Early warning scores: unravelling detection and escalation

Abstract

Purpose: The purpose of this paper is to increase understanding of how patient deterioration is detected and how clinical care escalates when early warning score (EWS) systems are used.

Design/methodology/approach: The authors critically review a recent National Early Warning Score paper published in IJHCQA using personal experience and EWS-related publications, and debate the difference between detection and escalation.

Findings: Incorrect EWS choice or poorly understood EWS escalation may result in unnecessary workloads forward and responding staff.

Practical implications: EWS system implementers may need to revisit their guidance materials; medical and nurse educators may need to expand the curriculum to improve EWS system understanding and use.

Originality/value: The paper raises the EWS debate and alerts EWS users that scrutiny is required.

Keywords: Adverse events; Cardiac arrest; Death; Early warning scores; Intensive care unit admission; National Early Warning Score; Rapid response teams.