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Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out

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Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out. / Scott, Lauren J.; Redmond, Niamh M.; Garrett, Joanna; Whiting, Penny; Northstone, Kate; Pullyblank, Anne.

In: Emergency Medicine Journal, Vol. 36, No. 5, 01.05.2019, p. 287-292.

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Scott, Lauren J. ; Redmond, Niamh M. ; Garrett, Joanna ; Whiting, Penny ; Northstone, Kate ; Pullyblank, Anne. / Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out. In: Emergency Medicine Journal. 2019 ; Vol. 36, No. 5. pp. 287-292.

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@article{a46318bc61a7432fbb93c0b33ac84b06,
title = "Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out",
abstract = "BackgroundEarly warning scores (EWS) were developed in acute hospital settings to improve recognition and response to patient deterioration. In 2012, the UK Royal College of Physicians developed the National Early Warning Score (NEWS) to standardise EWS across theNHS. Its use was also recommendedoutside acute hospital settings ;however, there is limited information about NEWS in these settings. From March 2015, NEWS was implemented across the healthcare system in the West-of-England, with the aim that NEWS would be calculated for all patients prior to referral into acute care.AimTo describe the distribution and use of NEWS in out-of-hospital settings for patients with acute illness or long-term conditions, following system wide implementation.MethodAnonymised data wereobtained from 115,030 ED attendances,1,137,734 ambulance electronic records,31,063 community attendances and 15,160 GP referrals into secondary care, in the West of England. Descriptive statistics are presented.ResultsMost attendance records had NEWS=0-2: 80{\%} in ED, 67{\%} of ambulance attendances and 72{\%} in the community. In contrast, only 8{\%}, 18{\%} and 11{\%} of attendances had NEWS≥5 (the trigger for escalation of care in-hospital), respectively. Referrals by a GP had higher NEWS on average (46{\%} NEWS=0-2 and 30{\%} NEWS≥5). By April 2016, the use of NEWS was reasonably stable in ED, ambulance and community populations, and still increasing for GP referrals.ConclusionsNEWS≥5 occurred in less than 20{\%} of ED, ambulance and community populations studied, and 30{\%} of GP referrals. This suggests thatin most out-of-hospital settings studied, high scores are reasonably uncommon.",
keywords = "clinical assessment, emergency ambulance systems emergency department, emergency care systems, prehospital care, communications",
author = "Scott, {Lauren J.} and Redmond, {Niamh M.} and Joanna Garrett and Penny Whiting and Kate Northstone and Anne Pullyblank",
year = "2019",
month = "5",
day = "1",
doi = "10.1136/emermed-2018-208140",
language = "English",
volume = "36",
pages = "287--292",
journal = "Emergency Medicine Journal",
issn = "1472-0205",
publisher = "BMJ Publishing Group",
number = "5",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out

AU - Scott, Lauren J.

AU - Redmond, Niamh M.

AU - Garrett, Joanna

AU - Whiting, Penny

AU - Northstone, Kate

AU - Pullyblank, Anne

PY - 2019/5/1

Y1 - 2019/5/1

N2 - BackgroundEarly warning scores (EWS) were developed in acute hospital settings to improve recognition and response to patient deterioration. In 2012, the UK Royal College of Physicians developed the National Early Warning Score (NEWS) to standardise EWS across theNHS. Its use was also recommendedoutside acute hospital settings ;however, there is limited information about NEWS in these settings. From March 2015, NEWS was implemented across the healthcare system in the West-of-England, with the aim that NEWS would be calculated for all patients prior to referral into acute care.AimTo describe the distribution and use of NEWS in out-of-hospital settings for patients with acute illness or long-term conditions, following system wide implementation.MethodAnonymised data wereobtained from 115,030 ED attendances,1,137,734 ambulance electronic records,31,063 community attendances and 15,160 GP referrals into secondary care, in the West of England. Descriptive statistics are presented.ResultsMost attendance records had NEWS=0-2: 80% in ED, 67% of ambulance attendances and 72% in the community. In contrast, only 8%, 18% and 11% of attendances had NEWS≥5 (the trigger for escalation of care in-hospital), respectively. Referrals by a GP had higher NEWS on average (46% NEWS=0-2 and 30% NEWS≥5). By April 2016, the use of NEWS was reasonably stable in ED, ambulance and community populations, and still increasing for GP referrals.ConclusionsNEWS≥5 occurred in less than 20% of ED, ambulance and community populations studied, and 30% of GP referrals. This suggests thatin most out-of-hospital settings studied, high scores are reasonably uncommon.

AB - BackgroundEarly warning scores (EWS) were developed in acute hospital settings to improve recognition and response to patient deterioration. In 2012, the UK Royal College of Physicians developed the National Early Warning Score (NEWS) to standardise EWS across theNHS. Its use was also recommendedoutside acute hospital settings ;however, there is limited information about NEWS in these settings. From March 2015, NEWS was implemented across the healthcare system in the West-of-England, with the aim that NEWS would be calculated for all patients prior to referral into acute care.AimTo describe the distribution and use of NEWS in out-of-hospital settings for patients with acute illness or long-term conditions, following system wide implementation.MethodAnonymised data wereobtained from 115,030 ED attendances,1,137,734 ambulance electronic records,31,063 community attendances and 15,160 GP referrals into secondary care, in the West of England. Descriptive statistics are presented.ResultsMost attendance records had NEWS=0-2: 80% in ED, 67% of ambulance attendances and 72% in the community. In contrast, only 8%, 18% and 11% of attendances had NEWS≥5 (the trigger for escalation of care in-hospital), respectively. Referrals by a GP had higher NEWS on average (46% NEWS=0-2 and 30% NEWS≥5). By April 2016, the use of NEWS was reasonably stable in ED, ambulance and community populations, and still increasing for GP referrals.ConclusionsNEWS≥5 occurred in less than 20% of ED, ambulance and community populations studied, and 30% of GP referrals. This suggests thatin most out-of-hospital settings studied, high scores are reasonably uncommon.

KW - clinical assessment

KW - emergency ambulance systems emergency department

KW - emergency care systems

KW - prehospital care, communications

UR - http://www.scopus.com/inward/record.url?scp=85062681462&partnerID=8YFLogxK

U2 - 10.1136/emermed-2018-208140

DO - 10.1136/emermed-2018-208140

M3 - Article

VL - 36

SP - 287

EP - 292

JO - Emergency Medicine Journal

T2 - Emergency Medicine Journal

JF - Emergency Medicine Journal

SN - 1472-0205

IS - 5

ER -