Table 2

Characteristics of participating NHS Trusts and their AKI electronic alert

NHS TrustTrust characteristicsAKI electronic alert
1University-affiliated, 1800-bed, multiple site tertiary referral hospital; contains regional renal unit, transplantation, cardiothoracic and hepatobiliary surgery as well as other major specialisms; the Renal Unit is based at one Trust site and although providing consultative input to the rest of the Trust, has no routine, on-site presence at these venues which include the emergency admissions suite and significant sections of general surgical, internal medical and elderly care services.Passive electronic alert consisting of a line of black text appearing underneath serum creatinine results in the patient’s electronic medical record (Powerchart, Cerner Millennium, Cerner, Kansas, Missouri , USA), which stated the stage of AKI where present.
Additional pop-up electronic alert that appeared when accessing the patient’s electronical medical record, and required dismissal to remove from the screen. A ‘more info’ link on the pop-up window, if clicked, took the end-user to a second window that contained further links to the Trust AKI protocol and specific guidance on aspects of management including essential assessments, key bedside observations and key investigations. The latter linked to quick order test panels including essential blood tests and urgent renal ultrasound requesting.
2Multisite university-affiliated district general with approximately 900 beds. All acute services on one site with internal medicine, elderly services, general and orthopaedic surgery along with obstetrics and paediatrics. Renal replacement provision from critical care. Renal input, provided from Trust one by remote consultation, no renal consultant presence within the trust.Passive electronic alert consisting of a line of black text appearing underneath serum creatinine results in the patient’s electronic medical record (TelePath Information Management System, Mill Systems, Belper, UK), which stated the stage of AKI where present.
Alert does not link with any other hospital information system, but instructs users to access local AKI guidelines.
3District general hospital with 300 beds in medicine. Renal input is from Trust 1 through a combination of remote consultation and weekly availability at the time of an outpatient clinic on site.Passive electronic alert consisting of a line of black text appearing underneath serum creatinine results in the patient’s electronic medical record (Medical Information Technology (MEDITECH), Westwood, Massachusetts, USA), which stated the stage of AKI where present.
Alert does not link with any other hospital information system, but instructs users to access local AKI guidelines.
  • See online additional files 1 and 2 for images of the electronic alerting systems.

  • AKI, acute kidney injury; NHS, National Health Service.