Automated Early Warning Scores (EWS)

Despite the potential to improve patient outcomes, the evidence supporting the utility of EWS systems has been mixed.([FOOTNOTE=Gao, H., McDonnell, A., Harrison, D. A., et al. Systematic review and evaluation of physiological track and trigger warning systems for identifying at-risk patients on the ward. Intensive Care Med. 2007;33(4):667-679.],[ANCHOR=],[LINK=]) One potential source of this inconsistency is human error in recording vital signs and calculating early warning scores. For example, an audit of night shift charts by Gordon et al. found that only 21% of charts had complete and correct EWS calculation.([FOOTNOTE=Gordon, C. F., & Beckett, D. J. Significant deficiencies in the overnight use of a Standardised Early Warning Scoring system in a teaching hospital. Scott Med J. 2011;56(1):15-18.],[ANCHOR=],[LINK=]) Therefore, automation of vital sign collection and EWS collection may add consistency to EWS implementation. EWS systems integrated into automated monitoring systems have been designed to streamline the recognition of clinical signs of deterioration. Evidence has demonstrated that the implementation of automated EWS systems may improve patient outcome, and reduce cost of implementation compared to traditional manually calculated systems.([FOOTNOTE=Bellomo, R., Ackerman, M., Bailey, M., et al. A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards. Crit Care Med. 2012;40(8):2349-2361.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Slight, S. P., Franz, C., Olugbile, M., Brown, H. V., Bates, D. W., & Zimlichman, E. The return on investment of implementing a continuous monitoring system in general medical-surgical units. Crit Care Med. 2014;42(8):1862-1868.],[ANCHOR=],[LINK=])