Realistic Evaluation of Early Warning Systems and the Acute Life-threatening Events--Recognition and Treatment training course for early recognition and management of deteriorating ward-based patients: research protocol.

Aim: This paper is a description of a study protocol designed to evaluate the factors that enable or constrain the delivery and sustainability of Early Warning Systems and the Acute Life-threatening Events--Recognition and Treatment training course in practice.

Background: Rapid response system initiatives have been introduced to try to improve early detection and treatment of patients who deteriorate on general hospital wards. However, recent systematic reviews of the effectiveness of these initiatives show no effect on patient outcomes.