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thumbnail of Sociotechnical factors influencing a digital early warnin

Author
Maeve Moran, Marie Ward, Siobhán Corrigan
Abstract
While digital Early Warning Systems (EWS)—integrated within Electronic Patient Records (EPR)—hold the potential to support the early identification and management of patient deterioration, their real-world effectiveness depends heavily on how clinicians interpret, trust, and integrate them in everyday practice (Wong et al., 2024). This qualitative study uses semi-structured interviews with four groups: physicians, nurses, quality and safety professionals, and information management and systems (IMS) staff. Engaging diverse stakeholder perspectives, this research seeks to generate a comprehensive, cross-disciplinary understanding of the processes shaping digital EWS uptake in a large urban teaching hospital.  Methods Interview topic guides were drawn loosely from the SEIPS 2.0 model (Holden et al., 2013). Questions evoke both broad perspectives on EPR performance as well as EWS-specific insights. Interviews underwent thematic analysis (Braun & Clarke, 2013; Pope & Mays, 2020) to identify patterns across and within professional groups. Results Interviews suggest notable variation in how different professional groups conceptualise the role and value of the digital EWS. Across groups, participants identify both positive outcomes (e.g., clearer escalation cues, automated score calculation, auditability) and concerns (e.g., interface usability, alert fatigue, documentation delays, and system workarounds).  Conclusion This study is beginning to illuminate the complex sociotechnical conditions that shape the adoption of digital EWS in acute care. Findings highlight the importance of aligning digital tools with clinical workflow and supporting professional judgement. This study more broadly highlights the value of qualitative perspectives in healthcare human factors, particularly in healthcare technology design and implementation.