Introduction The use of early warning score (EWS) charts in Obstetrics has been recommended for all maternity patients (CEMACH) to aid in prompt diagnosis of critically ill patients. Our current postnatal EWS system at Nottingham City Hospital has improved recognition of unwell patients (local audit). Current antenatal practice uses the postnatal EWS chart in combination with an old-style observation chart to record both maternal and fetal observations.

The authors introduced a novel antenatal EWS chart which records both maternal and fetal observations. Involving staff in a change of practice by means of a questionnaire helps improve implementation and motivation to accept change. Feed back also allows changes to be made to the chart if necessary.

Methods Midwives and Doctors views of the new chart were assessed using a questionnaire. The impact of the chart on documentation, early intervention, reduction in un-necessary calls and ease of finding information were assessed using a Likert score. Space for free text feed back was also provided.

Results All the Midwives felt the authors should continue using the chart. Only one Doctor did not like the chart and felt that it should not be used anymore. The most common negative feed back was that the printing quality was poor and it was difficult to read the chart.

Conclusion The new chart is generally liked by staff and they feel that it does improve documentation. Staff feed back has provided information about training needs as well as highlighting minor changes required.