Table 2A.

Example Quality Improvement Initiatives for Diagnostic Evaluation of AKI

Recognition	Action	Results
High readmission rates for persistent AKI after cardiac angiography were not properly screened for AKI.	• Assessment of risk for AKI pre angiography and increasing follow-up serum creatinine assessment post-angiography in those at high risk to improve initial detection and determine reversibility	• Documentation of risk assessment for AKI pre angiography • Improved proportion of patients with AKI that have a follow-up serum creatinine post angio • Reduced rehospitalizations for severe/complications of AKI
High incidence of progressive AKI following gynecologic surgery	• Assessment of urine volume following surgery, or screening for nephrotoxin use (e.g., NSAIDs) • Protocol for imaging with the detection of decreased urine volume or elevation of serum creatinine • Improved imaging frequency	Documentation of serial assessment of urine volume after surgery • Improved frequency of evaluation for ureteral injury • Decreased AKI frequency? /reduce nephrotoxin exposure?
General Hospital Population with persistent AKI (any stage)	• Determining populations and setting with increased AKI frequency • Assessment of risk factors for AKI in the specific population • Protocol for urinalysis, follow-up serum creatinine, nephrotoxin evaluation, ultrasound in patients with risk factors	• Documentation decreasing rates of AKI frequency in specific populations and settings • Increased detection of potential nephrotoxin exposures • Reduced severity/duration of AKI