In this thought paper, Blair Sadler and Kevin Stewart draw on experiences from their roles as chief executive of a children’s hospital in San Diego, California and as chief medical officer of a general hospital trust in the south of England
High reliability organisations are organisations that work in situations that have the potential for large-scale risk and harm, but which manage to balance effectiveness, efficiency and safety. They also minimise errors through teamwork, awareness of potential risk and constant improvement.
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury
The 2011 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury (AKI) aims to assist practitioners caring for adults and children at risk for or with AKI, including contrast-induced acute kidney injury (CI-AKI).
Improving the management of Acute Kidney Injury in a District General Hospital: Introduction of the DONUT bundle
The NCEPOD report (2009) on Acute Kidney Injury (AKI) found 20% of post-admission AKIs were avoidable and only 50% of AKI care was considered 'good'. The DONUT bundle comprises of six interventions aimed at improving the management of AKI.
The aim of the project was to increase the number of patients returning to a ward post-surgery who receive a serum creatinine measurement within two days of their urological surgery, excluding day cases.
Describe the formation of a multidisciplinary collaborative network focused on AKI. Authors have proposed uniform standards for diagnosing and classifying AKI which will need to be validated in future studies. The Acute Kidney Injury Network offers a mechanism for proceeding with efforts to improve patient outcomes.