Early warning scores: unravelling detection and escalation

Gary B. Smith, David Prytherch, Paul Meredith, Paul E. Schmidt

Research output: Contribution to journalArticlepeer-review


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.

– The paper raises the EWS debate and alerts EWS users that scrutiny is required.
Original languageEnglish
Pages (from-to)872-875
Number of pages4
JournalInternational Journal of Health Care Quality Assurance
Issue number8
Early online date6 Oct 2015
Publication statusPublished - Nov 2015


  • Adverse events
  • Cardiac arrest
  • Early warning scores
  • Intensive care unit admission
  • National Early Warning Score
  • Rapid response teams
  • Death


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