Clinical medicine (London, England)
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Comment Letter
Hyperbaric oxygen therapy for the treatment of long COVID.
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The National Early Warning Score 2 (NEWS2) is the established track and trigger system to assess illness severity and risk of deterioration for patients in acute episodes of care in the UK. It is also increasingly used internationally. In this article, we outline established and recommended practice for initial and ongoing assessment. We also highlight where practice may not meet these standards, how the full context and assessment of the patient is paramount, and opportunities for more accurate assessment in the future.
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This year is the 10th anniversary since the launch of the National Early Warning Score (NEWS) by the Royal College of Physicians in 2012. This review reflects on the journey, from the nascent concept of a standardised system to detect acute illness severity and clinical deterioration through to the adoption of NEWS2 by the NHS and, ultimately, its incorporation into quality indicators of acute care provision. The impact of NEWS/NEWS2 on the transformation of provision and configuration and training of acute care teams in hospitals is reviewed. ⋯ The ultimate aim of NEWS was to improve patient outcomes with acute illness or deterioration and the impact on outcomes is now becoming apparent but, paradoxically, an effective response can eliminate the link between the score and the ultimate outcome. This review concludes with a reflection on what the next 10 years may bring, particularly with the digital transformation of healthcare and its potential impact on scoring systems, as well as the necessary permeation of NEWS2 beyond the acute hospital setting into emergency response triage in primary and community care settings. Ten years on, via NEWS/NEWS2, the NHS is the first healthcare system globally with a 'common language' of illness severity and a standardised early warning system for acute clinical illness and deterioration, a system that is now being replicated in many other areas of the world.
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Early detection, timeliness and competence of clinical response are a triad of determinants of clinical outcome in people with acute illness. In 2012, the Royal College of Physicians published the National Early Warning Score (NEWS) with the aim of standardising the response to, assessment of and monitoring of acutely ill patients. ⋯ Alongside the development of NEWS/NEWS2, it was clear that a supportive educational package was going to be essential for dissemination, learning and national adoption of NEWS/NEWS2 across all healthcare settings. Another driver for the early development of an e-learning package to accompany the launch of NEWS in 2012 was the opportunity that it provided not only to standardise the early warning system across the NHS but also to use that standardised process to facilitate better and more consistent education and training across the entire healthcare system; building on the concept of NEWS providing a common language.