Exploring and Understanding the Management of Acute Kidney Injury (AKI) in Primary Care:
Dissemination of results at a Central Manchester Citywide event (03/10/18)
CLAHRC GM has been working in collaboration with medical practices across the Manchester Health and Care Commissioning (MHCC) and AKI Leads at Manchester University Hospital NHS Foundation Trust to examine processes of care and management of patients with Acute Kidney Injury (AKI) between secondary and primary care.
AKI is a clinical syndrome characterised by a sudden reduction in kidney function. AKI is a marker of illness severity and is associated with up to around one in five unplanned hospital admissions, with more than 60% of these episodes arising in the community and the remaining acquired during a hospital stay. AKI is associated with significantly worse health outcomes. Hospital related care of patients with AKI is estimated to cost around 1% of the NHS budget.
This project set out to examine improvement in:
- Processes to improve communication of AKI between secondary and primary care
- Processes to improve diagnosis and coding of AKI
- Timely care and surveillance (e.g. serum creatinine checks; medication reviews and information given to patients as per national guidelines).
The results were presented to GPs at the MHCC Citywide event on Wednesday 3rd October 2018. The event gave us an opportunity to share the learning from this project, and others, with colleagues across the MHCC footprint; with the aim to start conversations between clinical teams and the CCG on how to promote further initiatives locally towards improving the management of their patients with AKI.
Dr Tom Blakeman, Clinical Lead for the CLAHRC GM Kidney Health Programme, presented at the event. Some of his key messages were;
- Some key challenges identified / areas that would benefit from improvement were:
- Interactions and flow: improve flow of information (handover) to reduce time spent “digging” for information
- Clear diagnostic coding was an important step to enhance subsequent primary care management
- Delays in discharge information can affect timely medication reviews
- Communication with patients could be improved
- Learning from the practices in MHCC have opened lines of communication between primary and secondary care to improve care locally. Plus the results also fed into a national project with the Royal College of GPs (RCGP) involving 24 general practices across England and Scotland
- This learning informed the design of an RCGP AKI Toolkit, which is now available online at RCGP Website.
Date Published: 25/10/2018