I agree Anne
Dr Robert Hill
Consultant Clinical Biochemist
________________________________________
From: ACB AKI-Detection-Algorithm [[log in to unmask]] On Behalf Of Anne Dawnay [[log in to unmask]]
Sent: 30 October 2014 10:32
To: [log in to unmask]
Subject: AKI staging reporting
[cid:image001.gif@01CFF42C.DE590CB0]
Further to recent discussions we received a report from another hospital today. I don’t think reporting a non-existent stage 0 AKI to clinicians is helpful. I would have expected labs to make stage ‘0’ non-reportable and to only report stage 1/2/3 with appropriately worded local comments. What do you think?
best wishes
Anne
Dr Anne Dawnay PhD FRCPath
Consultant Biochemist
Clinical Lead for Clinical Biochemistry & Chair UCLH POCT Committee
020 344 72954 direct dial
-----Original Message-----
From: ACB AKI-Detection-Algorithm [mailto:[log in to unmask]] On Behalf Of ACB-AKI-ALGORITHM automatic digest system
Sent: 30 October 2014 00:02
To: [log in to unmask]
Subject: ACB-AKI-ALGORITHM Digest - 28 Oct 2014 to 29 Oct 2014 (#2014-15)
There is 1 message totaling 281 lines in this issue.
Topics of the day:
1. ACB-AKI-ALGORITHM Digest - 27 Oct 2014 to 28 Oct 2014 (#2014-14)
----------------------------------------------------------------------
Date: Wed, 29 Oct 2014 09:09:28 -0000
From: Anne Dawnay <[log in to unmask]>
Subject: Re: ACB-AKI-ALGORITHM Digest - 27 Oct 2014 to 28 Oct 2014 (#2014-14)
Hi Jeff, All comments should be locally configurable to ensure appropriate for your circumstances. Most of those you cite are not comments that would appear on the report. The exception is the flag high - I would not leave as ?AKI?CKD
Could use eg '?AKI ?CKD, suggest repeat creatinine to check' since this comment only appends when there is no result in the previous 365 days.
For the other 4 examples you give it would be useful for CSC to tag them to the end box on the AKI algorithm to see to which they apply,
eg 'AKI stage 0 Report without alert' (twice!)
'AKI stage NA No flag alert' and
'AKI stage NA insufficient data'.
We have only 3 green end boxes on the algorithm where we state no flag or no alert so would be useful for CSC to match their (non) comment to them.
Can't CSC tell you what the numbers mean?
Important to get this sorted during the run in audit period before you go live and great to share your experience.
best wishes
Anne
Dr Anne Dawnay PhD FRCPath
Consultant Biochemist
Clinical Lead for Clinical Biochemistry & Chair UCLH POCT Committee
020 344 72954 direct dial
-----Original Message-----
From: ACB AKI-Detection-Algorithm [mailto:[log in to unmask]] On Behalf Of ACB-AKI-ALGORITHM automatic digest system
Sent: 29 October 2014 00:07
To: [log in to unmask]
Subject: ACB-AKI-ALGORITHM Digest - 27 Oct 2014 to 28 Oct 2014 (#2014-14)
There is 1 message totaling 392 lines in this issue.
Topics of the day:
1. Comment interpretation
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Date: Tue, 28 Oct 2014 16:01:54 +0000
From: Mike Bosomworth <[log in to unmask]>
Subject: Re: Comment interpretation
So far as I am aware we have devised our own comments and also modified
some our CKD comments as the two together were confusing.
Kind regards
Mike
Dr. Mike Bosomworth
Clinical Service Lead for Blood Sciences and Specialist Laboratory
Medicine.
Tel. 0113 3922340
Mobile 07789 174344
>>> "Hill Robert (NORTH BRISTOL NHS TRUST)" <[log in to unmask]>
27/10/2014 22:50 >>>
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Hi Jeff,
I assume that these are the comments that the CSC algorithm adds to the
AKI Warning Stage Test result?
I do not know what the numbers mean - They may be used by CSC to define
the situation encountered by the algorithm that led to the" positive"
AKI test report.
CSC did not consult us on the detail of the comment output for their
algorithm although I can guess what these comments are meant to convey.
It would seem better for the test result to express the stage of AKI as
a numerical (dimensionless) result and allow flexibility in the
accompanying comment.
You are one of the first to see the new CSC module in action (assuming
it is indeed the new module) so there is little experience to share at
the moment unless anyone else would care to comment?
Best wishes,
Robert
Dr Robert Hill
Consultant Clinical Biochemist
________________________________________
From: ACB AKI-Detection-Algorithm [[log in to unmask]] On
Behalf Of Jeffrey Barron [[log in to unmask]]
Sent: 26 October 2014 18:14
To: [log in to unmask]
Subject: Comment interpretation
Dear Robert
We are implementing the AKI algorithm.
Your advice on the comments would be appreciated. What is the meaning
of the numbers in brackets? Is there a detailed interpretation of the
comments.
Have you kept the comments or changed the comments:
AKI stage 0 Report without alert (6)
AKI stage 0 Report without alert (7)
AKI stage NA Flag High ? AKI ? CKD
AKI stage NA No flag alert (9)
AKI stage NA insufficient data (10)
Best wishes
Jeff
Jeffrey Barron
Consultant Chemical Pathologist
-----Original Message-----
From: ACB AKI-Detection-Algorithm
[mailto:[log in to unmask]] On Behalf Of Hill Robert
(NORTH BRISTOL NHS TRUST)
Sent: 26 October 2014 13:56
To: [log in to unmask]
Subject: Re: Annual fee for LIMS providers?
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Hi Jon,
Thank you for posting this.
Members of the detection and measurement workstreams of the AKI project
will be meeting with CSC fairly soon - exact date to be arranged.We can
clarify their position on this and also
ensure that CSC understands the limited nature of any modifications we
intend to make in the future. Ultimately of course this will be a
contractual matter between Trusts and CSC.
Other comments refelecting experience with charges proposed by CSC or
other LIMS suppliers welcome.
Best wishes,
Robert
Dr Robert Hill
Consultant Clinical Biochemist
________________________________________
From: ACB AKI-Detection-Algorithm [[log in to unmask]] On
Behalf Of Jonathan Murray [[log in to unmask]]
Sent: 24 October 2014 09:17
To: [log in to unmask]
Subject: Annual fee for LIMS providers?
Hi Robert,
I wondered what the national consensus is regarding routine annual
payments to LIMS providers?
Several units in the Northern region use CSC and - in addition to an
initial set-up fee - they are mandating our Trusts agree to pay an
annual fee (£500 + VAT). We appreciate the figure is not necessarily
substantial but of course feel obliged to ensure that any NHS resource
is being used responsibly. We also appreciate that sometimes it is
necessary to maintain a payment for IT 'support' etc - but (as far as I
know) this is not routine in such circumstances. Of course we recognise
that - "if, as and when" any updates occur that an upgrade fee would be
charged - but of course it may be that no upgrades do occur, or perhaps
not for several years. Certainly when trying to justify payments, it is
easier to do so if you are 'getting something' when needed (ie an
upgrade) for your Trust's money - rather than committing to long term
annual payments 'in case' changes occur at some point in the future.
We would be most grateful for your / others opinion on this - and
indeed an idea of what others have done about this (if indeed they have
encountered it with CSC or other LIMS providers).
Best Wishes,
Jon
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