What were we trying to do?
CLAHRC GM was working in collaboration with GP practices across the Manchester Health and Care Commissioning (MHCC) and AKI Leads at Manchester University NHS Foundation Trust (MFT) to identify processes of care and management of patients with Acute Kidney Injury (AKI) between secondary and primary care. Using a quality improvement approach of testing and sharing learning, we aimed to explore:
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).
Facilitating the collaboration between secondary and primary care is at the core of this project, by creating a strong relationships between the teams and sharing important information to inform improvement at the interface between hospital and general practice care going forward.
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 rehospitalization, development or progression of Chronic Kidney Disease (CKD), and mortality. 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?
With a small number of general practices, in collaboration with the AKI team at MFT, we explored the processes of care for patients who have had illness complicated by AKI or had received a warning stage test alert, and identify barriers and systems to improve care. Each practice conducted casenote reviews on patients to identify the key lessons learned with the practice teams. This work also fed into a project being undertaken in partnership with the Royal College of GPs (RCGP).
We have shared the findings in the form of a report to the CCG, and also to GP practices across the MHCC footprint at an educational session during a Citywide event.
Who are we working with?
- Evaluation Reports
AKI MHCC Presentation Citywide Event 2018 - Waring D, Ghaffar N, Blakeman T