World Kidney Day Think Kidneys presentation
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Presentation for primary care given by Think Kidneys programme team member Tom Blakeman on World Kidney Day.
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World Kidney Day Think Kidneys presentation
- 1. Acute Kidney Injury Responding to AKI Warning Stage Test Results Developing Guidance for Primary Care Dr Tom Blakeman GP & Clinical Senior Lecturer in Primary Care NIHR CLAHRC for Greater Manchester tom.blakeman@manchester.ac.uk
- 2. Think Kidneys: Best Practice Guidance
- 3. Aims: •Put the test result in a clinical context •Treat the patient not the test result •Maximise clinical utility •Minimise information overload and burden •Ensure primary care engagement
- 4. 10 Key Steps: Development of Guidance Step 1: Form Think Kidney Primary Care Working Group Step 2: Review existing local and national AKI guidelines Step 3: Identify and align with other relevant guidelines Step 4: Conduct RAND Consensus Process Step 5: Develop early drafts Step 6: First Round of National Feedback Step 7: Think Kidneys Primary Care Resource Workshop Step 8: Multidisciplinary meeting 1 (North East) Step 9: Multidisciplinary meeting 2 (Out of Hours -Bristol) Step 10: Second round of National Feedback
- 5. Step 1: Form Think Kidneys Primary Care Working Group April 2015
- 6. Step 2: Review existing local and national AKI guidelines May-June 2015
- 7. Step 3: Identify and align with other relevant guidelines May-June 2015
- 8. Step 4: Conduct RAND Consensus Process Panel Membership: •Clinical Biochemistry •Acute & Emergency Medicine •Routine General Practice: Out of Hours Care GP Commissioning Medical ‘overdiagnosis’ July-September 2015
- 9. Step 4: Conduct RAND Consensus Process Two Rounds of Rating: 652 Scenarios •Timeliness in communication from Labs to primary care •Timeliness in clinician response on knowledge of AKI test result July-September 2015
- 10. Step 4: Conduct RAND Consensus Process - Leeds Round 2 Rating: • 1 Day Meeting • Discussion then individual rating • Not force consensus July-September 2015
- 11. Step 5: Develop early drafts October-December 2015
- 12. Step 5: Develop early drafts October-December 2015
- 13. Step 5: Develop early drafts October-December 2015
- 14. Step 6: Invite feedback – ‘A Handy Guide’ November 2015-January 2016
- 15. Step 6: Invite feedback November 2015-January 2016
- 16. Step 7: Think Kidneys Resource workshop - London January 2016
- 17. Step 8: Multidisciplinary meeting 1 – North East • A GP • A Biochemist • A Nephrologist February 2016
- 18. Step 9: Multidisciplinary meeting 2 – University of Bristol Out of Hours Test Results Project: • Medical Biochemist • GP & Urgent Care Clinical Lead • Consultant Medicine for Older People • GP & Clinical Lead for OOH • GP & AHSN perspective • Service Improvement Lead • OOH Case Manager February 2016
- 19. Step 10: Invite final feedback •Think Kidneys Workstreams Risk Education Intervention •RAND Panel members •Respondents from first round of feedback February-March 2016
- 20. Think Kidneys: Best Practice Guidance March 2016
- 21. Think Kidneys: Best Practice Guidance March 2016
- 22. Think Kidneys: Best Practice Guidance March 2016
- 23. Think Kidneys: Best Practice Guidance Publication 4th of April, 2016
- 24. How to find out more Karen Thomas Think Kidneys Programme Manager UK Renal Registry Karen.Thomas@renalregistry.nhs.uk Teresa Wallace Think Kidneys Programme Coordinator UK Renal Registry Teresajane.Wallace@renalregistry.nhs.uk 28.11.2014Acute Kidney Injury National Programme | Introducing the Think Kidneys campaign | Karen Thomas | 24 Contact Think Kidneys Richard Fluck National Clinical Director for Renal NHS England Richard.fluck@nhs.net Joan Russell Head of Patient Safety NHS England Joan.russell@nhs.net Ron Cullen Director UK Renal Registry Ron.cullen@renalregistry.nhs.uk www.linkedin.com/company/think-kidneys www.twitter.com/ThinkKidneys www.facebook.com/thinkkidneys www.youtube.com/user/thinkkidneys www.slideshare.net/ThinkKidneys www.thinkkidneys.nhs.uk
Editor's Notes
- A 10-person panel was identified with representation from clinical biochemistry, acute and emergency medicine and routine general practice. Individuals with an expressed interest and expertise in AKI through membership of the Think Kidneys Programme were invited as well as general practitioners who represented typical practice in relation to out of hours care, GP commissioning and those who represented a medical ‘over-diagnosis’ perspective. The panel was co-chaired by one researcher (SC), who is expert in the RAND Appropriateness Method, and a nephrologist (CT) who is expert in AKI.
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- Formed TK Working Group - picture of Charlie Tomson 7.Drawn upon local guidance documents, building on Nick Selby’s Derby Guidance- Derby/Manchester/Berkshire 8.Sought to be aligned with other relevant guidelines (e.g. RA 2014 Hyperkalaemia; Sepsis February 2016) – pictures of existing documents 9. RAND Conesus process to inform timeliness in communication from labs to primary care and timeliness in response by clinicians – picture of RAND/scenarios/Leeds 10. Blog – invite: 11. Draft circulated December 2015 – feedback – uttererly baffling – iterations Tables: Jung: algorithm slimmed down to current version 12. Discussed TK Programme Board January 2016 – Resource for London meeting 13. Redrafted following TK (cross-workstream) workshop, January 2016 – picture of South Tees - changes 14. Discussed at Meeting with GP, Biochemist and Nephrologist in North East – Feb 2016 – OOH of care Redrafted and taken to GP Discussion group (with OOH focus) in Bristol, led by professor Sarah Purdy (University of Bristol) February, 2016 15. Picture main front 16. Table 1 17 Table 2
- Formed TK Working Group - picture of Charlie Tomson 7.Drawn upon local guidance documents, building on Nick Selby’s Derby Guidance- Derby/Manchester/Berkshire 8.Sought to be aligned with other relevant guidelines (e.g. RA 2014 Hyperkalaemia; Sepsis February 2016) – pictures of existing documents 9. RAND Conesus process to inform timeliness in communication from labs to primary care and timeliness in response by clinicians – picture of RAND/scenarios/Leeds 10. Blog – invite: 11. Draft circulated December 2015 – feedback – uttererly baffling – iterations Tables: Jung: algorithm slimmed down to current version 12. Discussed TK Programme Board January 2016 – Resource for London meeting 13. Redrafted following TK (cross-workstream) workshop, January 2016 – picture of South Tees - changes 14. Discussed at Meeting with GP, Biochemist and Nephrologist in North East – Feb 2016 – OOH of care Redrafted and taken to GP Discussion group (with OOH focus) in Bristol, led by professor Sarah Purdy (University of Bristol) February, 2016 15. Picture main front 16. Table 1 17 Table 2