The Flag System in the field of Physiotherapy is categorized into three main types that are
1. Clinical flags
Clinical red flags are indications of potential severe abnormalities such as caused by inflammation or neural diseases, structural musculoskeletal damage or disorders, circulatory issues, suspected diseases, malignancies, or systemic conditions. Best example for this are the red flags for musculoskeletal issues. If present, these call for an immediate referral for surgery and additional research.
There are some symptoms and signs that, when seen during a patient's examination or medical history, make us aware that there may be a severe problem. Physiotherapists are well-versed in musculoskeletal disorders and can spot warning signs or rule them out.
2. Psychosocial flags
It allows us to pinpoint the individual, their issue, and their social setting, as well as how those elements influence the healing process and returning to work. The idea was first presented in 1997 by Kendall, who examined variables that helped identify patients who were at risk of acquiring chronic handicaps and did not heal as was anticipated for their disease.
Using psychosocial flags, we can evaluate and plan using a biopsychosocial model. These warning signs are neither diagnostic nor symptoms; instead, they are signs that a person might not recover as quickly as anticipated and may require more help to resume employment. A common term for these warning signals is recovery barriers. Psychosocial variables determine activities and involvement levels.
3. Efficient flag system
As we observe, the flag system addresses a variety of problems. On the one hand, it's implemented to spot problems like a malignancy requiring an oncology referral for a patient. It also enables the detection of crucial psychosocial elements for a successful recovery.
The flag system is significant because it incorporates how an injury affects a person's physiological and emotional aspects. We now know that worry or fear of experiencing pain while engaging in a therapeutic activity might hinder healing. Treating patients as living things rather than merely as a collection of joints and muscles is crucial.
Types of flags
The flag system is further divided into various types depending on the severity of the patient's condition, emotional distress, behaviour changes and all other aspects are also observed that will be discussed further in detail of these types.
1. Red flags
Red flags are conditions with severe pathologies that physiotherapists can not treat but must immediately refer to the respective physician to treat them properly. A physiotherapist should strictly not even that patient at all. Some of the examples of these red flags are as follows.
2. Yellow flags
In physiotherapy, yellow flags are those conditions that can be treated by physiotherapists but under great observation. They must continuously check on the patient to prevent worsening the situation. Yellow flags indicate the characteristics related to the patient's thoughts, beliefs and attitude. Some examples are as follows.
3. Orange flags
Orange flags indicate the psychiatric conditions of the patient. While dealing with patients with orange flags, physiotherapists may give 100% to the patient according to treatment. Still, patients complain that their pain is the same and don't trust anyone easily. Some examples are below.
4. Blue flags
Blue flags indicate the relationship between employees and the workplace. The employee's perception about their work and health issues that their health can cause difficulties in their work. In blue flags, as a physiotherapist, PT can create some changes at their workplace to change the environment according to their condition, such as changing their table height and asking other employees to be supportive and create a happy surrounding. However, the patient has a fear of blue flags.
5. Black flags
Black flags indicate the obstacles between the system and the employees' requirements for immediate modifications. When the changes cannot be done according to patients' needs, just like if a person lives on the 2nd floor and must climb stairs in any condition, they can not be modified; this is a black flag. Some of the red flags patients face at work are as follows.