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(GS - This is "as I understand it". I suspect the following is incomplete)

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The NephWork is a new SpR driven National SpR audit and research network supported by the Renal Association and the Renal Registry who’s aim is to develop, coordinate and deliver simple audit and research projects that answer a specific and simple question on a large scale by coordinating the audit and research activity of a large number of renal trainees nationally. The NephWork is part of and is financially supported by the Renal Association and runs with the support of the UK Renal Registry to undertake selected projects.

The first audit project selected is an audit of AKI care in acute admitting trusts nationally, 10 years on from the original NCEPOD report. Data will be used to compare patterns of care across the UK to nationally agreed audit standards for the care of patients with AKI (recently published RA guidelines) in order to review care standards and patient outcomes identified through the Renal Registry Master patient index for AKI.

Project: AKI Alert Audit

Description

The audit pro-forma has been developed by the NephWork steering committee following the Renal Association AKI audit guidelines. SpR's working in an NHS Trust who agree to be member of Nephwork will register the audit locally using a guidance which the Nephwork steering committee will provide in order to help with the process of registering. It will be necessary for a Consultant within the department to nominally be lead for the Audit locally.

We will be auditing the care of all episodes of AKI stage 2 and stage 3 which occur in patients admitted to Acute NHS Trusts during a period of four weeks in early 2020 (start date to be confirmed). These patients will be identified through the Master Patient Index at the UK Renal Registry and a patient identifier for each episode will be sent electronically from the Registry through a specially designed, secure, electronic portal hosted on a dedicated platform to SpR’s completing the Audit locally. SpR’s will review patient notes and records for the selected episodes and then return data using the electronic pro-forma securely through the portal. 

This data will be analysed by the renal registry, following a pre-specified statistical analysis plan looking at:

• variations in care regionally/locally and
• associations between measures of AKI care and outcome

An important aspect of this project is that because each identifier contains a unique patient identifier code, we will then be able to link the data gained from the audit in order to analyse patient outcomes, including mortality.

Identifying Patients

This project involves anna generating a list of patients to audit for from participating hospitals. 

Anna will produce a cohort from the Lab-AKI and HES data such that -

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Systems will be required to provide the demographics by masking the hashed nhs no etc. to the Lab AKI database.

The data will be split by "Hospital of Admission" and sent to the contacts there. This will only be done for sites that are Renal Units.

Trainee staff at each unit will then check the hospital records for each of the patients, record certain bits of information and return it to the UKRR.This data will be loaded in to a Django based audit tool and participating SpRs will be able to login and see patients to check up on. They will then answer a series of questions about treatment care and outcomes for patients from their sites. saving the records via the audit interface.

The resulting audit data will then be analysed. The project is being run by Garry King and coordinated by Manuela Savino.

Documents