TARGET: STROKE MEASURE Door to IV rt-PA in 60 minutes (Historic-Quality): Percent of ischemic stroke patients receiving IV t-PA at your hospital who are treated within 60 minutes after triage (ED arrival). Measure Set Stroke Measure ID # STR-1 Measure Name Prehospital Screening for Suspected Stroke Patients <>>> There are currently at least 5 major US-based stroke quality improvement programs implementing stroke measures. STK-2 Discharged on Antithrombotic Therapy13. Monthly sampling for the Hemorrhagic sub-population for Joint Commission certification purposes: A hospitals Hemorrhagic sub-population is 228 during March. % The change in the performance measure requirements for Acute Stroke Ready Hospitals, (i.e., STK-OP-1 replacing ASR-OP-2 effective with discharges on and after July 1, 2021) can be found in several places. A hospitals Hemorrhagic sub-population is 3 patients during the first quarter. If the ICD-10-CM Principal Diagnosis Code is on Table 8.1, the patient is in the first Ischemic Stroke sub-population and is eligible to be sampled for the first STK sub-population. A hospitals ischemic stroke patient population size is 200 patients during March. Using the monthly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 25 cases for the month. An official website of the United States government If the Length of Stay is less than or equal to 120 days, continue processing and proceed to ICD-10-CM Principal Diagnosis Code Check. CPT only copyright 2019 American Medical Association. Researchers also have the opportunity to conduct investigator-led research projects using data from the Get With The Guidelines- Stroke program. Using the quarterly sampling table for the Ischemic sub-population, the sample size is less than the minimum required quarterly sample size, so 100% of this sub-population is sampled. x\_s6fE4f+[Itd2)Q" 2tIB.|Qe{r?);|_gb-rv>XS?m>`_\WNO>(b\@~f'4( L`yXS7?b!0@qp) Find out about the current National Patient Safety Goals (NPSGs) for specific programs. CMS will go through a public notice and comment rule-making for implementation of these core sets and looks forward to public input on the measures included in these core measure sets. 1 0 obj Head CT or MRI Scan Results for Acute Ischemic Stroke or Hemorrhagic Stroke Patients who Received Head CT or MRI : Scan Interpretation Within 45 minutes of ED Arrival: 2012 . They are responsible for making the necessary updates to the measure and for informing NQF (National Quality Forum) about any changes that are made to the measure on an annual basis. The AMA does not directly or indirectly practice medicine or dispense medical services. Set the Initial Patient Population Reject Case Flag to equal No. ** The Adult Core Set includes the NCQA version of the measure, whichis adapted from the CMS measure (NQF #1879). <> 2021). Using the quarterly sampling table for the Ischemic sub-population, the sample size required is 20% of this sub-population, or 79 cases for the quarter (twenty percent of 392 equals 78.4 rounded up to the next whole number equals 79). >0SPJ*@6W/rq+ERY_X&14>k( The primary goal of rehabilitation is to prevent complications, minimize impairments, and maximize function. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. <> For information concerning how to perform sampling, refer to the Population and Sampling Specifications section in this manual. This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the American Medical Association, 330 North Wabash Avenue, Chicago, Illinois 60611. Commercial health plans are rolling out the core measures as part of their contract cycle. A hospitals hemorrhagic stroke patient population size is 60 cases during March. It is important to always refer to the latest edition. *** AHRQ is the measure steward for the survey instrument in the Adult Core Set (NQF #0006) and NCQA is the developer of the survey administration protocol. 3 0 obj But hospitals see benefits as well. CSTK-10a Functional Status Prior to Stroke-Independent: IV Alteplase Only2. The two Measure Stewards (CMS and TJC) require hospitals to submit their chart-abstracted data in two different ways. The goal is to establish broadly agreed upon core measure sets that could be harmonized across both commercial and government payers. endobj Percent of ischemic stroke patients with atrial fibrillation or atrial flutter who are prescribed anticoagulation therapy at hospital discharge. hWn8,CIDE ;its8MZAt,9!%_e'Kaxs8>f9! Create your baseline by entering 30 records into the Patient Management Tool. A hospitals ischemic stroke patient population size is 7 cases during March. % *7.`"}K3t;qBEN]1F"9V>7[?)] A hospitals hemorrhagic stroke patient population size is 67 cases during the second quarter. We keep you on track for your submission deadlines and ensure you dont miss critical dates. Of FSRMC patients treated with tPA, a clot-dissolver, or who underwent a procedure to retrieve a blood clot, 2.4% experienced complications, compared to the national average complication rate of 6.8%. <> STK-6 Discharged on Statin Medication9. This content does not have an English version. Measure 6a is new and is being pilot tested in 2009. ASR-IP-3: Discharged on Antithrombotic Therapy4. The American Medical Association reserves all rights to approve any license with any Federal agency. This item requires a Core Return or Core Charge. Patients admitted to the hospital for inpatient acute care are included in the CSTK 1-Ischemic Stroke Without Procedure subpopulation sampling group if they have: ICD-10-CM Principal Diagnosis Code as defined in Appendix A, Table 8.1, a Patient Age (Admission Date Birthdate) 18 years and a Length of Stay (Discharge Date - Admission Date) 120 days. Visit: . 