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A pediatric hospital-wide asthma severity score: Reliability and effectiveness
Sarah C McBride1, Kendall McCarty1, Jackson Wong1,2
1Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.
Pediatric Pulmonology
|February 19, 2022
Summary
The hospital-wide asthma severity score (HASS) is a reliable tool for pediatric asthma patients. It improves communication among providers without impacting hospital length of stay or adverse events.
Area of Science:
- Pediatric Pulmonology
- Healthcare Quality Improvement
- Clinical Assessment Tools
Background:
- Asthma is a major cause of pediatric hospitalizations in the U.S.
- Fragmented care settings challenge communication about asthma severity.
- A need exists for a standardized pediatric asthma severity assessment.
Purpose of the Study:
- To assess the feasibility, reliability, and safety of the hospital-wide asthma severity score (HASS).
- To evaluate HASS implementation across diverse care units in a tertiary pediatric center.
Main Methods:
- Retrospective chart review of 150 pediatric patients (2-18 years) with status asthmaticus.
- Comparison of outcomes (errors, transfers, length of stay) before and after HASS implementation.
- Assessment of interrater reliability using blinded staff evaluations.
Main Results:
- High interrater reliability was observed for the HASS among untrained staff.
- No significant differences in hospital length of stay, adverse events, medical errors, or early transfers were found post-HASS implementation.
- The HASS demonstrated feasibility and reliability in a real-world hospital setting.
Conclusions:
- The HASS is a reliable tool for trending clinical progress in hospitalized pediatric asthma patients.
- HASS optimizes communication among providers, especially during care handoffs.
- The score can be effectively used across multiple clinical settings and providers.
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