Tackling Acute Kidney Injury (AKI)

In a nutshell: The Improvement Academy has been supporting two trusts (Bradford Teaching Hospitals NHS Foundation Trust and Leeds Teaching Hospitals NHS Trust) involved in the Health Foundation funded ‘Tackling Acute Kidney Injury’ project along with two other trusts (Frimley Health NHS Foundation Trust and Ashford and St. Peter's Hospitals NHS Foundation Trust). Aiming to reduce incidence and harm from acute kidney injury.

The Challenge

Acute Kidney Injury (AKI) is a major cause of harm. Research tells us that 1 in 5 emergency admissions have acute kidney injury, there are delays in recognising it in hospital patients in around 43% of cases, and all patients are at risk. If unrecognised, acute kidney injury will result in uraemia, acidosis, hyperkalaemia, chronic kidney disease (CKD) and ultimately death. It is known that around 20-30% of acute kidney injury cases are avoidable and is estimated to account for 12,000 unnecessary deaths a year in the UK.

What we are doing about it

The project has been set up to test a potential solution to address these problems and to test whether a package of interventions that have been developed and shown to be successful in the lead centre (Derby Teaching Hospitals) can be adopted and be effective in other hospitals. We want to improve the quality of care that patients receive when acute kidney injury happens. By doing so, we hope to improve the number of patients who recover from it. 

The package of Interventions to be tested includes acute kidney injury detection and alert (using the nationally approved algorithm), hospital wide education and an AKI care bundle. Their aim is to increase recognition, enhance awareness and understanding and drive improvements in basic elements of care. With longer term aims to impact on 30 day mortality, incidence of hospital AKI, incidence of AKI progression, length of stay, and proportion of AKI patients with renal recovery by discharge. 

The Tackling AKI project has a ‘stepped wedge design’ this means that instead of introducing the AKI interventions in all hospitals at the same time, there has been a staggered roll-out across the 4 Trusts. Outcomes are measured at regular time periods, with measurement taking place at each step in the wedge; each Trust supplies data in the control and intervention periods allowing each site to act as its own control.



Patient Safety Collaborative

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Further Information

 Tackling AKI Project Site


Natalie Jackson


01274 383931