JMIR Publications

ABSTRACT

Background:

Acute Respiratory Infections (ARIs) remain a significant global health challenge, ranking as the second leading cause of disease burden and mortality. Early warning systems (EWS) play a key role in detecting clinical deterioration, alerting healthcare providers (HCPs), and supporting pandemic surveillance. While existing literature highlights HCPs positive experiences with EWS in confirming assessments and guiding escalation, their perspectives on optimizing these systems for ARI management remain underexplored.

Objective:

This study aims to qualitatively explore the experiences and insights of frontline clinicians and researchers involved in pandemic response on using EWS for ARI care in Canada.

Methods:

Eleven participants, including primary care providers, emergency department (ED) physicians, and researchers from across Canada, who regularly manage ARI patients or played key roles in pandemic response were individually interviewed. Codebook thematic analysis was employed to identify key patterns and themes, with subthemes emerging under broader thematic categories. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines to ensure transparency and rigor.

Results:

Three overarching themes emerged: 1- General knowledge: participants demonstrated a broad understanding of EWS, including their role during the COVID-19 pandemic and in ARI management; 2- Desirable attributes: an ideal EWS should be accurate, timely, integrated, and equitable within the Canadian healthcare system; and 3- Anticipated challenges: barriers were categorized into four stages of EWS development: initiation, implementation, use, and evaluation, with each presenting distinct obstacles relevant to Canada’s healthcare landscape.

Conclusions:

This study highlights perspectives on EWS for ARI management and pandemic preparedness in Canada from those directly involved in patient care and public health response. Findings underscore the need for co-designing EWS with experts and key stakeholders to enhance their effectiveness and integration into clinical practice across Canada.