National Early Warning Score systems that alert to deteriorating adult patients in hospital

The 5 technologies described in this briefing are integrated software systems that output the national early warning score for adult patients in hospital.

The innovative aspects are the potential for more accurate alerts and the greater availability of this information to identify a deteriorating adult patient, thereby reducing avoidable harm and making services more efficient.

The intended place in therapy would be replacing paper-based charts that record observations and manually calculate the national early warning score.

The main points from the evidence summarised in this briefing are from 2 prospective studies and 1 multicentre retrospective observational study in the NHS. This limited evidence base suggests that electronic systems that send out national early warning score-based alerts can release staff resources, reduce unplanned admissions to intensive care and reduce the frequency of cardiac arrests, compared with standard care.

Key uncertainties are the lack of evidence for national early warning score-based alerts from these technologies in the NHS. Further research could improve understanding of how best to use them, and help determine the cost and resource impact.

The cost of early warning systems typically ranges from £30,000 to £90,000 for initial system installation, configuration and set up, with ongoing annual licence costs from £0.35 to £0.70 per acute bed, per day (exclusive of VAT). The resource impact would be in addition to standard care because it requires changes to IT infrastructure and initial staff training. But once adopted it could release nursing resources for other tasks. There is limited evidence to support this release of resources.