10.6084/m9.figshare.4499090.v1
Alavijeh O.S.
Alavijeh
O.S.
Bansal J.
Bansal
J.
Hadfield K.
Hadfield
K.
Laing C.
Laing
C.
Dawnay A.
Dawnay
A.
Supplementary Material for: Implementation of an Automated Primary Care Acute Kidney Injury Warning System: A Quantitative and Qualitative Review of 2 Years of Experience
Karger Publishers
2016
Acute renal injury
Acute renal failure
Chronic renal disease
Epidemiology
Outcome and incidence
2016-12-28 12:41:57
Dataset
https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Implementation_of_an_Automated_Primary_Care_Acute_Kidney_Injury_Warning_System_A_Quantitative_and_Qualitative_Review_of_2_Years_of_Experience/4499090
<p><b><i>Background:</i></b> Acute kidney injury (AKI) is often detected
late, leading to worse clinical outcomes. In 2012, we pioneered an
AKI-alerting system for primary care clinicians (PCCs). We
retrospectively analysed the alerts and evaluated PCC satisfaction to
assess the feasibility of the system. <b><i>Methods:</i></b> The study
used a 2-pronged approach. AKI alerts, generated by an algorithm
designed by University College London Hospital biochemistry department
between June 2012 and June 2014, were analysed to reveal the
demographics and outcomes of each patient generating an alert. Second, a
survey was sent to all PCCs assessing awareness and satisfaction with
the service. Simple statistical methods were applied (mean, median, SD
and interquartile range). <b><i>Results:</i></b> One hundred forty-two
alerts were generated, of which 101 were genuine. Generally, the patient
demographics, AKI stratification and aetiology were in keeping with the
inpatient AKI population. Forty-eight percent of cases were referred to
the hospital with a median length of stay of 9.9 days. Three-month
mortality was 12%. Among PCCs, there was good awareness of the system
with most finding it valuable. The key complaints around the system were
to do with lack of knowledge of its existence. <b><i>Conclusions:</i></b>
Our evaluation has demonstrated that the implementation of AKI alerts
in the community is technically feasible, does not result in excessive
demand on hospital services, appears to influence PCC behaviour and was
perceived overwhelmingly as a useful service by these clinicians. This
experience should inform further developments including behavioural
interventions (such as clinician alerts) to improve community AKI care.</p>