Early Warning System

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Early Warning System

A quality improvement intervention to improve the care of acutely ill patients

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Patients admitted to hospital are at risk of becoming more unwell and potentially developing critical illness. In LMICs critical illness carries a high risk of death and so early recognition and effective treatment is vital to save lives.

This innovative project is harnessing our data gathering, data analytics and quality improvement expertise to improve acute care provision for the patients at District General Hospital Moneragala, rural South East Sri Lanka. The project uses both real time vital signs data display and clinical skills training to enable staff at the hospital to recognise and respond to patients who are becoming sicker and are at risk of becoming critically ill. The project has seen the appointment of a team of locally developed and empowered Rapid Response Nurses who work across wards with the multidisciplinary team to help provide hands-on clinical support for the sickest patients. NICST is collaborating directly with the hospital leadership and frontline staff at the hospital, providing expert input, facilitation and training to enable the local team to drive improvement in their acute care wards. Rapid response nurses assessing a patient identified as unwell our system. Once assessed their observations are immediately displayed so that their progress can be seen by all the team both on the ward and remotely.

The learning from this pilot project in Sri Lanka has potentially far reaching implications both across the Sri Lankan health system and globally. For instance, whilst the Rapid Response Nurse model is common in the United Kingdom currently only a handful of hospitals combine this with data analytics systems. The ability to use such systems to assist healthcare teams in the earlier recognition of the acutely ill patient may offer real potential to improve the quality and safety of care. Our quality improvement and training project is part of a wider research study to evaluate the effects of our activities. Further information on the Rapid Response System Project is summarised at https://clinicaltrials.gov/ct2/show/NCT0252


  1. Help nurses and doctors recognise deteriorating conditions
  2. Help doctors and nurses care for the sickest patients more effectively
  3. Prevent avoidable deaths and improve outcomes for the sickest patients



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Please click here to view the datasheet