Recognising when a patient's condition is deteriorating is a key aspect of patient safety and the use of early warning scoring systems is integral to this. Compliance with such systems can often be poor. Through the introduction of a competency framework and audit system, the Heart of England NHS Foundation Trust has demonstrated improvements in compliance with a modified early warning scoring tool, which has had significant benefits in terms of patient safety.
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Maries-Tillott et al. (2008) studied this question.