"We receive referrals from a number of avenues--from EWSS triggers, medical and nursing staff, and emergency calls.
A MEMBER of the PART receives a referral for a patient who is triggering the EWSS. The PART nurse receives a handover from the ward nurse, who provides a brief background on the patient.
This is a significantly different organisational approach from most other CCO teams where, most commonly, CCONs only review patients with either high EWSs or those that ward nurses have directly referred to the service.
She explained that EWSs may "fail to guide nurses in recognising deterioration as the abnormal vital signs are at odds with how patients appear to nurses" (p4).
 EWSs are known for their ability to detect physiological changes relating to vital signs.
It is acknowledged that accurate triage is compromised when using EWSs without considering clinical discriminators such as purpuric rash and dehydration.
Kathy Duncan, RN, faculty expert on Rapid Response Teams for IHI, says an EWSS
can add another layer of early detection to the Rapid Response Team system.
The development and implementation of EWSs are likely to be costly and labor intensive; thus, several factors must converge to support their use.
However, it is likely that EWSs that provide broad coverage will be more expensive to operate and maintain than EWSs that provide narrow coverage; therefore, the cost-benefit ratio for each system and decisions regarding desirability must be assessed at the local level.