbidity

Reduce cost

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‘Think Kidneys’ AKI Programme

Who is at risk?

When do people sustain AKI?

How should patients with AKI be

managed?

What do people need to know?

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KDIGO Clinical Practice Guideline for Acute Kidney InjuryKidney International Supplement 2012; 2(1): 1-138

How is AKI defined?

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National Algorithm

Based in LIMS

Compares serial creatinine measures

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Improving diagnosis: using changes in serum creatinine

Laboratory definition and standardisation

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Detect Alert

Lets talk about ‘alerts’

Respond

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Care bundles http://bit.ly/27Xxn9I

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Primary Care Guidelines http://bit.ly/1TNQNqe

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Patient information http://bit.ly/1qTXKM0

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Risk http://bit.ly/1TGGphD

Risk factors

Non modifiable or fixed factorsAgeCo morbidities

Modifiable factorsDrugsExposure to new drugs and contrastVolume

TriggersSepsisHypovolaemia

Key pointsFew drugs are ‘nephrotoxic’ – avoid use of word

Most drugs are ‘situational’ in cases of AKI

1. Causative2. Adjuncts3. Altered side effect profile

Role in reducing risk of AKISick day guidance position statementhttp://bit.ly/22sGdbs

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Medicines management http://bit.ly/1TNSGTD

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Paediatric guidance http://bit.ly/1UlUPGi

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The community and care homes http://bit.ly/1TJG00K

Public awareness campaign http://bit.ly/1OViw3K

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‘AKI warning stage’

Patient management

system

Alert Response

Local systems

Message

Master patient index

Other data systems

AKI Registry

RegionalNational Research

QI

System Measurement

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Measurement http://bit.ly/1TJG00K

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Patients with a AKI alert in each region AKI rate per 1000

people

Year 1Discharge communicationCommunication of AKINeed for follow upMedications

Why?High readmission ratesPrimary care knowledgeFuture riskMedicines management

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Commissioning: national CQUIN

Key points for Quarter 3 2015/16:AKI data collection

Overall, case notes from a sample of 7,784 covering 31,136 key criteria for AKI. This is an increase of 8% since Quarter 2 (28,869 items)

A rate of 55% (17,113 items) were completed in the review of AKI discharge summaries. A 60% increase of compared to Quarter 2 (10,668 items)

All the NHS regions (London, North of England, South of England, Midlands and East of England) achieved between 51%-63% completed items (an increase in from 25%-39% in Quarter 2).

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Case studies (http://bit.ly/1X5dcmS) , examples, other work

The brand

Improvement ingredients

Data

Tools

Exemplars

Leadership

Links

NHS Improvement

NHS England

Sustainability

UK Renal Registry and funding

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Going forward – sustainability and programme future

www.thinkkidneys.nhs.uk A summary

Think Kidneys

Has delivered system levers

Providing a framework for action

Raised the profile

It is supportive of other change agents

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Karen ThomasThink Kidneys Programme ManagerUK Renal RegistryKaren.Thomas@renalregistry.nhs.uk

Annie TaylorCommunications Consultant to the Acute Kidney Injury National Programmeanniemtaylor331@gmail.com

The UK Renal Registry team, chairs, co-chairs and teams of all the workstreams in ‘Think Kidneys’

Joan RussellHead of Patient SafetyNHS Englandjoan.russell@nhs.net

Ron CullenDirectorUK Renal RegistryRon.Cullen@renalregistry.nhs.uk

www.linkedin.com/company/think-kidneys

www.twitter.com/ThinkKidneys

www.facebook.com/thinkkidneys

www.youtube.com/user/thinkkidneys

www.slideshare.net/ThinkKidneys

www.thinkkidneys.nhs.uk

Acknowledgements

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