Performance of early warning scoring systems to detect patient deterioration in the emergency department

© Springer-Verlag Berlin Heidelberg 2014. Acute hospital wards in the UK are required to use Early Warning Scoring (EWS) systems to monitor patients’ vital-signs. These are often paper-based, and involve the use of heuristics to score the vital signs which are measured every 2-4 hours by nursing staff. If these scores exceed pre-defined thresholds, the patient is deemed to be at risk of deterioration. In this paper we compare the performance of EWS systems, that use different approaches to score abnormal vital-signs, to identify acutely-ill patients, while attending the Emergency Department (ED). We incorporate the use of data acquired from bed-side monitors into the EWS system, thereby offering the possibility of performing patient observations automatically, between manual observations.