Welcome to the Right Decision Service (RDS) newsletter for August 2024.
Following the recent RDS outages, Tactuum and the RDS team have been reviewing the learning from these incidents. We are committed to doing all we can to ensure a positive outcome by strengthening the RDS to make it fully robust and clinically resilient for the future.
We would like to invite you to a webinar on 26th September 3-4 pm on national and local contingency planning for future RDS outages. Tactuum and the RDS team will speak about our business continuity plans and the national contingency arrangements we are putting in place. This will also be a space to share local contingency plans, ideas and existing good practice. We would also like to gather your views on who we should send communications to in the event of future outages.
I have sent a meeting request for this date to all editors – please accept or decline to indicate attendance, and please forward on to relevant contacts. You can also contact Olivia.graham@nhs.scot directly to register your interest in participating.
2.National IV fluid prescribing calculator
This UK CA marked calculator is now live at https://righdecisions.scot.nhs.uk/ivfluids . It has been developed by a multiprofessional steering group of leads in IV fluids management, as part of the wider Modernising Patient Pathways Programme within the Centre for Sustainable Delivery. It aims to address a known cause of clinical error in hospital settings, and we hope it will be especially useful to the new junior doctors who started in August.
Please do spread the word about this new calculator and get in touch with any questions.
The following toolkits are now live;
We have updated and simplified this guidance within our standard operating procedures. We have clarified the guidance on how to determine whether an RDS tool is a medical device, and have provided an interactive powerpoint slideset to steer you through the process.
We have developed a guide to support editors and toolkit leads through the process of scoping, designing, delivering, quality assuring and implementing a new RDS toolkit. We hope this will help in project planning and in building shared understanding of responsibilities throughout the full development process. The guide emphasises that the project does not end with launch of the new toolkit. Implementation, communication and evaluation are ongoing activities throughout the lifetime of the toolkit.
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.)
7 Evaluation projects
Dr Stephen Biggart from NHS Lothian has kindly shared with us the results of a recent survey of use of the Edinburgh Royal Infirmary of Edinburgh Anaesthesia toolkit. This shows that the majority of consultants are using it weekly or monthly, mainly to access clinical protocols, with a secondary purpose being education and training purposes. They tend to find information by navigating by specialty rather than keyword searching, and had some useful recommendations for future development, such as access to quick reference guidance.
We’d really appreciate you sharing any other local evaluations of RDS in this way – it all helps to build the evidence base for impact.
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
The patient and their parents/carers will be invited to an SDR clinic appointment to discuss surgery and the inpatient stay.
There will be an opportunity for the family to meet clinicians who will involved in their care and ask questions. Any operative risks will be discussed. We also use this opportunity to discuss patients goals and expectations following the SDR procedure.
A pre-op physiotherapy assessment will be arranged once a date for surgery is set. Videos and measurements forms the mainstay of this assessment.
Patients will normally be admitted on the day prior to surgery.
Neurosurgical review with the surgical team
Gait Analysis
Gait Analysis or physiotherapy assessments will be carried out at regular agreed intervals after surgery and are patients are usually followed up until they leave children services and transition into adult services.
This can help to focus problem solving if changes during development occur to the child.
Local physiotherapy Assessments
Local CPIPs annually by local therapists will be carried out as normal.
Will be carried out again 6 months after surgery along with:-
Other tests may be used where appropriate.
The local MDT SDR team will receive feedback from some of the above assessments in order to evolve their informed decisions in relation to the service.
Children who have had SDR surgery are likely to need Ankle Foot Orthotics (AFOs) after surgery.
As part of the inpatient journey SDR patients will be seen by an orthotist from the hospital who will assess the child's current orthoses. If replacements are required a plan will be made to provide new AFOs and this will be arranged by the orthotic team.
The child may also require resting ankle splints (off the shelf heel pressure relieving AFOs) and knee gaiters. These will also be provided if required.
Ongoing orthotic care will be by the child's local services following surgical discharge.
Selective Dorsal Rhizotomy - SDR