SLIDE 1 e-Alerts for AKI
Overview NHS Tayside
Dr Bill Bartlett Consultant Clinical Scientist, Blood Sciences
SLIDE 2 RCPE UK Consensus Conference 16-17th November 2012
Management of acute Kidney injury: the role of fluids, e-alerts and biomarkers. Recognised KDIGO, and NICE in progress. Identified 3 areas requiring greater focus: -
- Role of fluid therapy in AKI
- The role of e-alerts based on KDIGO criteria
- Role of Biomarkers
SLIDE 3
Elements of an e- alerting process
SLIDE 4 E-alerts for AKI meeting
- July 2013 Derby Royal Infirmary
- Th algorithm that was agreed by the meeting
- All LIMS suppliers present agreed
– algorithm was deliverable – no issues that would delay implementation beyond the industry standard requirements to configure and test the algorithm.
SLIDE 5
SLIDE 6
SLIDE 7 AKI Alerting NHS Tayside
Clinisys Lab System.
ACB Algorithm Flags: AKI 1, AKI2, or AKI3 Comments Generated with non active hyperlinks to Guidance
Paper Reports: with Commentary Electronic Reports: Sunquest ICE: 1°& 2 ° Care Clinical Portal/GP systems EDT to Primary care: DocMan: Image
Sunquest Ice: -
Patient Report analysis based on AKI Flag. Visual Queues Ice Mail NHS Mail AKI Lists
Lab System Flags Reporting Outputs Post-reporting processes
Telephone: AKI2 and AKI3
SLIDE 8 Printed report
AKI status Not found, AKI1, AKI2 or AKI3
- Commentary depending on stage
- Hyperlink given to renal page
– Primary Care – Secondary Care – AKI 3 phone renal Reg.
- Appends all conventional or electronic reports
SLIDE 9
ICE REPORTING AND E-ALERTS
SLIDE 10
SLIDE 11
Hot Links to guidance within ICE
SLIDE 12 Visual Queues:
Driven by patient report analyser in ICE
SLIDE 13
No Alert Ice
No Alert CHI Search Standard Coloured Banner
SLIDE 14
Extreme Alert: AKI 3
Red Alert Click on Icon CHI Search Standard Coloured Banner
SLIDE 15
Appearance of Alert in Report View
Patient banner Red to indicate extreme Alert Click Alert Icon to deal with alert, or see actions AKI Stage AKI Comments from Lab System: Will give details of link to guidance or suggest other actions (phone renal)
SLIDE 16
Alert Levels AKI 1 AKI 2 AKI 3
SLIDE 17
Extreme Alert: Add Notes
Extreme Alert AKI Icon Add notes Red Coloured Background for extreme Alert Hyperlink to Renal Guidance
SLIDE 18
Extreme Alert: Actions against alert
Actions Taken
SLIDE 19
E-Mail and Alerts: ICE mail and beyond
SLIDE 20
Alerts Ice mail
Ice Mail sent in Response to alert. Can also be forwarded to NHS mail
SLIDE 21
Alerts Ice mail
Ice Mail date and time of alert
SLIDE 22 Alerts ICE mail
High priority alert
Link to report Details of Alert
SLIDE 23
AKI Lists
SLIDE 24
AKI List
SLIDE 25 Issues to come back to
- Algorithm not fool proof.
– Identification of baseline – Catch all disclaimers so as to not to introduce complacency – Dialysis patients
- Lots of AKI 1
- GP workflow not based around ICE
- NHS Mail issues
- 24/7 cover
- Granularity in the AKI lists.
- ADT Links required
