Achievements of the Chronic Kidney Disease HIT in 2016-17

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.