Fig. 1

Study flow diagram of the systematic search. The systematic search was conducted for six review questions. These include: 1: What EWSs and or track and trigger systems are currently in use for the detection or timely identification of physiological deterioration in adult (non-pregnant) patients in acute health care settings? 2: How effective are the different EWSs in terms of improving key patient outcomes in adult (non-pregnant) patients in acute health care settings? 3: What education programmes have been established to train healthcare professionals (HCPs) relating to the implementation of EWSs or track and trigger systems for the detection/timely identification of physiological deterioration in adult (non-pregnant) patients in acute health care settings? 4: What are the findings from the economic literature on cost-effectiveness, cost impact and resources involved with the implementation of EWSs or track and trigger systems for the detection or timely identification of physiological deterioration in adult (non-pregnant) patients in acute health care settings? 5: Are modified EWSs (e.g. CREWS) more effective than the NEWS for the detection or timely identification of physiological deterioration in specific adult sub-populations in acute health care settings? 6: Why do HCPs fail to escalate as per the NEWS escalation protocol? * = Note the total number of eligible studies is (n = 154). However the total across all six review questions equals more than n = 154 as some studies were eligible for more than one review question