The impact that a Post Acute kidney injury clinic can have on a patient's journey.

AKI poses a worldwide concern, with a notable prevalence among patients in various acute care settings (NICE, 2023, NICE, 2021a). This condition is linked to substantial clinical repercussions and increased healthcare expenditures, attributing cost of over 1 billion pound in the UK (Kerr, Bedford, Matthews & Donoghue, 2014). Studies have indicated that preventive measures and prompt AKI identification can enhance outcomes. Ensuring excellent care for patients with AKI by recognising at community level and extending through the emergency department, hospital environment, and post-discharge from inpatient care (Renal Association, 2019). We invited all eligible patients who had been identified as experiencing AKI, dedicating a half-hour clinic appointment to their care where we delved into the patients' journey throughout their admission, discussing the AKI diagnosis, risk factors, management, and recovery. These clinics served as opportunities to provide patient education, offer health advice, medication review and formulate plans for ongoing management. Throughout the process, we gathered data, incorporating patient feedback and outcomes. Over a quarter of the patients in the clinic did not know that they had an AKI during their inpatient stay. Additionally, 70% reported they knew little or nothing about AKI and what it meant prior to their clinic appointment. The Post AKI clinic, addresses gaps in primary care and significantly contributing to the delivery of patient education surrounding medicine management, sick day guidance and providing healthy kidney advice (NICE 2021a). This service also contributes to enhanced patient journey. The feedback from the patient survey showed that the Post AKI clinic helped 87.6% understand more about AKI and of that, 46% of those patients learnt it from a nurse and 38.5% learnt it from a doctor. Around 85% felt the clinic helped them to understand their individual risk factors with 84.5% having a clear understanding of medicine management and sick day guidance in the future to reduce risk of a reoccurring AKI NICE guidance recognised that adults discharged from hospital post AKI are at higher risk of ongoing health issues but follow up enables early identification, prevention and this reduce readmission (NICE, 2023). The trust readmission rate, since the Post AKI clinic was introduced, has gone from an average of 17% to now 14.8%. The average inpatient length of stay was 20 days and has reduced to 16.8 days highlighting another positive outcome from Post AKI clinics. The data illustrates enhanced patient satisfaction and experience. This directly benefits patients and aligns with the aims outlined in the NICE guidance for early detection and prevention (NICE, 2021a). Moreover, the Post AKI clinic has proven its effectiveness in reducing hospital readmissions and it contributes to a reduced length of hospital stay by instilling confidence in care teams for early discharge, accompanied by a comprehensive follow-up plan. In summary, the Post AKI clinic has proven to be a success for both patients and the hospital.