Establish a proactive plan to support management of future episodes of acute illness
Proactive follow-up for this high-risk patient population
provides an opportunity to ensure involvement of patients and carers in decision making.
Person-centred care planning includes
- supporting people to co-create individualised plans, visible to patients, carers and all sectors of healthcare.
This will support better co-ordinated, safer healthcare and includes a need for:
Shared understanding of the relevance of kidney health and AKI risk,
in the context of chronic disease monitoring and medicines optimisation
Plans for escalation of treatment in the event of acute illness
Plans for modification of medication in the event of an acute illness
These priorities will vary according to individual need,
incorporating: pre-existing co-morbidities;
characteristics of the AKI associated illness;
and the degree of kidney recovery
Utilise generic resources to support patient and carer involvement in post-AKI care planning
Patient Capacity Assessment
This instrument aims to shift 'the focus from the medical condition of the person
to their situation in life,
identifies what the person values doing and being,
explores how healthcare and other resources serve or limit this person,
and recognises and cultivates opportunities to advance the person and their situation.'
Social Prescribing
Taking into account individual’s health and social needs,
consider the potential benefits of referring people to local, non-clinical services in the community
Proactive follow-up for this high-risk patient population
provides an opportunity to ensure involvement of patients and carers in decision making.
Person-centred care planning includes
- supporting people to co-create individualised plans, visible to patients, carers and all sectors of healthcare.
This will support better co-ordinated, safer healthcare and includes a need for:
Shared understanding of the relevance of kidney health and AKI risk,
in the context of chronic disease monitoring and medicines optimisation
Plans for escalation of treatment in the event of acute illness
Plans for modification of medication in the event of an acute illness
These priorities will vary according to individual need,
incorporating: pre-existing co-morbidities;
characteristics of the AKI associated illness;
and the degree of kidney recovery
Utilise generic resources to support patient and carer involvement in post-AKI care planning
Patient Capacity Assessment
This instrument aims to shift 'the focus from the medical condition of the person
to their situation in life,
identifies what the person values doing and being,
explores how healthcare and other resources serve or limit this person,
and recognises and cultivates opportunities to advance the person and their situation.'
Social Prescribing
Taking into account individual’s health and social needs,
consider the potential benefits of referring people to local, non-clinical services in the community
