Welcome to the Right Decision Service (RDS) newsletter for June 2024.
1. Issues with RDS
Hopefully you all received the notification on Friday 28th June about the worldwide security vulnerability relating to use of code from the Polyfill.io code library – typically used to enable use of functionality in older browsers and operating systems. This vulnerability has now been addressed within RDS. Thanks to Tactuum for their prompt action on this.
This incident served as a useful reminder about the importance of making sure all devices and desktop/laptop computers have up to date anti-malware installed.
2.Redesign and improvements to RDS
The most recent information is that final fixes and developments will take place during July, with a view to user testing taking place in August 2024.
3.Evaluation
3.1 Usage statistics
We will be running the six-monthly usage statistics reports for all RDS toolkits during July. Please contact his.decisionsupport@nhs.scot if you would like to receive the usage report for your toolkit(s).
3.2 Palliative care
The Scottish Palliative Care Group is carrying out a value and impact survey of the national Palliative Care Guidelines toolkit on RDS. We would appreciate your help in circulating this survey, available at https://rightdecisions.scot.nhs.uk/scottish-palliative-care-guidelines/evaluation-survey/ /
3.3 Standard evaluation survey form
The Palliative Care Guidelines toolkit is using an adapted version of a generic impact evaluation form which the RDS team now encourages all toolkit owners to apply 6-12 months after launch of their toolkit. Please contact ann.wales3@nhs.scot if you would like to find out more.
4. Training and communications
The RDS Learning working group is in the final stages of developing and uploading new learning resources including:
- Clinical and Care governance of RDS toolkits
- The RDS toolkit development journey – from scoping to implementation and evaluation.
- New 5-minute videos demonstrating key editorial functionality
We have also drafted a communication and training plan to support implementation of the redesigned RDS. The plan aims to reach both end-users and editors, who will benefit from new features such as the archiving and version control functionality.
4.1 Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:
- Thursday 1 August 11 am – 12 pm
- Wednesday 7 August 4-5 pm
To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)
4.2 Google analytics training
Remember that you can also organise 1-1 training sessions with Olivia on running Google Analytics reports if you want to look at data more frequently than the six-monthly reports.
5. New toolkits
The following RDS toolkits are now live:
- SARCS (Sexual Assault Response Coordination Service)
- Child protection procedures (North Lanarkshire)
- NHS Lothian neonatal guidelines
The following toolkits are due to go live imminently:
- NHS Grampian critical care
- Care Inspectorate Safe Staffing guidance.
6. Toolkits in development
Some of the toolkits the RDS team is currently working on:
- SIGN/NICE/BTS Asthma guideline – combination of old and new guidance.
- New SIGN guideline around prevention and remission of type 2 diabetes
- Updating of HIS national tissue viability guidance in collaboration with the and transfer to RDS as an extension to the Skin and wound care toolkit
Please contact his.decisionsupport@nhs.scot if you would like to learn more about a toolkit. The RDS team will put you in touch with the relevant toolkit lead.
7. Implementation projects
HIS is working with the Scottish Library and Information Council and the ALLIANCE to implement the second phase of the Collective Force for Health and Wellbeing Action Plan. This plan aims to strengthen the role of public, health and school libraries in empowering people to use digital tools and health information for self-management and choices about health and wellbeing. A key element of this new phase is supporting public libraries to promote the RDS citizen-facing apps for health and wellbeing.
We held a webinar on 28th June about the implementation challenge for health and wellbeing apps for citizens. This included an overview of the evidence base around implementation, the critical importance of health literacy skills, and the early findings from tests of change of implementing the Being a partner in my care app. Please contact his.decisionsupport@nhs.scot if you would like a copy of the slides or access to the recording of this webinar (NHS staff only.)
If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.
With kind regards
Right Decision Service team
Healthcare Improvement Scotland
FAQs
The Red Flag indicators of serious pathology include: A past history of cancer. Unexplained weight loss (>10kg body weight in 3 months) Non-mechanical and/or night pain.
Are any red flags, signs, or symptoms which indicate serious spinal pathology necessitating immediate intervention present? ›
Severe head, neck, or back pain, especially when associated with following red flag signs, requires immediate assessment by a spine physician:
- Trauma (fall from height, road traffic accident, assault, weight lifting)
- Fever, chills or sweats.
- Neurological signs such as. ...
- Pain at rest.
- Pain at night.
- Rapid fatigue.
