[Early Warning Scores at the nursing ward: what do you really want to know?]

Early Warning Scores (EWSs) are based on the assumption that critical illness is preceded by physical deterioration. The question is whether measuring 5 vital parameters several times a day can predict changes in a highly complex and dynamic clinical condition. Little evidence has yet been found for clinical superiority of current EWSs over good clinical assessment. If we want to predict better and act structurally proactively, the measurement frequency of vital parameters must increase and much more complex scores are needed to identify specific changes in individual patients at an early stage. It is plausible that the many innovative developments in this area are the stepping stone to an era in which care in regular nursing wards is increasingly directed in the right direction by predictive algorithms. Integration of such super EWSs in new working methods may contribute to continuously adaptive care that is ultimately better and more efficient and relieves the care provider.