Key Elements of Clinical Communication After Inpatient Acute Kidney Injury: Modified Delphi Study From the AKINow...

There is a lack of consensus on the key elements needed to foster clear and effective clinical communication after an episode of inpatient acute kidney injury (AKI). This study sought to achieve consensus on key elements of AKI communication between inpatient and outpatient healthcare professionals.

Three sequential rounds of a modified Delphi process to develop, refine, and achieve consensus on items for inclusion in standardized post-AKI clinical communications. Each round included a survey followed by a virtual discussion.

Forty-seven participants from 12 countries were recruited through purposive and snowball sampling, including 33 physicians (27 nephrologists), 10 allied health practitioners, and 4 patients and/or caregivers.

Quantitative data were summarized using counts and percentages. Qualitative content analysis was performed to capture additional themes. Consensus recommendations (≥80% agreement) and qualitative findings were iteratively integrated into a draft guide.

Participants strongly agreed that post-AKI communication between health care teams should focus on medication changes and describe the trends in serum creatinine. For patients requiring dialysis at discharge, the dates dialysis began and was last administered should be reported. Topics of post-AKI communication by clinicians to patients should focus on medication changes as well as follow-up testing and clinical monitoring. Qualitative evaluation highlighted that the effectiveness of a post-AKI clinical communication guide is dependent on the systematic reporting of clinical information, the provision of actionable guidance for health care professionals and patients, and the monitoring for kidney recovery.

Potentially limited generalizability because participants were mostly health care practitioners from high resource healthcare settings.

A multidisciplinary panel of stakeholders reached consensus on key elements of post-AKI clinical communication. The recommendations may valuably inform post-AKI care.