Data from: Implementation of an automated early warning scoring system in a surgical ward: practical use and effects on patient outcomes

Introduction: Early warning scores (EWS) are being increasingly embedded
in hospitals over the world due to their promise to reduce adverse events
and improve the outcomes of clinical patients. The aim of this study was
to evaluate the clinical use of an automated modified EWS (MEWS) for
patients after surgery. Methods: This study conducted retrospective
before-and-after comparative analysis of non-automated and automated MEWS
for patients admitted to the surgical high-dependency unit in a tertiary
hospital. Operational outcomes included number of recorded assessments of
the individual MEWS elements, number of complete MEWS assessments, as well
as adherence rate to related protocols. Clinical outcomes included
hospital length of stay, in-hospital and 28-day mortality, and ICU
readmission rate. Results: Recordings in the electronic medical record
from the control period contained 7929 assessments of MEWS elements and
were performed in 320 patients. Recordings from the intervention period
contained 8781 assessments of MEWS elements in 273 patients, of which 3418
were performed with the automated EWS system. During the control period,
199 (2.5%) complete MEWS were recorded versus 3991 (45.5%) during
intervention period. With the automated MEWS systems, the percentage of
missing assessments and the time until the next assessment for patients
with a MEWS of ≥2 decreased significantly. The protocol adherence improved
from 1.1% during the control period to 25.4% when the automated MEWS
system was involved. There were no significant differences in clinical
outcomes. Conclusion: Implementation of an automated EWS system on a
surgical high dependency unit improves the number of complete MEWS
assessments, registered vital signs, and adherence to the EWS hospital
protocol. However, this positive effect did not translate into a
significant decrease in mortality, hospital length of stay, or ICU
readmissions. Future research and development on automated EWS systems
should focus on data management and technology interoperability.