title: Improving prevention, early recognition and management of acute kidney injury after major surgery: results of a planning meeting with multidisciplinary stakeholders.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is common after major surgery, and is associated with morbidity, mortality, increased length of hospital stay, and high health care costs. Although recent guidelines for AKI provide recommendations for identification of patients at risk, monitoring, diagnosis, and management of AKI, there is lack of understanding to guide successful implementation of these recommendations into clinical practice.
  
  
  METHODS
  We held a planning meeting with multidisciplinary stakeholders to identify barriers, facilitators, and strategies to implement recommendations for prevention, early identification, and management of AKI after major surgery. Barriers and facilitators to knowledge use for peri-operative AKI prevention and care were discussed.
  
  
  RESULTS
  Stakeholders identified barriers in knowledge (how to identify high-risk patients, what criteria to use for diagnosis of AKI), attitudes (self-efficacy in preventive care and management of AKI), and behaviors (common use of diuretics, non-steroidal anti-inflammatory drugs, withholding of intravenous fluids, and competing time demands in peri-operative care). Educational, informatics, and organizational interventions were identified by stakeholders as potentially useful elements for future interventions for peri-operative AKI.
  
  
  CONCLUSIONS
  Meeting participants were from a single centre.
  
  
  CONCLUSIONS
  The information and recommendations obtained from this stakeholder's meeting will be useful to design interventions to improve prevention and early care for AKI after major surgery.
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada ; Division of Nephrology, Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB T2N 2T9 Canada.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: James
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada ; Department of Surgery, University of Calgary, Edmonton, Alberta Canada.
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada ; Department of Surgery, University of Calgary, Edmonton, Alberta Canada.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Roberts
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Barry
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: Carlee
authors.initials: C
authors.lastname: Balint
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: Aleem
authors.initials: A
authors.lastname: Bharwani
authors.affiliation: Department of Surgery, University of Calgary, Edmonton, Alberta Canada.
authors.forename: William Don
authors.initials: WD
authors.lastname: Buie
authors.affiliation: Department of Critical Care, University of Calgary, Calgary, Alberta Canada.
authors.forename: Tomas
authors.initials: T
authors.lastname: Godinez
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada.
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.affiliation: Department of Surgery, University of Calgary, Edmonton, Alberta Canada.
authors.forename: John B
authors.initials: JB
authors.lastname: Kortbeek
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada.
authors.forename: Braden J
authors.initials: BJ
authors.lastname: Manns
authors.affiliation: Department of Surgery, University of Calgary, Edmonton, Alberta Canada.
authors.forename: Andria
authors.initials: A
authors.lastname: Marin
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: Nairne
authors.initials: N
authors.lastname: Scott-Douglas
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta Canada ; Department of Critical Care, University of Calgary, Calgary, Alberta Canada.
authors.forename: Henry Tom
authors.initials: HT
authors.lastname: Stelfox
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Alberta Canada.
authors.forename: Neesh
authors.initials: N
authors.lastname: Pannu