Winning Poster: Leveraging the implementation of an automated scoring system (MPEWS) to earlier identify clinical deterioration of acute care patients

Early identification of clinical deterioration and intervention in pediatric patients is correlated with lower morbidity and mortality. Modified Pediatric Early Warning Score (MPEWS) was a manual scoring system instituted at the organization as an additional layer of monitoring for clinical deterioration (2014). When predetermined threshold was surpassed in the electronic health record (EHR) system, the Recognized Illness Severity in Kids (RISK) team was automatically alerted to evaluate the patient. However, acute care nurses have a variety of barriers and competing priorities that may have delayed real time documentation of MPEWS. Additionally, in 2022, the organization converted its EHR, rendering the MPEWS system non-functional. Recognizing the need for a functional early warning system (EWS), considering lessons learned from previous MPEWS system and incorporating updated research; the organization rebuilt, revamped, and reinstituted a fully automated MPEWS system within the EHR in June 2024. Being fully automated negated the need for bedside nurses to manually score and document MPEWS into the EHR eliminating delays in real time notifications to the RISK team. Post-implementation, preliminary data shows impact in the number of RISK evaluations, rapid responses, and Rescue events (generally defined as requiring ICU level intervention within 2 h of admission to the ICU). The total number of patients the RISK nurse evaluates daily has increased from an average of 46.5 to 59.5. Conversely, the number of rapid responses called daily has decreased from 3.41 to 2.98. Furthermore, the number of Rescue events has decreased from a rate of 0.41 to 0.32 per day. Ongoing data collection will continue to inform and guide early warning system practices within the organization.