Recognition and response systems across New Zealand had been developed at a local level. There was considerable variation in the vital sign triggers used to prompt escalation of care, models of clinical response, and organisational approaches to managing the care of deteriorating patients.
A nationally consistent approach to recognising and responding to acute deterioration benefits patients, clinicians and the system as a whole. An effective and sustainable system includes a standardised national vital signs chart with early warning score and localised clinical escalation, response processes and clinical governance. Underpinning the clinical components are education and training, teamwork and communication, measurement, evaluation and continuous improvement.
The majority of district health board hospitals (DHBs) have now implemented improvements to their recognition and response systems. We congratulate the project teams for their hard work in preparing for and implementing these improvements.
We are continuing to support teams to sustain their improvements.
Clinical engagement, governance and leadership, measurement and building clinical and quality improvement capability remain important factors for successful implementation and sustainable recognition and response systems. Read our tools and guidance for hospitals.
Components of a recognition and response system
Vital sign chart and early warning system: A scoping literature review
Following the implementation of the national adult early warning system (NZEWS) and maternity early warning system (MEWS) across the motu, Adapt Research, on behalf of Te Tāhū Hauora Health Quality & Safety Commission has undertaken a scoping review of recent literature in 2024 to ensure the national adult and maternity vital signs charts remain aligned to best practice.
The literature review found that the NZEWS and MEWS performs comparably to the best-performing paper-based systems and did not find strong evidence that changes to the paper-based charts are warranted.
However, it highlighted that the best-performing early warning systems use integrated electronic systems that can combine demographic information, vital signs and laboratory results to more accurately predict a person’s risk of deterioration.
Read the report: Vital sign charts and early warning systems: A scoping literature review.
Infographic and factsheets
The following infographic and factsheets provide helpful information and links to other resources.
Related Resources
Published: 21 Oct 2021
Modified: 20 Aug 2024
