The second set of interventions was targeted at medical wards only: two announcements at the departmental meetings, two group emails to the consultant body, a targeted email to senior ward nurses and documented discussions at two morbidity and mortality meetings, creating a control arm (acute medical wards) and an intervention arm (medical wards). There was no significant difference in EWS amendment in the control group between 2018 and 2019 (Table 1). Interestingly, a recent study showed that nurses' pattern recognition can provide important information for the detection of acute physiological deterioration. ...data is required from different healthcare settings where EWS are implemented to limit futile activity, avoid distress for dying patients and their relatives and make more appropriate use of nursing resources.