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E-alerts for AKI meeting report

26/09/2013 10:38:54

On July the ACB Scientific Committee ran a meeting at Royal Derby Hospital, attended by Biochemists, Renal Physicians and LIMS Suppliers, to develop an algorithm for generating e-alerts for Acute Kidney Injury (AKI) based on the KDIGO guidelines. The report and recommendations from the meeting are now available to view through the below link.

www.acb.org.uk/docs/E-Alerts_for_AKI_meeting_statement

This document is for information rather than comment. The scientific committee recognises that a number of questions about implementation will arise when reading this report. Until the project has developed further, it will not be possible to answer questions from individual members. The algorithm will be further developed into software modules for all collaborating UK suppliers of LIMS systems. LIMS suppliers are expected to enter into discussions with their customers at an appropriate time.

The concept for an e-alert system is as follows:  E-alerts for AKI generated by the LIMS will be sent to a Trust integration engine which will also receive messages from other Trust systems e.g. Hospital Information System (admission, discharge, transfer information) and Renal Register (dialysis status). The further transmission of the e-alert will be modified by this information before being received by the Trust alerting system.

Few if any of these intelligent Trust integration engines currently exist so in the interim the LIMS AKI e-alert module will generate auto-comments on reports. The algorithm will be locally configurable to some extent to recognise local limitations. The overall purpose of this development however is to produce nationally standardised recommendations and the tools to implement them.

Because the algorithm sits within a LIMS system rather than in isolation, there are some issues around the boundaries between the AKI algorithm and the existing mechanisms for dealing with abnormal results in the LIMS. These are colour coded green in the flow chart. Please note that the recommendations in the green boxes should be considered in the light of existing lab practices and resources. They will not form part of the e-alert software module from your LIMS supplier. 

We hope that this initiative will gather momentum from the recently published NICE guidelines on AKI:  http://guidance.nice.org.uk/CG169 . We have received endorsement of these guidelines from the IBMS.

 

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