Kathleen Trocki



An Evaluation of the Modified Early Warning Scoring System in an Acute Care Hospital

Primary Investigator: Kathleen K. Trocki, BSN, RN

Purpose: The purpose of this project was to evaluate the effectiveness of the Modified Early Warning Scoring system (MEWS) on improving patient outcomes in an acute care hospital.  The patient outcomes measured included mortality rates, rate of adverse events (AE), rate of patient transfers to a higher level of care and patient discharge dispositions.   

Methods:  This project was a retrospective study evaluating pre and post-implementation data specific to patient mortality rate, rate of patient transfers to a higher level of care, and rate of patients discharged alive post adverse event.  

Results:  Improvements in adverse event outcomes and patient discharge dispositions were seen after the MEWS system was implemented house wide.  A decrease in mortality rate for patient’s experiencing an AE was demonstrated as well as an increase in the rate of patients discharged alive.  

Discussion:  The results of this review were able to demonstrate improved patient outcomes with the implementation of the MEWS system in an acute care hospital.  The increase in rapid response calls seen in this project suggests more patients were receiving clinical evaluations for physiological changes in condition, leading to earlier intervention. The reduction in cardiac arrests and mortality rates seen in the post-implementation period suggests the impact of the process change was able to demonstrate improvement in early clinical assessment, intervention and treatment.  

Conclusions:The Modified Early Warning Scoring System demonstrated a reduction in adverse event mortality rates and improvement in patient discharge dispositions.  The use of an early warning system in the acute care setting has the potential to decrease adverse events, improve patient outcomes and lower healthcare costs.  


Major Professor: Alicia Craig-Rodriguez, DNP, MBA, APRN, FNP-BC  



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