Electronic alerts for acute kidney injury

Abstract

The current ad-hoc development of e-alert systems needs to be addressed by arriving at consensus around the way in which these systems should apply diagnostic criteria, particularly with respect to selection of baseline creatinine value. Enhancements in IT provision may provide the only durable solution to this, while at the same time facilitating wider uptake. Wider use will allow for further study of the value of e-alerts, including their use in other settings such as primary care.

Standardizing the Early Identification of Acute Kidney Injury: The NHS England National Patient Safety Alert

“…However, is there evidence to support this approach? A number of previous reports have suggested that electronic detection of AKI can be effective in changing physician behaviour, triggering earlier intervention and introduction or change of therapy [16] . These data would support the premise that the uptake of AKI detection can improve standards of delivered care.…”

Electronic Alerts for Acute Kidney Injury

“…Figure 1 shows the principle underlying an AKI early warning system. Some individual publications or narrative reviews found patient-relevant benefits (12,13), and some others didn't (14). What is not clear is whether consistent alert triggers were used and what the extent was to which the alarm signal targeted the recipients and provided concrete treatment recommendations.…”

Design and Rationale of ‘Tackling Acute Kidney Injury', a Multicentre Quality Improvement Study

“…Commonly reported deficiencies include delayed AKI recognition, inconsistent investigation, omissions in fluid/medication management and inadequate senior clinician review [4]. Efforts to address these care gaps are increasingly gaining attention and although initial reports are encouraging [10,11,12], further robust evidence is required. Over the last 6 years, we have introduced and reported a number of interventions at the Royal Derby Hospital to address care gaps in patients with AKI.…”

“…These comprise an electronic AKI detection and alerting system [13], a tailor-made education package [14] and an AKI care bundle [11]. Early data suggest that this combined approach has improved delivery of basic care and reduced hospital mortality rates [11,12]. More recently, similar findings from another UK hospital have been reported in the abstract form [15].…”