A key aim of the ASSIST-CKD quality improvement programme is to see if the benefits observed at the pilot site (Heart of England Foundation Trust -HEFT, Birmingham) are transferable elsewhere.
To this end we are working closely with the UK Renal Registry who collect and report data on all people with end-stage renal disease (ESRD) in the UK. Our most important quantitative analysis will involve looking at the rate of late presentation for dialysis at all our participating sites and seeing whether this has changed since implementing the intervention. This is significant because delayed refer ...
THE SOUTH WEST WALES ASSIST-CKD EXPERIENCE
September 14, 2018
The ASSIST-CKD programme has been running at the ABMU Health Board in South West Wales for almost a year (South East and North Wales are yet to begin). Our graphs are interpreted weekly by a renal doctor or pharmacist.
Our renal secretary screens each marked graph and patients known to us are referred to a Nephrologist for opinion or review. The ability to track patients via our system in this way in Wales is similar to in Northern Ireland and gives us important local data and results which will strengthen the ASSIST-CKD message ahead of the expected overall results from the UK Renal Re ...
ASSIST-CKD SOFTWARE SUPPORT FROM 1st NOVEMBER 2018
September 7, 2018
To ensure sustainability of the ASSIST-CKD project it is time to consider and plan your software support from November 1st 2018.
We very much want to avoid an ‘orphan’ software product.
The overall consensus at last year’s CPD event in Birmingham was that ongoing running and support costs were not seen as a problem and that the preferred approach was to embed IT and software costs into the overall lab budget.
There is also potential to investigate funding from either CCGs/commissioners or from research/audit funding to cover any required software support training costs.
We su ...
The ASSIST-CKD Legacy
August 24, 2018
The ASSIST-CKD project team has started to work on a variety of legacy materials that will support sustainability in your sites in the longer term.
One of the materials is a letter that could be given to staff that might encourage them to undertake the interpretation of the eGFR graphs. In most sites there is a member of the laboratory team that interprets the graphs, but there are also renal nurses, pharmacists and a nephrologist taking on the role around the UK in our participating sites.
This document is the first draft of the letter we hope to send out that outlines CPD opportunitie ...
How did we cope with major changes in the ASSIST-CKD intervention?
August 17, 2018
Many interventions are a step into the unknown and do not always go according to plan. This is not necessarily unexpected or unwelcome. It is not unusual for interventions designed for QI purposes, particularly those that are still evolving, are complex or occurring in dynamic environments, to change during the course of a project.
Many times during the ASSIST-CKD QI intervention, a hard judgement has been made about whether to stop, continue or adjust the study and whether the level of change was practical, appropriate, affordable or even achievable. One major change, which was totally une ...
On-going ASSIST-CKD application performance
August 8, 2018
The latest version of ASSIST-CKD (v4.4.3) software was developed with usability and performance in mind. eGFR graphs were overhauled with more consistent axes and better zooming and panning functionality, and under the hood, tweaks were made to graph creation and patient retrieval to increase the application's overall speed.
However, there's an aspect of ASSIST-CKD performance which can't be solved by the application - that is, the performance of the database.
As more and more data is uploaded in reporting runs, the database can become sluggish and slow down the application's reporting s ...
Is eGFR graph analysis restricted to biochemists?
August 3, 2018
The majority of sites involved in the ASSIST-CKD project have laboratory staff interpreting the eGFR graphs, but other NHS staff are also undertaking this important role. In about 25% of participating sites, a renal nurse is interpreting the graphs. These renal nurses usually work within advanced kidney care (pre-dialysis) teams and have expertise in assessing declining kidney function.
It is critical to now start thinking about succession planning in your site, especially if there is a chance the person currently reviewing the graphs might leave (or be promoted!).
Staff who have been ...
What other data are we collecting?
July 27, 2018
We are collecting headline data on outpatient activity to track what is happening to referral numbers as a result of running the ASSIST-CKD programme. The overall national quantitative data which is being collected and analysed by the UK Renal Registry will be available later and expected to be reported on in the summer 2020.
We have also developed a Smart Survey online questionnaire to gather the views of your primary care community on the eGFR surveillance programme. This is available to any site to personalise and send out as a URL link. Southport, St Helier, Lanarkshire and Newry alread ...
What new ideas for development have sites come up with?
July 20, 2018
Electronic graph reporting - if you have a nice IT department. Trying to develop a machine learning algorithm to report graphs - if we can do in one site we will be looking for other sites to validate the process. Local evaluation - some sites are doing more detailed patient level local evaluations which may give us important insights above and beyond our headline figures.
Do let us know if you are doing anything specific to your site which we can share with other sites and look out for our ASSIST-CKD Newsbite next week. ...
July 17, 2018
A simple infographic describing the ASSIST-CKD project which can be customised to your local situation
Not yet available ...
Business as usual
July 17, 2018
The low annual cost of implementing the ASSIST-CKD programme compared to the clear gains for both the patient and healthcare providers has proved to be one of the main benefits and attractions of ASSIST-CKD.
We're grateful to all those sites involved in the earlier phases for their creativity and ongoing commitment to ensure that the intervention is sustained in an ' everyday ' setting – in other words – ‘business as usual’.
Don’t forget you can still use the infographic, should you need to show a simple business case to help secure funding.
Look out for our ASSIST-CKD Newsb ...
