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Management of Acute Kidney Injury in Primary Care: Development and evaluation of a model for Learning & Improvement - RCGP toolkit


What did we do?

In year 1 we explored the key issues associated with the processes of care for patients with Acute Kidney Injury (AKI), to inform production of a toolkit as a resource for primary care teams. The next phase of work aimed to support the implementation of quality improvement methods into routine practice, in order to improve patient safety in general practice and at the interfaces between healthcare sectors, through the lens of AKI.


We worked in collaboration with Royal College of GPs,Think Kidneys, AHSN Kent Surrey Sussex, AHSN North East and North Cumbria, NIHR Greater Manchester Patient Safety Translational Research Centre, Health Improvement Scotland and NHS Education for Scotland.


Why was it important?

AKI is a major marker of patient safety and illness severity. Illness complicated by AKI is associated with poor health outcomes in terms of high rates of rehospitalisation, development or progression of Chronic Kidney Disease (CKD), and mortality. NHS England has introduced a Level 3 Patient Safety Directive to improve the recognition and response to AKI.


As a clinical syndrome, AKI offers a lens to learn and improve care delivery and patient safety for people with a range of conditions, particularly those taking multiple medicines and living with complex health and social care needs (i.e. multi-morbidity).


How did we do it?

The work we did was done through the use of a RAND study. In summary, this entailed:

  • A review of existing guidelines and literature

  • Development of clinical scenarios for testing

  • Creation of panel of experts to review clinical scenarios

  • Organisation and facilitation of two-day meeting to determine agreed treatment


Aside from the development of the consensus guidance, we continued to update the RCGP AKI Toolkit and developed a series of podcasts to raise awareness of AKI and signpost GPs to the toolkit.


Who did we work with?

Royal College of GPs

Think Kidneys

AHSN Kent Surrey Sussex

AHSN North East and North Cumbria

NIHR Greater Manchester Patient Safety Translational Research Centre

Health Improvement Scotland

NHS Education for Scotland


Downloadable Resources



More information

For further information, please contact Susan Howard (Programme Manager) or Tom Blakeman (Principle Investigator)