ASSIST-CKD: Evaluation of eGFR surveillance system (template)

You are being sent this questionnaire because your Practice is part of the national ASSIST-CKD project, the aim of which is earlier identification of people with declining kidney function through laboratory-based graphical surveillance of long-term kidney function trends. Further information on the project can be found here

We would now really appreciate your feedback on this eGFR surveillance system which has been running in XXXXXXXXXX since XXXXXXXXX. There are ten short questions and places to add free text if you wish. The survey will take 5-10 minutes to complete.

This survey is not about the acute kidney injury (AKI) alerts. Thank you very much.

Dr XXXXXXXXXX Consultant Nephrologist, XXXXXXXXXXXXXXX NHS Foundation Trust

1. Are you answering this question as: *

as an individual (GP, practice nurse, nurse practitioner, practice manager, other)
on behalf of your Practice

2. Approximately how many graphs of eGFR over time (see sample below) have you/your Practice received during the last six months?

*

3. Are the the graphs helpful in conveying information on changes in kidney function over time? *

If 'no', please explain why:

4. Do you find the information provided at the bottom of the graphs useful? *

If 'no', please explain why:

5. How clear are you about what to do following receipt of a graph? *

Very clear
Quite clear
Not at all clear

If the explanation about what to do next could be improved, please explain how:

6. Following receipt of a graph have you (tick all that apply): *

Reviewed the NICE guidance on CKD
Contacted the renal consultants/specialist nurse via phone for advice
Contacted the renal consultants/specialist nurse via email advice service (if available)
Referred patient(s) to the renal clinic
Other
None of these

If other, please explain what you did. If none of these, then please explain why:

7. Would you prefer to receive the eGFR graphs via the post as currently, or electronically? *

Post
Electronically via email

8. To date, has receiving an eGFR graph(s) influenced your clinical practice or the way in which you have managed your patients? *

If yes, please explain how. If no, please explain why:

9. Have you ever shown a graph to a patient(s)? *

If yes, please add any feedback you have had from patients. If no, please explain why:

10. On a scale from 0 to 5, where 0 is the least useful and 5 is the most useful, what number would you use to rate the usefulness of the eGFR surveillance system overall? *

1	2	3	4	5
1	2	3	4	5

11. Thinking about your management of patients with kidney disease, have you found that seeing the eGFR graphs: *

	Not at all	A little	A reasonable amount	Most definitely
has helped you to understand CKD	has helped you to understand CKD Not at all	has helped you to understand CKD A little	has helped you to understand CKD A reasonable amount	has helped you to understand CKD Most definitely
has increased your focus on CKD	has increased your focus on CKD Not at all	has increased your focus on CKD A little	has increased your focus on CKD A reasonable amount	has increased your focus on CKD Most definitely
has had a positive impact on your coding of CKD on the CKD register	has had a positive impact on your coding of CKD on the CKD register Not at all	has had a positive impact on your coding of CKD on the CKD register A little	has had a positive impact on your coding of CKD on the CKD register A reasonable amount	has had a positive impact on your coding of CKD on the CKD register Most definitely

Any additional information you would like to add about the eGFR graphs