This project has been a collaborative one between the NHS Institute for Innovation and Improvement (NHSIII) and major Trusts in England, e.g. Great Ormond Street Hospital for Children and the Royal Free NHS Foundation Trust.
Previously almost every hospital in the UK used different PEWS charts and calculated PEWS in different ways. There is limited research into the trigger points for scoring and escalation. Even where a system is in place, usage can be variable, scoring unreliable, and escalation unstructured. The NHS Institute led a collaborative with paediatric units across England to address some of the design and implementation issues. They have produced resources which are free and available on their website.
Staff at NHSIII worked with nurses and doctors at the Royal Free NHS Foundation Trust in North London to develop and test the prototype charts. Using established models for improvement and small scale tests of change (PDSA cycles), the chart design was refined and the escalation procedure using SBAR was added.
The project was further tested in a number of major paediatric units in Trusts in England.
18 months after the project was completed, the charts are still in use and paediatric units are currently updating them to support further improvements.