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Primary Care and AKI Test Results
The document outlines the development of best practice guidance for primary care in responding to acute kidney injury (AKI) test results by Think Kidneys. It describes the 10 key steps taken, including forming a working group, reviewing existing guidelines, conducting a consensus process, and getting feedback. The guidance aims to put AKI test results in clinical context, treat the patient not just the test, maximize utility, and minimize burden on primary care. Forthcoming pieces include medicines optimization guidance and risk cards for primary care.
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Primary Care and AKI Test Results
- 1. Primary care andAKI test results: Guidance and support Richard Fluck Chair Think Kidneys 15th March 2016
- 2. Guidance for PrimaryCare in responding to the e-Alerts Medicines Optimisation for Primary Care Primary Care Risk Matrix STOP at risk of AKI cards 15/03/2016 Coming soon! 4th April 2016 AKi and Primary Care: Richard Fluck | 2
- 3. Think Kidneys: BestPractice Guidance 15/03/2016AKi and Primary Care: Richard Fluck | 3
- 4. Aims: •Put the testresult in a clinical context •Treat the patient not the test result •Maximise clinical utility •Minimise information overload and burden •Ensure primary care engagement 15/03/2016AKi and Primary Care: Richard Fluck | 4
- 5. 10 Key Steps:Development of Guidance: led by Tom Blakeman 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 15/03/2016AKi and Primary Care: Richard Fluck | 5
- 6. Step 1: FormThink Kidneys Primary Care Working Group April 201515/03/2016AKi and Primary Care: Richard Fluck | 6
- 7. Step 4: ConductRAND Consensus Process Panel Membership: •Clinical Biochemistry •Acute & Emergency Medicine •Routine General Practice: Out of Hours Care GP Commissioning Medical ‘overdiagnosis’ July-September 201515/03/2016AKi and Primary Care: Richard Fluck | 7
- 8. Step 6: Invitefeedback November 2015-January 201615/03/2016AKi and Primary Care: Richard Fluck | 8
- 9. Think Kidneys: BestPractice Guidance March 201615/03/2016AKi and Primary Care: Richard Fluck | 9
- 10. Think Kidneys: BestPractice Guidance March 201615/03/2016AKi and Primary Care: Richard Fluck | 10
- 11. Think Kidneys: BestPractice Guidance March 201615/03/2016AKi and Primary Care: Richard Fluck | 11
- 12. Think Kidneys: MedicinesOptimisation Publication 4th April, 2016 15/03/2016AKi and Primary Care: Richard Fluck | 12
- 13. Drugs and therelationship with kidneys Avoid the term ‘nephrotoxic’ Effects of renal physiology, volume, electrolytes Does the side effect profile change? Any actions direct on the kidneys? 15/03/2016AKi and Primary Care: Richard Fluck | 13
- 14. Medicines optimisation 15/03/2016AKi andPrimary Care: Richard Fluck | 14
- 15. Patient information 15/03/2016AKi andPrimary Care: Richard Fluck | 15
- 16. Patient information 15/03/2016AKi andPrimary Care: Richard Fluck | 16
- 17. 15/03/2016AKi and PrimaryCare: Richard Fluck | 17 STOP AKI risk cards: in pilot
- 18. 15/03/2016AKi and PrimaryCare: Richard Fluck | 18 Infographic on the kidneys: working with the public
- 19. Guidance for PrimaryCare in responding to the e-Alerts Medicines Optimisation for Primary Care Primary Care Risk Matrix STOP at risk of AKI cards 15/03/2016 Coming soon! 4th April 2016 AKi and Primary Care: Richard Fluck | 19
- 20. How to findout 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 15/03/2016AKi and Primary Care: Richard Fluck | 20 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
- #8 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.