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
Common Differential Diagnoses:
The following articles contain general information relating to the pathology of pes cavus.
Cote, K.P., Brunet II, M.E., Gansneder, B.M. and Shultz, S.J., 2005. Effects of pronated and supinated foot postures on static and dynamic postural stability. Journal of athletic training, 40(1), p.41.
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Franco, A.H., 1987. Pes cavus and pes planus. Analyses and treatment. Physical therapy, 67(5), pp.688-694.
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The following articles contain general information relating to the pathology of midfoot osteoarthritis.
Thomas, M., Peat, G., Rathod, T., Moore, A., Menz, H.B. and Roddy, E., 2014. 188. The Epidemiology of Midfoot Pain and Symptomatic Midfoot Osteoarthritis: Cross-Sectional Findings from the Clinical Assessment Study of the Foot. Rheumatology, 53(suppl 1), pp.i129-i130.
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Thomas, M.J., Roddy, E., Rathod, T., Marshall, M., Moore, A., Menz, H.B. and Peat, G., 2015. Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot. Osteoarthritis and cartilage, 23(12), pp.2094-2101.
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Menz, H.B., Munteanu, S.E., Zammit, G.V. and Landorf, K.B., 2010. Foot structure and function in older people with radiographic osteoarthritis of the medial midfoot. Osteoarthritis and cartilage, 18(3), pp.317-322.
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The following articles contain general information relating to the pathology of impingements and subluxations affecting the midfoot.
Lau, S., Bozin, M. and Thillainadesan, T., 2017. Lisfranc fracture dislocation: a review of a commonly missed injury of the midfoot. Emerg Med J, 34(1), pp.52-56.
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Anderson, J.G., Bohay, D.R., Patthanacharoenphon, C.G. and Ertl, A.M., 2014. Midfoot injuries. In Sports Injuries of the Foot (pp. 71-85). Springer US.
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Kirby, K.A., 1997. Foot and Lower Extremity Biomechanics: A Ten Year Collection of Precision Intricast Newsletters. Precision Intricast Incorporated, pp. 165-166
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The following articles contain general information relating to the pathology of tarsal disorders.
Tuthill, H.L., Finkelstein, E.R., Sanchez, A.M., Clifford, P.D., Subhawong, T.K. and Jose, J., 2014. Imaging of tarsal navicular disorders: a pictorial review. Foot & ankle specialist, 7(3), pp.210-224.
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The following articles contain general information relating to the pathology of calcaneo-navicular (spring) ligament dysfunction.
Omar, H., Saini, V., Wadhwa, V., Liu, G. and Chhabra, A., 2016. Spring ligament complex: Illustrated normal anatomy and spectrum of pathologies on 3T MR imaging. European Journal of Radiology, 85(11), pp.2133-2143.
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Williams, G., Widnall, J., Evans, P. and Platt, S., 2014. Could failure of the spring ligament complex be the driving force behind the development of the adult flatfoot deformity?. The Journal of foot and ankle surgery, 53(2), pp.152-155.
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The following articles contain general information relating to the pathology of adult acquired flat foot deformity, including posterior tibial tendon dysfunction.
Ness, M.E., Long, J., Marks, R. and Harris, G., 2008. Foot and ankle kinematics in patients with posterior tibial tendon dysfunction. Gait & posture, 27(2), pp.331-339.
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Rabbito, M., Pohl, M.B., Humble, N. and Ferber, R., 2011. Biomechanical and clinical factors related to stage I posterior tibial tendon dysfunction. journal of orthopaedic & sports physical therapy, 41(10), pp.776-784.
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Giza, E., Cush, G. and Schon, L.C., 2007. The flexible flatfoot in the adult. Foot and ankle clinics, 12(2), pp.251-271.
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Razeghi, M. and Batt, M.E., 2002. Foot type classification: a critical review of current methods. Gait & posture, 15(3), pp.282-291.
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Ross, M.H., Smith, M.D., Mellor, R., Durbridge, G. and Vicenzino, B., Clinical Tests of Tibialis Posterior Tendinopathy: Are They Reliable and How Well Are They Reflected in Structural Changes on Imaging?. The Journal of orthopaedic and sports physical therapy, pp.1-29.
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The orthotics evidence portal