Evaluating the Impact of an Early Warning Scoring System in a Community Hospital Setting

Failure to recognize and respond to early signs of deterioration in hospitalized patients can have significant implications associated with delays in treatment. This lack of recognition was the impetus for rapid response teams in the United States and the recommendation by the Institute of Healthcare Improvement for use of early warning scores. This project was designed to evaluate the pilot implementation of an early warning score on 2 units in a community hospital in the Northeast. The practice-focused question was used to explore how patient outcomes changed following implementation of an early warning score (EWS) compared to patient outcomes associated with a rapid response team alone. The translating evidence into practice model informed this project. Supporting evidence from existing hospital data was collected for rapid response, code blue, and mortality. Analysis using the chi-square test of homogeneity compared post-implementation with baseline data. The findings indicated the differences between the proportions were not statistically significant, indicating the metrics did not change appreciably following the implementation of the early warning score. While the evaluation analytics of this pilot did not demonstrate significant change in the outcome measures post-implementation, the results may be useful for the facility when performing a future evaluation of the EWS. It is possible that the results of the 2 units were not representative of the facility, and it is therefore recommended to repeat the evaluation using data from the entire facility for a longer period. Increasing the capacity for early recognition in decline has implications for social change through improvement in safety and quality of health care for all hospitalized patients