Impact of Electronic-Alerting of Acute Kidney Injury: Workgroup Statements from the 15thADQI Consensus Conference

Canadian Journal of Kidney Health and Disease - Tập 3 - Trang 101 - 2016
Eric Hoste1, Kianoush Kashani2, R. T. Noel Gibney3, F. Perry Wilson4, Claudio Ronco5, Stuart L. Goldstein6, John A. Kellum7, Sean M. Bagshaw8
1Intensive Care Unit, Ghent University Hospital, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium ; Research Foundation-Flanders (FWO), Brussels, Belgium.
2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, 200 First St, SW, Rochester, MN USA ; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First St, SW, Rochester, MN USA.
3Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, CSB 2-124, 8440-112 Street, Edmonton, AB, Canada
4Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, 60 Temple Street Suite 6C, New Haven, CT 06510 USA.
5Department of Nephrology and International Renal Research Institute, Ospedale San Bortolo, Vicenza, Italy.
6Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7022, Cincinnati, OH, 45229, USA,
7Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
8Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8440-112 ST NW, Edmonton, AB T6G2B7, Canada

Tóm tắt

Purpose of the review:Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15thAcute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert.Sources of information:Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts.Findings:Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation.Limitations:This paper reflects the findings of a non-systematic review and expert opinion.Implications:We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.

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Canadian Journal of Kidney Health and Disease

Tập 3

101

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