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The Royal College of General Practitioners (RCGP) has launched an Acute Kidney Injury (AKI) Toolkit for GPs and healthcare professionals. The toolkit, created in partnership, aims to improve the recognition, response and management of AKI in primary care.
AKI is a major barometer of patient safety across the UK, with NHS England specifying it as a priority to delivering the vision of the Five Year Forward View. Illness complicated by AKI costs around 1% of the NHS budget and is associated with poor health outcomes in terms of high rates of rehospitalisation, progression and mortality. It is associated with approximately 1 in 5 unplanned hospital admissions and an estimated 100,000 deaths per year.
This toolkit provides resources including national guidance, case studies and shared learning about quality and safety issues to improve patient safety in general practice. AKI offers a lens to improve 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. multimorbidity). By focusing on AKI there are opportunities to improve medication, safer transitions of care and safety for vulnerable patients and their carers.
The RCGP's Clinical Champion for Acute Kidney Injury and GP Clinical-Academic Lead for the NIHR CLAHRC Greater Manchester Kidney Health Programme, Dr Tom Blakeman, who led the development of the toolkit, commented, “The RCGP AKI Quality Improvement Project has provided the vehicle to support partnership working and maintain momentum in tackling a national clinical priority. Building on the multidisciplinary approach taken through the Think Kidneys Programme, the AKI toolkit aims to be grounded in an in-depth understanding of routine clinical practice. Through engagement with a range of professionals and practices, we seek to navigate the challenge of overdiagnosis. That is, there is a collective need to find approaches to maximise the utility of detecting AKI whilst at the same time minimise the potential of treatment burden for patients and carers as well as unnecessary workload for clinicians. The AKI Quality Improvement toolkit represents the next step in this journey.
As a marker of illness severity that is relevant across health and social care settings, AKI offers a lens to improve systems of care. The toolkit introduces QI strategies with the intentions of supporting a shift away from performance management to a model of learning and improvement. Through a generalist approach, we envisage that targeting AKI provides an important exemplar to drive improvements in patient safety and health outcomes.”
The AKI toolkit was created in partnership between the RCGP and Think Kidneys; NIHR CLAHRC Greater Manchester; Kent, Surrey, Sussex Academic Health Science Network (KSS AHSN); and North East and North Cumbria Academic Health Science Network (AHSN NENC), with input from NHS Education for Scotland and Healthcare Improvement Scotland.
Dr Jonathan Murray, Renal Consultant and AKI Regional Project Lead for AHSN NENC said,
“The toolkit has been developed based upon learning from structured AKI case reviews undertaken by 24 GP practices across the country, addressing issues highlighted through this process to promote safe, quality and holistic patient care. It encompasses AKI risk reduction, recognition, response and aftercare, including care across primary-secondary care interfaces. Case reviews highlighted, for example, challenges Primary Care teams face when patients return from hospital post AKI, without timely, relevant discharge information - the toolkit aims to provide a structured approach to facilitate safe and quality patient care in such circumstances”
Dr Edward Kingdon, Renal Consultant and AKI Project Lead for KSS AHSN added, “The RCGP AKI Quality Improvement Project has a discreet clinical focus that has great clinical significance. However, the project has led to conversations that revealed the practicalities and challenges of the patient pathway and the difficulties faced when patients and information cross between sectors and between multiple professional groups. The project seeks to begin to understand the complexity of the many interactions identified and to make improvements in many domains of quality.”
View the Acute Kidney Injury Toolkit at www.rcgp.org.uk/aki
RCGP Press office – 020 3188 7574/7575/7633
Out of hours: 0203 188 7659
The Royal College of General Practitioners is a network of more than 52,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.
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