Pediatric Early Warning System (PEWS)

Background/ Why Is This Important?

Pediatric Early Warning Systems (PEWS) are used internationally to promote early identification and mitigation of deterioration in hospitalized pediatric patients. BC health authority leaders and clinicians have identified the implementation of PEWS as a high priority in hospitals that care for children across sites at all Tiers of Service.

The Child Health BC Steering Committee endorsed a standardized approach to the development, implementation and evaluation of PEWS in BC hospitals (BC PEWS) .  
BC PEWS is a five-component system that provides a standardized framework and language to identify potential deterioration in a child, mitigate the risk and escalate care as needed as early as possible. 

Overview video



What Actions Have Already Been Taken?


PEWS combined image

Through the work of Child Health BC and collaborating Regional Health Authorities, British Columbia is the first jurisdiction in North America to adapt a province-wide standardized early warning system for pediatrics. To date: 

•    50 hospitals have implemented BC PEWS in their inpatient units.  
•    97 hospitals/health centers & 7 First Nations Health Authority Nursing Outposts have implemented BC PEWS ED in their Emergency Departments
•    The inpatient implementation was comprehensively evaluated at the end of year one, showing positive outcomes overall with some opportunity for further development.
•    A research pilot at Richmond Hospital Emergency Department (ED): demonstrated the potential value of using PEWS in the ED and has been published in BMC Emergency Medicine.


Where Are We Now?

Based on evaluation and research results, Child Health BC redesigned the PEWS documentation and developed a
PEWS Refresher Course as an online education resource. 

A new short online course for physicians is now available and located in our Formal Learning section. This accredited course was developed in partnership with UBC CPD and is designed for physicians working in emergency and inpatient settings.

Child Health BC is partnering with provincial stakeholders to research BC PEWS ED within 16 sites representing EDs at each Tier of Service across all health authorities. The study involves two phases; the first is an ongoing survey of direct care providers. The second uses medical record review and administrative data to answer defined questions related to implementation fidelity, impact on care, patient outcomes and the health system, and diagnostic performance of PEWS in the ED setting.