Implementing Obstetric Early Warning Systems

AbstractSevere maternal morbidity and mortality are often preventable and obstetric early warning systems that alert care providers of potential impending critical illness may improve maternal safety. While literature on outcomes and test characteristics of maternal early warning systems is evolving, there is limited guidance on implementation. Given current interest in early warning systems and their potential role in care, the 2017 Society for Maternal-Fetal Medicine (SMFM) Annual Meeting dedicated a session to exploring early warning implementation across a wide range of hospital settings. This manuscript reports on key points from this session. While implementation experiences varied based on factors specific to individual sites, common themes relevant to all hospitals presenting were identified. Successful implementation of early warnings systems requires administrative and leadership support, dedication of resources, improved coordination between nurses, providers, and ancillary staff, optimization of information technology, effective education, evaluation of and change in hospital culture and practices, and support in provider decision-making. Evolving data on outcomes on early warning systems suggest that maternal risk may be reduced. To effectively reduce maternal, risk early warning systems that capture deterioration from a broad range of conditions may be required in addition to bundles tailored to specific conditions such as hemorrhage, thromboembolism, and hypertension.

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Early warning systems in maternity care: protocol for a qualitative evidence synthesis of maternity care providers’ views and experiences

HRB Open Research ◽

10.12688/hrbopenres.13270.1 ◽

2021 ◽

Vol 4 ◽

pp. 59

Author(s):

Valerie Smith ◽

Kumaresan Cithambaram ◽

Deirdre O'Malley

Keyword(s):

Early Warning ◽

Maternity Care ◽

Qualitative Data ◽

Evidence Synthesis ◽

Early Warning Systems ◽

Successful Implementation ◽

Qualitative Evidence Synthesis ◽

Warning Systems ◽

Care Providers ◽

Qualitative Evidence

Background: Early warning systems (EWS) have been widely adopted for use in maternity settings internationally. The idea in using these systems is early recognition of potential or actual clinical deterioration in pregnant or postpartum women, and escalation of care. Barriers to successful implementation and use of EWS, however, have been identified. If EWS are to be applied consistently, a greater understanding of the views and experiences of EWS from the perspectives of those using and applying EWS in maternity practice is needed. This protocol describes a qualitative evidence synthesis of maternity care providers’ (midwives, obstetricians, and allied maternity care professionals) views and experiences of EWS use and application in practice. Methods: Studies will be included in the review if they report on maternity care providers use and application of EWS in any birth setting. Qualitative studies and studies of mixed methods design, where qualitative data can be extracted separately, will be included. To source relevant literature the electronic databases of MEDLINE, CINHAL, Web of Science Core Collection (incorporating Social Science Citation Index) and Maternity and Infant Care (MIDIRS), from date of inception, will be searched. The methodological quality of the included studies will be appraised using the 12-criteria of the assessment tool developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. Thematic synthesis will be used for synthesising the qualitative data from included studies. The confidence in the findings will be assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research. Conclusions: The findings of this qualitative evidence synthesis may provide valuable information on the barriers, challenges, and facilitators for EWS use based on the experiences of those directly involved in EWS application in maternity care provision. PROSPERO registration: CRD42021235137 (08/04/2021)

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Risk-based modeling of early warning systems for pollution accidents

Water Science & Technology ◽

10.2166/wst.2002.0050 ◽

2002 ◽

Vol 46 (3) ◽

pp. 41-49 ◽

Cited By ~ 16

Author(s):

W.M. Grayman ◽

R.M. Males

Keyword(s):

Early Warning ◽

Warning System ◽

Early Warning Systems ◽

Ohio River ◽

Warning Systems ◽

Simulation Techniques ◽

Wide Range ◽

Contamination Event ◽

Probabilistic Nature ◽

The Impact

An early warning system is a mechanism for detecting, characterizing and providing notification of a source water contamination event (spill event) in order to mitigate the impact of contamination. Spill events are highly probabilistic occurrences with major spills, which can have very significant impacts on raw water sources of drinking water, being relatively rare. A systematic method for designing and operating early warning systems that considers the highly variable, probabilistic nature of many aspects of the system is described. The methodology accounts for the probability of spills, behavior of monitoring equipment, variable hydrology, and the probability of obtaining information about spills independent of a monitoring system. Spill Risk, a risk-based model using Monte Carlo simulation techniques has been developed and its utility has been demonstrated as part of an AWWA Research Foundation sponsored project. The model has been applied to several hypothetical river situations and to an actual section of the Ohio River. Additionally, the model has been systematically applied to a wide range of conditions in order to develop general guidance on design of early warning systems.

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The CARE Telematics Network for the Surveillance of Influenza in Europe

Methods of Information in Medicine ◽

10.1055/s-0038-1634617 ◽

1995 ◽

Vol 34 (05) ◽

pp. 518-522 ◽

Cited By ~ 13

Author(s):

M. Bensadon ◽

A. Strauss ◽

R. Snacken

Keyword(s):

Public Health ◽

Early Warning ◽

Early Warning Systems ◽

Warning Systems ◽

Surveillance Networks ◽

Spanish Flu ◽

The 1950S ◽

National Networks ◽

First Time

Abstract:Since the 1950s, national networks for the surveillance of influenza have been progressively implemented in several countries. New epidemiological arguments have triggered changes in order to increase the sensitivity of existent early warning systems and to strengthen the communications between European networks. The WHO project CARE Telematics, which collects clinical and virological data of nine national networks and sends useful information to public health administrations, is presented. From the results of the 1993-94 season, the benefits of the system are discussed. Though other telematics networks in this field already exist, it is the first time that virological data, absolutely essential for characterizing the type of an outbreak, are timely available by other countries. This argument will be decisive in case of occurrence of a new strain of virus (shift), such as the Spanish flu in 1918. Priorities are now to include other existing European surveillance networks.

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