Acute Kidney Injury – RCGP Quality Improvement Toolkit

What are we trying to do?

The RCGP Acute Kidney Injury (AKI) Quality Improvement Project represents the next step in the development of resources to improve the recognition, response and management of AKI in primary care. The aim is to develop an AKI safety toolkit to support the implementation of national guidance in routine primary care. Key objectives include:

  • Post-AKI care: Development of safety tools to improve delivery of care for patients who have had an episode of illness complicated by AKI
  • Recognition & Response to AKI: Development of safety tools to support the implementation of AKI Warning Stage Test Results in primary care


Why is it important?

Acute Kidney Injury (AKI) is common, harmful and costly and is a major barometer of patient safety across the NHS. AKI is associated with significantly worse health outcomes including a higher risk of a further episode of AKI, increased risk of development or progression of chronic kidney disease (CKD) and is associated with higher mortality rates both in the immediate and longer term. As such, AKI is a marker of illness severity and is associated with approximately 1 in 5 unplanned hospital admissions and an estimated 100,000 deaths per annum.

To date, AKI initiatives have largely focused on improving management in secondary care and recognising that that approximately two-thirds of episodes of AKI start in the community setting, efforts have broadened to address primary care as well as across the interfaces of care, with awareness raising national initiatives such as Think Kidneys established to tackle the harm associated with AKI.

Although there are mechanisms for improving safety and quality already embedded in routine care, there is evidence that they currently do not realise their full potential. There is a recognised need for Quality Improvement Activities to improve system factors impacting on patient safety, whilst encouraging learning and improvement within and across organisations.   


How will we do it?

In collaboration with the Royal College of General Practitioners (RCGP), Think Kidneys, Kent Surrey Sussex AHSN and AHSN  North East and North Cumbria, the project will produce an AKI Safety Toolkit, actively learning from general practice teams, building on the existing evidence base. This will provide primary care with a repository of resources to draw on, and provide a framework for ongoing shared learning to improve systems of care in general practice and across the interfaces of care. The approach taken is underpinned by a need to navigate the challenge of maximising AKI care as a marker of patient safety, whilst minimising the potential for workload burden for general practices, and the potential for treatment burden for patients and their carers.


Who are we working with?

The Royal College of General Practitioners

Think Kidneys

Bury Clinical Commissioning Group

Kent Surrey Sussex Academic Health Science Network 

Academic Health Science Network North East and North Cumbria

Manchester Health & Care Commissioning

Central Manchester University Hospital NHS Foundation Trust


More information
For further information, please contact Dr Susan Howard, Programme Manager, or Dr Tom Blakeman, academic lead.