New early warning alert for Tayside patients

Consultant renal physician Dr Samira Bell (left) and renal specialist registrar Dr Claudine Jennings reviewing the acute kidney injury electronic alert.
Consultant renal physician Dr Samira Bell (left) and renal specialist registrar Dr Claudine Jennings reviewing the acute kidney injury electronic alert.

NHS Tayside is the first health board in Scotland to introduce a new electronic early warning alert system which identifies acute kidney injury in patients at a much earlier stage.

Acute kidney injury (AKI) is damage to the kidneys that causes them to stop working.

It can range from minor loss of kidney function to complete kidney failure and has been identified as a major patient safety issue in UK hospitals.

AKI is associated with worse survival rates and increased hospital stays, yet up to a third of cases are thought to be preventable. AKI is common and normally happens as a complication of another illness. It is not the result of a physical blow to the kidneys, as the name may suggest.

The new electronic alert system has gone live across NHS Tayside, enabling early identification of patients with developing acute kidney injury.

Following analysis of a patient’s bloods in the laboratories where acute kidney injury is identified, a message is sent to computer systems holding the patient results for the doctors to action. This system clearly informs clinicians that a patient under their care is at risk of acute kidney injury. The system helps clinicians by identifying the severity of the AKI and gives them information on the best course of action through access to expert advice at the time they receive the report. It also enables specialist staff from the renal team to attend quickly to the more severe cases requiring more expert intervention.

Consultant renal physician Dr Samira Bell said: “Acute kidney injury affects one in five people in hospital. People who develop acute kidney injury may have a shorter life expectancy and are more likely to develop problems with their kidneys in the long term.

“There are currently no treatments available for acute kidney injury and patients are dialysed in severe cases to support the kidneys once they have failed completely. This is why prevention and early identification of acute kidney injury is vital. By introducing these early warning alerts which flag-up indications of kidney injury to health care staff at a much earlier stage, we hope to reduce the numbers of patients experiencing avoidable kidney damage.”

Clinical scientific staff and IT specialists within NHS Tayside’s blood sciences laboratories and the renal clinical team have worked in partnership to deliver this system which helps address the important patient safety issue of acute kidney injury.

The Acute kidney injury awareness programme is being led by consultant renal physician Dr Samira Bell and her team. Dr Bill Bartlett, consultant clinical scientist is leading the laboratory team and was also a member of the UK group that developed the AKI algorithm, now recommended for use across the UK, for delivering e-alerts.

Consultant clinical scientist Dr Bill Bartlett said: “This new electronic alert system which has been introduced across NHS Tayside this week identifies kidney injury in patients at a much earlier stage.

“We are fortunate in Tayside to have both a keenly interested group of professionals and to have had the investment in technology to enable delivery of this e-alerting system for acute kidney injury.

“It is an excellent example of a multi-disciplinary and multi-professional group working together to deliver safer health care to the population of Tayside.” The kidneys provide a wide range of vital functions including removing wastes and water from blood, balancing chemicals in your body, releasing hormones, helping to control blood pressure and helping to produce red blood cells.