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

Child Health BC in collaboration with the BC Regional Health Authorities, have become 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 after one year, 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?

Child Health BC redesigned the PEWS documentation based on the evaluation results and developed a PEWS Refresher Course as an online education resource.  
To further complement the above an online course is now available for physicians 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.
Results of the BC PEWS ED research were shared with the health authorities for further discussion on optimization of the system including the integration of PEWS in the electronic health records to help address efficiency.
Child Health BC continues to promote and support the use of BC PEWS and BC PEWS ED as systems to be used collaboratively and with clinical judgement.