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Modified Early Warning System (MEWS)

Modified Early Warning System (MEWS)

What is the Modified Early Warning System?

MEWS is a tool that is used by your healthcare team to quickly see if there have been changes to your health condition. MEWS calculates a score that helps them see if changes to treatment or medicines are needed for your care. The MEWS score is made up of 6 pieces of information, including heart rate, blood pressure, and breathing rate. MEWS helps give the healthcare team a “snapshot” or quick look at your overall health condition at that time.

Checking your vital signs is a routine part of any hospital stay. Tracking key information (like your temperature and heart rate) over time gives your nurses and doctors a quick look of how you’re doing during your hospital stay. 

Vital signs awareness systems and tracking has been used in hospitals for many years. MEWS gives a score based on changes to commonly measured vital signs. The tool gives scores based on changes within a single vital sign and it contributes to an overall score. Small changes can be picked up more quickly and your healthcare team is able to act or make changes to your care sooner if they need to.

What does the MEWS score do?

By itself, the score doesn’t do anything. Your MEWS score does help show patterns in your health information. Your healthcare team will use the MEWS information and act on it to give you the appropriate care for your health needs.

Sometimes it’s hard to see how sick a person is by just looking at them or taking a single vital sign reading. The scoring ranges help show how sick you are or if you’re getting better. This helps guide the actions of your healthcare team. The MEWS score also gives them a tool to better talk to each other about changes they see in your overall condition.

Your healthcare team develops a care plan that includes what they need to do to meet your specific healthcare needs. To make decisions about your care plan, your healthcare team uses information that includes:
  • your MEWS score
  • your medical history and what other health conditions you have
  • what you and your family or caregivers tell them about how you’re feeling and what they see

For example, a change in score could prompt your healthcare team to review what medicines you’re on or may need. They may add more tests, treatments, or therapies to your care plan. 

What does it mean if I have a high score?

A high MEWS score can mean different things depending on your situation. It can mean that your health condition is changing and that you need more or different treatment or medicines. But sometimes a high score is normal. There are some areas of the hospital where you’d expect to have higher Early Warning System (EWS) scores.

For example:
  • If you just came out of surgery, your EWS score would be higher. In that case a high EWS score is normal.
  • Some people have pre-existing conditions that will give them a higher score to start than others. This would be considered normal for that person.

A change from your baseline score is what your healthcare team will watch for. To make sure that you’re safe it may be necessary to check vital signs even if you’re sleeping. Talk to your healthcare team if you have any questions about this.

Has MEWS been used before?

Many hospital healthcare teams have been using this kind of tool for a long time. It’s used to help them make decisions and plan for each person’s care. The MEWS is a way of showing helpful information so your healthcare team can see and respond more quickly to changes. Many studies have shown this scoring tool is useful in helping to prevent or reduce adverse events.

When and where is my score seen?

Your MEWS score can be seen when your healthcare provider opens your chart while you're in hospital. This information is only on your chart while you’re in the hospital. It doesn’t get saved in your personal health record. However, the tests, treatments, and care that come from decisions based on your score will be included in your health record.

The MEWS score is a helpful tool or guide for your healthcare team and is only a single part of your entire health assessment. How you look and feel, along with all the other clinical information about you, gives the best picture of how you’re doing.

If you’re worried or have questions, ask a healthcare team member involved in your care about your score and what it means for you.

Current as of: June 19, 2023

Author: Early Warning Scores Group - Alberta Health Services