Acute Kidney Injury

Acute Kidney Injury

Published Date: 10 Oct 2018

Acute Kidney Injury (AKI) is a key clinical priority. NIHR CLAHRC Greater Manchester aligns local and national initiatives with a view to improving health outcomes through better AKI prevention, detection and management.

  • CLAHRC GM have contributed significantly to NHS England’s Think Kidneys (TK) Programme, which was shortlisted for a National Patient Safety Award. TK Resources for Primary Care have been accessed over 22,000 times. A National Position Statement was informed by their sick day guidance card evaluation and a systematic review on the risks and benefits of temporarily stopping medications to prevent AKI (co-produced with CLAHRC West).
  • Programme Lead Tom Blakeman was a lead developer of the 5-star rated British Medical Journal learning module, which has been completed by 3885 clinicians since 2016 and 1343 clinicians in the last year.
  • 31 Bury CCG general practices participated in our post-AKI project. AKI coding increased from 28% to 36%, positively impacting on patient care. 12% of patients had medication reviews within 1 month of discharge when not coded, compared to 23% when coded; 58% vs 79% serum creatinine tested within 3 months of discharge; and 1% vs 15% were supplied written AKI information. NICE are keen to learn from these findings to inform their AKI QOF indicator development. This builds on our contribution to TK shared learning database supporting the implementation of NICE AKI Quality Standards.

Collaborating with two AHSNs and the Royal College of GPs, a learning event/toolkit was delivered. Event feedback indicated changes were planned, for example new policy on AKI follow up.

 

The expertise of the CLAHRC team enabled the numerous education sessions to be delivered to a wide range of professionals to a high standard, with cutting edge thinking and clinical knowledge.

Contribution of CLAHRC Greater Manchester

NIHR CLAHRC GM has supported the delivery of interventions and evaluations with Salford CCG, Bury CCG, Manchester Health and Care Commissioning, Manchester University NHS Foundation Trust and Salford Royal Foundation Trust. The mix of academic and clinical expertise meant that these interventions were implemented with additional benefit in a relatively short time frame. Without CLAHRC GM input this would not have been possible. In addition, the expertise of the CLAHRC team enabled the numerous education sessions to be delivered to a wide range of professionals to a high standard, with cutting edge thinking and clinical knowledge.

What happened next?

  • The RCGP AKI Toolkit will be launched in June 2018. Another year of funding has been approved to support toolkit implementation into practice, with the RCGP Clinical Innovation and Research Centre and evaluated by NIHR CLAHRC GM.
  • With their ongoing NIHR CLAHRC Wessex collaboration, CLAHRC GM plan to spread resources across the country.
  • With Vision (GP software provider), CLAHRC GM continues to develop a potentially marketable tool to assess AKI care in general practice, aligned with NICE AKI indicators.
  • A collaborative bid is being submitted to the NIHR Health Services & Delivery Research programme; focussing on the development, implementation and evaluation of a self-management intervention.