This study aims to analyze the implementation of EWS according to standards and the factors that influence the implementation of EWS inpatient care Siloam Hospitals Balikpapan. The object in this study was Inpatient Room at Siloam Hospitals Balikpapan (SHBP). This type of research used the qualitative method and field research. Primary data were obtained from in-depth interviews with structural and functional staff related to inpatient room. Secondary data were obtained in the form of EWS for inpatient patient which measures in April-May 2019. Qualitative analysis is used to see the relationship between factors (communication, resources, disposition, and bureaucratic structure) on EWS implementation. The results of the study showed that (1) The implementation of EWS hospitalized by SHBP has not yet run according to the standards. Completeness of documents that are closely related to the implementation of the EWS SOP that has been set is still 81%; (2) The implementation of EWS Monitoring inpatient services at SHBP has been carried out even though it has not been contained in the EWS implementation policy on how the EWS monitoring is carried out by the development Nursing initiative aimed at getting an overview of the results of the EWS implementation inpatient care at SHBP. The description of EWS implementation monitoring is hospitalized by SHBP in total, 87% consisting of eight forms related to EWS as much as 86% and officers\\\' knowledge about EWS is 81%; (3) Factors influencing the implementation of EWS hospitalized by SHBP consist of communication, resources, disposition and bureaucratic structure.