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A Pediatric Hospital-wide Asthma Severity Score (HASS): Reliability and Effectiveness
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  • Sarah McBride,
  • Kendall McCarty,
  • Jackson Wong,
  • Marc Baskin,
  • Denise Currier,
  • Vincent W. Chiang
Sarah McBride
Boston Children's Hospital

Corresponding Author:[email protected]

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Kendall McCarty
Boston Children's Hospital
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Jackson Wong
Broward Health Medical Center
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Marc Baskin
Boston Children's Hospital
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Denise Currier
Boston Children's Hospital
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Vincent W. Chiang
Boston Children's Hospital
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Background: Asthma is a leading cause of pediatric hospitalization in the United States. Children hospitalized with asthma are often cared for in different care settings during a single hospitalization. Our objective was to study the reliability and safety of a new pediatric hospital-wide asthma severity score (HASS) across different care units within a single tertiary-care pediatric center. Methods. 150 patients between the ages of 2 and 18 years hospitalized with a principal diagnosis of status asthmaticus were included. Study patients were followed from initial triage in the emergency department until the time of medical readiness for discharge. Rates of medical errors, early transfers to a higher level of care and medically indicated hospital length of stay (LOS) were compared between 75 patients prior to and 75 patients after implementation of the HASS using retrospective chart review. Inter-rater reliability was determined by collecting independent HASS scores from blinded staff members after tandem or simultaneous patient assessment. Results. Inter-rater reliability among untrained staff members using the HASS was high. Rates of preventable adverse events and medical errors were low and not significantly different before and after implementation of the HASS. LOS was shorter after implementation of the HASS but without statistical significance. Rates of early transfer to a higher level of care were unchanged between study years. Conclusion. The HASS is a reliable asthma severity tool that can be used throughout hospitalization and also among multiple clinical providers to trend clinical progress and optimize communication, particularly during times of care handoffs.
11 Feb 2021Submitted to Pediatric Pulmonology
12 Feb 2021Submission Checks Completed
12 Feb 2021Assigned to Editor
15 Feb 2021Reviewer(s) Assigned
05 Mar 2021Review(s) Completed, Editorial Evaluation Pending
08 Mar 2021Editorial Decision: Revise Major
12 Jun 20211st Revision Received
17 Jun 2021Assigned to Editor
17 Jun 2021Submission Checks Completed
17 Jun 2021Reviewer(s) Assigned
16 Jul 2021Review(s) Completed, Editorial Evaluation Pending
02 Aug 2021Editorial Decision: Revise Minor
30 Oct 20212nd Revision Received
01 Nov 2021Submission Checks Completed
01 Nov 2021Assigned to Editor
01 Nov 2021Reviewer(s) Assigned
22 Nov 2021Review(s) Completed, Editorial Evaluation Pending
22 Nov 2021Editorial Decision: Revise Minor
14 Jan 20223rd Revision Received
17 Jan 2022Submission Checks Completed
17 Jan 2022Assigned to Editor
17 Jan 2022Reviewer(s) Assigned
07 Feb 2022Review(s) Completed, Editorial Evaluation Pending
12 Feb 2022Editorial Decision: Accept
May 2022Published in Pediatric Pulmonology volume 57 issue 5 on pages 1223-1228. 10.1002/ppul.25861