County Durham and Darlington improves patient safety with AI

County Durham and Darlington NHS Foundation Trust has created and implemented an artificial intelligence (AI) model to protect patients from acute kidney injury (AKI).

The trust’s AI-driven model helps healthcare staff to identify patients who are at risk from AKI and to swiftly respond with treatment. The technology uses risk stratification digital tools that staff are able to access through an app. These are combined with care processes developed at the trust and which involve a new specialist nurse team, preventive specialist intervention, assessment and follow-up.

Its implementation at County Durham and Darlington has led to a reduction in both hospital-acquired and community AKI. Overall, the incidence of AKI within the trust fell from 6.5% between March and May 2020, to 3.8% during the same period in 2021. The most significant reduction was seen in hospital-acquired AKI – which fell by more than 80%.

Jeremy Cundall, medical director for County Durham and Darlington NHS Foundation Trust and executive lead for the project, said: “The partnership has resulted in patients being detected earlier – preventing AKI from occurring or mitigating the worsening of existing AKI. Accordingly, patients have been more effectively triaged to the right pathways of care including referral and transfer to tertiary renal units where appropriate.”

The AI-powered model provides a predictive AKI risk app, used at the point of care. It was developed using an MHRA-registered medical device called CRAB, which is used to monitor the safe performance of a range of clinical specialities.

The newly recruited specialist nursing team provides staff at the trust with ward-based education and expert advice, and has enabled a standardised referral process for those patients who require specialist renal support.

Claire Stocks, early detection, resuscitation and mortality lead nurse for County Durham and Darlington NHS Foundation Trust, said: “This work has been a project very much about using collaborative partnerships to enhance patient safety and quality. An idea that was developed in a ‘cupboard conversation’ is now a fully operational specialist nurse service. Utilising digital innovations supports rapid triage, early detection and treatment to improve outcomes.”

In addition to the improvements in patient safety, the technology has delivered cost savings for the trust too. County Durham and Darlington saved more than £2million in direct costs from reductions in AKI incidence. The improved transfer of patients has also released ICU capacity, vital at a time when the NHS is dealing with a growing national backlog for elective surgery.

The new care model has been developed in partnership with the NHS technology provider, C2-Ai. It could now be rolled out to the wider NHS community.

Dr Mark Ratnarajah, UK managing director at C2-Ai, said: “There has been a big policy emphasis on the importance of data in saving lives in the NHS in recent months. This project is a prime example of how using technology to give healthcare professionals near real-time and quantifiable risk information, combined with a culture focused on learning and driving forward clinical best practice, can make a big difference to patient safety and ease pressure on busy NHS hospitals.”

At the end of last year, County Durham and Darlington signed a 10-year deal with Cerner for the implementation of an integrated EPR.