Development

Building your toolkit using an Agile software development process involves breaking the development process into short phases, sometimes called "Sprints." Each sprint generally lasts 2-4 weeks and comprises an iteration of the following steps:

1. Plan requirements 
2. Build software/content
3. Test with stakeholders
4. Respond to testing feedback 

These iterations are shorter development cycles within the overarching Agile project methodology (see Project initiation module above) and within the whole development lifecycle from conception to retirement of a toolkit. 

The Right Decision Service implementation guide highlights  best practice quality improvement  methods that will support the iterative, agile approach to building your toolkit with a focus on continually responding to user feedback. Quality improvement at any scale is based on answering the following three questions:

1. What are we trying to achieve? This is the overall aims statement. Teams need to set clear and focused goals with measurable targets. These goals require leadership and should focus on problems that cause concern, as well as on patients or service users and staff. The goals should be relevant to the length of the project and be bold in aspiration.
2. How will we know if the change is an improvement, ie. what measures of success will we use?
3. What changes can we make that will result in improvement? These are the initial changes to be tested in Plan, Do, Study, Act (PDSA) cycles; other ideas for changes often emerge during the PDSA cycles.

The Plan-Do-Study-Act (PDSA) cycle uses these three questions to support iterative improvement, and aligns well with an Agile development approach:

Plan

Do

Study

Act

As outlined in the Design module of this learning resource, the Building your toolkit and Core features sections in the RDS Learning and support area provide an overview of the following functionality and formatting options. Some of the most commonly used tools include:

Simple content pages with accordion sections - i.e. expand-collapse headings that offer a concise way of packaging lengthy content enable the user to go direct to the relevant section within a lengthy document. The Alfentanil medicines information resource within the Palliative Care toolkit is an example of a simple content page with accordion sections. All medicines resources within this toolkit follow the same structure, giving the user a consistent experience throughout.

Listing pages - i.e. landing pages that direct the user to a menu of subpages. The BTS-NICE-SIGN asthma toolkit provides multiple examples of listing pages.

Embedding Youtube and Vimeo videos within an RDS page. The Being a partner in my care: Realistic Medicine together toolkit embeds videos throughout.

Media pages - Link the user directly to a PDF or image file. The GP factsheets section within the national Neurology pathways toolkit links the user to a list of PDF documents.

Shared content library - enables you to embed content from one toolkit within other toolkits, or to embed the same content in multiple locations within the same toolkit. The "Building my ability to change" sections within the Prevent the progress of diabetes toolkit provide examples of re-using shared content in multiple locations. 

Visual pathway builder - to visualise pathways and flowcharts in a consistent way within your website or app. You can link from pathway nodes to more information. The Scottish Cancer Network pathways toolkit provides multiple examples of visual pathways - for example the TNBC (HR- HER2-) Neoadjuvant pathway.

Question and answer pathway builder - to guide the user through a logical sequence of questions and answers to reach a recommended course of action. This tool also supports creation of risk stratification and scoring tools. The national Type 2 diabetes quality prescribing toolkit provides an example of the same pathway for managing cardiovascular and renal risk presented as a visual pathway and as an interactive question and answer tool.

Agile build phases ("Sprints.) (from TechTarget)

Quality improvement methods including Plan-Do-Study-Act -  Right Decision Service implementation guide 

RDS tools for building your toolkit - Building your toolkit and Core features sections in the RDS Learning and support area.

Thinking about a current or recent toolkit development:

• Which RDS build tools have you found most useful, and why? 
• Which tools would you like to learn more about - for example, have you seen other RDS toolkits that use approaches you would like to try? 
• How could you acquire this learning?  You can approach the RDS team (mailto:his.decisionsupport@nhs.scot ) to request a tutorial, or to be put in touch with the owner of an existing toolkit which uses approaches you would like to emulate.