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Achievements of the Chronic Kidney Disease HIT in 2016-17

9 May 2017

Dr Udaya Udayaraj gives an update on the work of the Chronic Kidney Disease Health Integration Team (CKD HIT) over the last year.

One in ten people live with chronic kidney disease (CKD). This is a long-term condition that can increase the risk of heart disease or a sudden deterioration in kidney function, also known as acute kidney injury. The Chronic Kidney Disease Health Integration Team (CKD HIT) is a team of clinical staff and patients, working together to improve patient outcomes and care pathways for patients with kidney disease.

This year we have successfully developed a telephone clinic service for kidney transplant patients. Our team has long agreed that this service could provide a benefit for patients who regularly have to attend follow-up appointments at Southmead Hospital. Since July 2016 we have been supported by the West of England Academic Health Science Network (AHSN) to run a quality improvement project to introduce this. The AHSN has given the HIT £20,000 to deliver this project.

So far, we have held 11 telephone clinics involving 109 patients. On average we are saving each patient 37 miles of travel to and from the hospital. The feedback we’ve had so far has been positive, with 100 per cent of patients telling us that they would recommend the telephone clinics to other patients with their condition.

We continue to work with NIHR CLAHRC West to explore a research project on extending the telephone clinics so that they are delivered by nurses. We are also in touch with clinical commissioning group colleagues about extending the service to the wider CKD population.

Acute kidney injury (AKI) is sudden damage to the kidneys that disrupts their function. Twenty per cent of AKI cases are thought to be predictable or avoidable. Our AKI working group has representatives from acute trusts in the region, co-ordinating and improving our work.

We have developed a dashboard which has been adopted at both University Hospitals Bristol NHS Foundation Trust and North Bristol NHS Trust (NBT), which records incidences of acute kidney injury by stage, location and consultant. This is an excellent basis for identifying and addressing issues.

One of our responses to improve the management of AKI has been training sessions, developed for a range of professional groups. For example, about 50 per cent of new NBT registrars have attended training on AKI.

Our training on CKD and AKI for primary care nurses and allied health care professionals continues to be successful and well attended. We are meeting shortly to discuss future work programmes that will build on this year’s achievements.

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