The Health Quality & Safety Commission has developed a national paediatric early warning system (PEWS) to help clinicians identify hospitalised tamariki with the potential to become more unwell, so they can respond quickly.

The system includes:

• four standardised paediatric vital signs charts (or electronic equivalent), banded by age, with early warning scores
• a localised escalation pathway
• effective clinical governance and leadership
• clinical and non-technical education and training resources
• ongoing measurement for improvement
• an escalation process for clinician, tamariki and whānau concerns.

The paediatric vital signs charts are similar to those in the existing national adult early warning system, which the Commission has introduced to hospitals as part of its patient deterioration programme. They use seven vital sign parameters to calculate a paediatric early warning score. When the score is reached, it triggers a response following the local escalation pathway, so the appropriate actions can be taken to manage the tamariki’s condition.