Development and Implementation of an Automated Electronic Maternal Early Warning System (E-MEWS) in a Level IV Obstetric Unit

Maternal morbidity and mortality are increasing in the United States of America (USA), and automated early-warning surveillance systems have been suggested as a strategy to detect and reduce maternal morbidity and mortality. We report the development and implementation of a Maternal Early Warning System (MEWS) and automated alert notification platform into the electronic medical record (EMR) at the level IV obstetric unit at Lucille Packard Children's Hospital Stanford (Palo Alto, California, USA). This has been named E-MEWS. The development of the E-MEWS triggers and alert system occurred in three phases, each phase incorporating changes following analysis of interim audits. Here, we demonstrate the logistics involved in implementing MEWS into an EMR, including potential modifications required for operational functionality. The impact on maternal morbidity and mortality was not measured in this study.