National Patient Safety Drivers
A number of national levers were used to support improvement in the detection, treatment, management and prevention of AKI.
These levers have included two patient safety alerts, published by NHS England and subsequently by NHS Improvement and a CQUIN.
The first Patient Safety Alert , issued June 2014, ‘Standardising the early detection of Acute Kidney Injury’ prescribed inclusion of a newly created algorithm into pathology lab information systems to standardise the detection and staging of AKI. It does this by providing an alert to improve the speed of response to positive test results, leading to improved patient outcomes.
About the AKI Algorithm
The algorithm standardised the definition of AKI and, when implemented in pathology lab information management systems, ensures a timely and consistent approach to the detection and diagnosis of AKI across the NHS.
The algorithm identifies potential cases of AKI from the lab data in real time and produces a test result which is sent via existing IT connections to patient management systems. More information about the algorithm can be found here.
Transmitting Data on the Warning Stage Test Results
The data from path labs on AKI test results is being sent to the UK Renal Registry and is being used to create the first master patient index on AKI in the world. This will provide evidence of the rates of AKI and its stages, and in time, will drive a reduction in variance, improve the management of the disease and improve the experiences and outcomes of patients.
Best practice guidance on transmitting AKI warning stage test results to the UK Renal Registry can be found here
The second Patient Safety Alert , issued August 2016, ‘Supporting the care of patients with Acute Kidney Injury’ promotes the resources developed by the Think Kidneys team for the improvement of the detection and management of AKI for all health care professionals, including primary and secondary care teams, pharmacists, dieticians and care home staff as well as others. All the resources are available here, and many can be accessed on the Think Kidneys AKI App which can be downloaded from you App store for your smart phone or tablet.
A Commissioning for Quality and Innovation (CQUIN) initiative, launched 2015, for AKI was designed to improve the recovery of individuals with AKI and to ensure appropriate follow up to minimise short and long term consequences. The change required was for discharge summary information for people with AKI to include the stage of AKI (a key aspect of AKI diagnosis) and primary diagnosis; evidence of a medicines review having been undertaken (a key aspect of AKI treatment), and information about tests required on discharge for monitoring. During the year of operation, the CQUIN, rapidly improved the quality of information in records of people who had experienced AKI.
Frequently Asked Questions about the patient safety alert can be found here