Evaluating our success
July 6, 2018
We will be sending sites a summary of their qualitative data after the themes have been identified and this will form the basis of the full qualitative evaluation report which will be shared across all sites in early Autumn 2018.
The longer term quantitative review incorporating data from the UK Renal Registry will be completed in the Summer 2020.
In addition, up to 4 sites will also be undertaking their own local population analysis.
Do please share your success stories with us so we can let other sites know, and look out for our ASSIST-CKD Newsbite next week. ...
What happens after the project finishes?
June 29, 2018
We envisage 20 locations using the ASSIST CKD intervention by October 2018 which is a great achievement and with some sites having over two years experience of using the software. We have gained invaluable spread and sustainability experience from national, network and individual sites' perspectives.
We are keen to ensure that each location 'owns' the ASSIST-CKD approach and can adapt it for their own needs and context which will support overall durability after 2018 - the team are grateful to everyone for their continued support and commitment.
See a recent poster at the 2018 UK Kidne ...
Poster at UK Kidney Week 2018 – Wirral Experience
June 28, 2018
Please click here to see full poster: ASSIST-CKD (WIRRAL)_UKKW2018 ...
Home Nation Coverage Achieved
June 22, 2018
Home nation coverage has been achieved.
We have strategic national support in Wales with Swansea already running the programme and Clwyd, Wrexham and Bangor about to ‘go live’. Another Welsh Health Board is in discussions and is considering working in tandem with Swansea.
Three Health and Social Care Trusts are taking part in Northern Ireland (Newry, Derry and Antrim).
Monklands Hospital, Lanarkshire were one of our first sites and have now been running since September 2016.
We have 12 single live sites throughout England, four of ...
ASSIST-CKD eGFR Graph Surveillance Programme
June 15, 2018
Most sites taking part in the ASSIST-CKD QI programme have continued beyond the one year's funding support
9 of our sites have been running the ASSIST-CKD eGFR graph surveillance programme for 2 to 3 years and have embedded eGFR weekly reporting into their day to day routine laboratory practice.
Southport have even included the ASSIST-CKD programme into their staff development and lab job description.
Look out for our ASSIST-CKD Newsbite next week and do feel free to share your own experiences with the programme. ...
How many sites are now running the ASSIST-CKD programme?
June 7, 2018
We are delighted to report that we now have 17 sites around the UK including England, Scotland, Wales and Northern Ireland, with another 4 very close to 'going live'.
Lookout for our next ASSIST-CKD Soundbite next week. ...
ASSIST-CKD Learning Exchange Event
December 4, 2017
The purpose of this meeting was to work with and encourage sites along the path to long-term independence by creating the foundation of a network for innovation, spread and sustainability. We hope you enjoyed your visit to Austin Court in Birmingham and found discussions useful. Copies of each presentation can be located at https://assist-ckd.org/events/birmingham2017/ ...
ASSIST-CKD poster presented at UK Kidney Week (June 2017)
July 7, 2017
Poster presented during the 2017 UK Kidney Week conference in Liverpool by Hugh Gallagher (Clinical Lead) and Ian Stott (Doncaster)
PDF of poster - ASSIST_CKD_A0_Poster_UKKW_FINAL_small ...
Newsletter (Issue 4) April 2017
April 21, 2017
Welcome to the fourth ASSIST-CKD project newsletter designed to update you all with the project’s progress, share hints and tips from participating sites and keep you informed on how the project is being promoted through conferences and publications. We would really welcome your feedback to help ensure there is something for everyone in the newsletter and to start to build up a project community. In this issue there is news about adoption of the system throughout Wales, an update on the new version 4 software and web portal, a case study from Doncaster as well as the usual updates from vario ...
CPD Event – Birmingham, November 2016
November 28, 2016
The second ASSIST-CKD CPD learning event took place on Monday 28th November 2016 in Birmingham. Copies of each of the slide presentations can be found at https://assist-ckd.org/events/birmingham2016/. ...
Newsletter – Issue 3
April 28, 2016
Welcome to the third ASSIST-CKD project newsletter designed to update you all with the project’s progress, share hints and tips from participating sites and keep you informed on how the project is being promoted through conferences and publications. We would really welcome your feedback to help ensure there is something for everyone in the newsletter and to start to build up a project community. Putting together a cohesive business case to local commissioners to ensure ongoing funding is key to the principles of ASSIST-CKD being adopted within routine practice beyond the project itself. Amji ...
Newsletter – Issue 2
December 20, 2015
Welcome to the second ASSIST-CKD project newsletter designed to update you all with the project’s progress, share hints and tips from participating sites and keep you informed on how the project is being promoted through conferences and publications. We would also encourage you to give us some feedback to help ensure there is something for everyone in the newsletter and to really start to build up a project community. Four of the first wave sites are now reporting on eGFR graphs having started this Autumn. The Royal Cornwall Hospitals NHS Trust. Doncaster & Bassetlaw Hospitals NHS Foundation ...
Newsletter – Issue 1
September 28, 2015
Welcome to the first ASSIST-CKD project newsletter. We plan to issue these on a regular basis as a way of updating you all with the project’s progress, sharing hints and tips from participating sites and keeping you up to date with how the project is being promoted through conferences and publications. We also welcome feedback and hope to include a ’View from the Coalface’ section in future editions where we will feature a particular site. We have started! The 4 renal units (5 labs) randomised to start in the first step have either finished or are just completing their final on-site IT t ...