The Intersection Of Cognitive Competence And Organizational Support In Early Warning System (Ews) Accuracy: A Multifactorial Analysis In A Regional Hospital Setting

Background : Failure to recognize clinical deterioration remains a global systemic challenge leading to preventable hospital mortality. Aims: This study evaluated the multifactorial determinants predicting the accuracy of Early Warning System (EWS) implementation among clinicians in a regional hospital setting. Methods: An analytical observational study with a cross-sectional design was conducted in 2025 at RSUD Perdagangan, Indonesia, involving 203 health professionals (specialists, general practitioners, midwives, and nurses) using total sampling. Data were collected via validated questionnaires and analyzed using Chi-square tests. Results: Statistical analysis revealed that knowledge (p=0.001), training (p=0.002), attitude (p=0.005), and organizational support (p=0.001) significantly correlate with EWS implementation accuracy. Notably, 77.1% of clinicians failed to implement EWS effectively in environments lacking managerial support. Discussion: These findings highlight that EWS precision is a manifestation of cognitive competence integrated with systemic organizational reinforcement. Conclusion: Bridging the "accuracy gap" requires a paradigm shift from administrative compliance to a robust patient safety ecosystem that integrates structured training and active managerial oversight.