Development and Implementation of an Automated Electronic Maternal Early Warning System (E-MEWS) in a Level IV...

Area of Science:

• Obstetrics and Gynecology
• Health Informatics
• Patient Safety

Background:

• Increasing rates of maternal morbidity and mortality in the United States.
• Need for effective strategies to detect and reduce adverse maternal outcomes.
• Potential of automated early-warning surveillance systems in obstetric care.

Purpose of the Study:

• To report the development and implementation of an electronic Maternal Early Warning System (E-MEWS).
• To integrate an automated alert notification platform into the electronic medical record (EMR).
• To demonstrate the logistics of implementing a MEWS within an EMR system.

Main Methods:

• Development of E-MEWS triggers and alert system in three iterative phases.
• Incorporation of changes based on interim audit analyses.
• Implementation within a Level IV obstetric unit at Lucille Packard Children's Hospital Stanford.

Main Results:

• Successful development and integration of the E-MEWS into the EMR.
• Identification of logistical considerations and necessary modifications for operational functionality.
• The study focused on the implementation process, not the clinical impact.

Conclusions:

• The E-MEWS represents a feasible approach to integrating early warning systems into EMRs.
• Implementation requires careful planning, iterative refinement, and adaptation to clinical workflows.
• Further studies are needed to evaluate the impact of E-MEWS on maternal morbidity and mortality.