Only around 1% of all musculoskeletal presentations in primary care will be due to serious pathology. Such pathologies include spinal infection, cauda equina, fracture, and malignancy. Vertebral fracture is the most common serious spinal pathology, followed by metastatic bone disease.
What are the red flags for LBP? ›
Night pain and pain at rest are red flags that can indicate a serious cause. Be suspicious for infection or malignancy in patients presenting with low back pain who experience unexplained weight loss, night pain, or pain with rest.
What are 5 red flag symptoms? ›
Examples of red flag symptoms in the older adult include but are not limited to: fever, sudden unexplained weight loss, acute onset of severe pain, neural compression, loss of bowel or bladder function, jaw claudication, new headaches, bone pain in a patient with a history of malignancy or that awakens the patient from ...
What does it mean when a doctor says red flag? ›
All red flags, whether highly diagnostic or not, general or specific, warn us the possibility of life-threatening disorders. The term 'red flag' was originally associated with back pain and now lists of red flags are available for other common presentations such as headache, red eye and dyspepsia as well.
What are the 5 D's and 3 N's? ›
The classic cardinal signs of cervical ischemia, colloquially referred to as the '5Ds and 3 Ns,' also present in the late stage of CAD: diplopia, dizziness, drop attacks, dysarthria, dysphagia, ataxia, nausea, numbness, and nystagmus [19,20].
Which back pain red flags are most predictive of serious pathology in the emergency department? ›
Association of red flags and serious spinal pathology
The red flags with the highest positive likelihood ratios were saddle anaesthesia (LR + 11.0), history of TB (LR + 9.8), intravenous drug use (LR + 6.9) acute onset of urinary retention (LR + 6.4), and loss of anal sphincter tone (LR + 6.3).
Are red flags reliable in spinal cord compression? ›
Therefore, while red flags may remain important clinical markers, the degree of suspicion in such patients needs to be very low. Although the prognostic power of the red flags is poor, it is still positive.
What are the red flags of cauda equina? ›
Cauda equina syndrome.
Red flags include: Bilateral sciatica. Severe or progressive bilateral neurological deficit of the legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion. Gait disturbance or difficulty walking.
Pathology is a branch of medical science that is focused on the study and diagnosis of disease. Clinical pathology involves the examination of surgically removed organs, tissues (biopsy samples), bodily fluids, and, in some cases, the whole body (autopsy).
What does pathology results mean? ›
A pathology report is a medical report about a piece of tissue, blood, or body organ that has been removed from your body. The specimen is analyzed by a pathologist, who then writes up a report for the medical provider who has either ordered the report or performed the procedure.
What to do if you notice red flags? ›
If you notice some red flags in your relationship, here's how to approach them.
- Acknowledge your own needs. ...
- Communicate. ...
- Avoid being overly emotional. ...
- Seek professional help. ...
- Be honest with yourself. ...
- Set boundaries. ...
- Reconnect with friends or family. ...
- Know when to leave.
“There are red flags that are, or should be, fairly universal. Think violent behaviour, being overly jealous or controlling and any behaviour that has a tendency for abuse or manipulation.” At the same time, something that is a red flag for one person may not be a problem for another.
What are rules red flags? ›
The Federal Trade Commission's Red Flag Rule requires many businesses and organizations to implement a written Identity Theft Prevention Program designed to detect the warning signs, or red flags, of identity theft in their day-to-day operations.
What are the red flags of malignancy? ›
Recurrent nausea or vomiting. Blood in urine. Blood in stool (either visible or detectable by special tests) A recent change in bowel habits (constipation or diarrhea)
What are the 5 d's and 3 n's? ›
The classic cardinal signs of cervical ischemia, colloquially referred to as the '5Ds and 3 Ns,' also present in the late stage of CAD: diplopia, dizziness, drop attacks, dysarthria, dysphagia, ataxia, nausea, numbness, and nystagmus [19,20].
What are clinical Red Flag Warning signs? ›
Red-flag symptoms can be general (e.g. weight loss or fatigue) or specific (e.g. haemoptysis) and act as an alert of potentially sinister pathology[2]. However, red flags are not diagnostic tests; their main role is that they raise suspicions of a severe underlying cause[3].
What is a critical red flag condition? ›
A Red Flag Warning is issued by the National Weather Service (NWS) when weather conditions exist for destructive or rapidly spreading fires. In many cases, fire departments rely on these warnings to make sure firefighters and resources are readily available if a fire were to break out.
