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CKD HIT Udaya Udayaraj Consultant Nephrologist NBT Chronic - PowerPoint PPT Presentation

Nov 18, 2023 •567 likes •678 views

CKD HIT Udaya Udayaraj Consultant Nephrologist NBT Chronic Kidney Disease (CKD) Initial proposal submission - April 2013 Approved - Jan 2014 Change of leadership March 2014 First CKD HIT meeting 14 th May 2014 CKD Workstreams Prevention

  1. CKD HIT Udaya Udayaraj Consultant Nephrologist NBT

  2. Chronic Kidney Disease (CKD) Initial proposal submission - April 2013 Approved - Jan 2014 Change of leadership March 2014 First CKD HIT meeting 14 th May 2014

  3. CKD Workstreams • Prevention – Acute Kidney Injury (AKI) • Provision of care : - Service redesign - Telehealth, remote CKD monitoring, CKD e-consultation - Patient related outcomes and empowerment shared decision making, personalised care plans • Education • Research • Innovation

  4. AKI Challenges • £500 million annual expenditure • 12-15 % of hospital admissions • ~ 60 % episodes are acquired in community • 20-30 % avoidable • NCEPOD AKI report- suboptimal care in hospitals • NHS England commissioned project to reduce and improve management of AKI

  5. Aims • Risk assessment – identify patients at risk of AKI at admission • Early detection – e-alerts for AKI from blood tests • Education of patients and clinical teams – standardised intervention advice in hospitals and community • Medicines management eg: sick day rules for ACE i/ARBs; concurrent use of NSAIDs &ACEi and potassium sparing diuretics

  6. Progress • Current position in NBT – Risk assessment tool in all medical admissions • Ongoing projects in NBT – Setting up e-alert of AKI ( summer 2015) – Standardised intervention advice for AKI in hospital (June 2014) – Include AKI details in discharge summary

  7. Role of CKD – Influence other non renal trusts to adopt risk assessment and setting up e-alerts – Adoption of standardised intervention advice and referral pathway ( post AKI detection) in primary care and in other trusts – Medicines management in community to prevent AKI

  8. Telephone Clinics • Ideal for selected CKD/transplant patients – Regional service – patient travels > 50 miles for 10 min consultation – Physical signs are few – Consultation directed mainly at symptoms, BP and GFR • Barriers – Tariff based payment by activity – IT barriers – Practical issues of getting blood tests and BP measurements at GP

  9. Challenges for CKD • Projects proposed and driven by secondary care clinicians • Representation from all partner organisations • Would like to hear what commissioners, GPs , other partner organisations and patients want us to do. • Funds – ? invest to save

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