646 0 obj <> endobj A hospitals hemorrhagic stroke patient population size is 200 cases during the second quarter. A hospitals hemorrhagic stroke patient population size is 129 cases during March. CSTK-05b:Hemorrhagic Transformation Patients Treated with Intra-Arterial (IA) Thrombolytic (t-PA) Therapy or Mechanical Endovascular Reperfusion Therapy, 2. A hospitals ischemic stroke patient population size is 392 cases during the second quarter. Written by American Heart Association editorial staff and reviewed by science and medicine advisers. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Please see link below for more information. The required quarterly sample is 45 cases. Domain-specific outcomes for stroke clinical trials: what the modified Rankin isn't ranking. Measure Information 2021 Reporting Period; CMS eCQM ID: CMS71v10 Short Name: STK-3 NQF Number: Not Applicable Description: Ischemic stroke patients with atrial fibrillation/flutter who are prescribed or continuing to take anticoagulation therapy at hospital discharge. One-hundred and twenty-three (123) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during March. These measures include aggressive use of medications, such as antithrombotics, anticoagulation therapy, deep vein thrombosis prophylaxis, cholesterol-reducing drugs and smoking cessation, all aimed at reducing death and disability and improving the lives of stroke patients. MjMO2n7( LBm6N.Hl#|oKP?lEF@L9ew,w\XpP{]8vxmtV}Or,kU{ `B7{"'Tf(DL[}ZEY 7'XoFo(|{%Jlv,_v}%DPnpoAucQGPy'YVJGXv:E j5(kts,?BcBKd?R . STK-6 Discharged on Statin Medication17. May 2021 Measure ID# Measure Short Name Measure Description STK-1 Venous Thromboembolism (VTE) This measure captures the proportion of ischemic or hemorrhagic Prophylaxis stroke patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission. LqV)%0w#lP.s9XsG58gX'5L S AP*=;%)e0J9_T-NXC4*~bTdsSFnde#;nOOyOqsi]qQV/Fb3KtK. CSTK-10b Functional Status Prior to Stroke-Dependent: IV Alteplase Only, 3. STK-OP-1e Ischemic Stroke; No IV Alteplase Prior to Transfer, LVO and NOT MER Eligible6. Using the quarterly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 20% of this subpopulation or 78 cases for the quarter (20% of 392 equals 78.4 rounded to the next highest whole number equals 78). The AMA does not directly or indirectly practice medicine or dispense medical services. Nozzle assembly is comprehensively flow tested to measure flow rate, leak and seat condition to validate injection consistency. endobj Part 2: A review of the different stroke certifications. Using the monthly sampling table for the ischemic stroke subpopulation, the sample size required is 14 cases for the month. m/P]H(ZVk[/ "+TPy9|9J1C0.ZOK_i@"$B'r~-("tNZmO}cv!eB In the Hospital Inpatient VBP Program Final Rule, CMS adopted the 30-day mortality measures for acute myocardial infarction (AMI), heart failure (HF), and pneumonia* under the Outcome domain. The core measurescan be found at: http://www.qualityforum.org/cqmc/. The median number of Adult Core Set measures reported by states is 22.5 measures for FFY 2019, up from 20 measures reported for FFY 2018 and 17 measures for FFY 2017. <> A hospitals Ischemic sub-population is 5 patients during February. 1-800-AHA-USA-1 CSTK-02 Modified Rankin Score (mRS at 90 Days)3. The following are the list of required chart-abstracted stroke measures for each certification program. A hospitals ischemic stroke patient population size is 495 cases during the second quarter. Hospitals whose Initial Patient Population size is less than the minimum number of cases per quarter/month for the sub-population cannot sample that sub-population. STK-OP-1h Ischemic Stroke; IV Alteplase Prior to Transfer, LVO and NOT MER Eligible**ADDED as of 7/1/2021**9. STK-1 Venous Thromboembolism (VTE Prophylaxis)7. Learn more about the communities and organizations we serve. ASR-OP-2b Hemorrhagic Stroke3. Appointments at Mayo Clinic Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. If you search for multiple terms, CMIT will return all deliverables containing at least one of the terms. The responsibility for the content of this product is with The Joint Commission, and no endorsement by the AMA is intended or implied. endobj Chart Abstracted Measures for Certification. Regardless of the option used, hospital samples must be monitored to ensure that sampling procedures consistently produce statistically valid and useful data. Heres a good reference document in case you get confused. Due to exclusions, hospitals selecting sample cases MUST submit AT LEAST the minimum required sample size. Heres how you know. The CQMC is a diverse coalition of health care leaders representing over 75 consumer groups, medical associations, health insurance providers, purchasers and other quality stakeholders, all working together to develop and recommend core sets of measures by clinical area to assess and improve the quality of health care in America. In regard to stroke, The Joint Commission has four different types of certification programs that go along with these stroke measure sets. 4= highly recommended; the outcome measure has excellent psychometric properties and clinical utility. STK-8 Stroke Education10. Start STK Initial Patient Population logic sub-routine. with acute ischemic stroke in the hospital setting will submit this measure. STK-2 Discharged on Antithrombotic Therapy5. Length of Stay, in days, is equal to the Discharge Date minus the Admission Date. Patient Age, in years, is equal to the Admission Date minus the Birthdate. STK-4 Thrombolytic Therapy15. Sixty (60) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during March. 3 0 obj Due to exclusions, hospitals selecting sample cases MUST submit AT LEAST the minimum required sample size. Youll see them abbreviated like this: Measure Type: InpatientNumber of Measures Included: 10Certification Requirement: The Joint Commissions Comprehensive Stroke Certification. R,A`=N T$gZq,AW@0H#`.K#AJk_~}~Dc7?o=0T,qp{"+&y8N^-9yG-W +~ZY(DA[xvc2EGJv;P.Q12`3'o0f}ahq+ci;")i EmNW`0}d\K?QD-ki'e1ACa%i^\|.I$a-4>b(L CSTK-10d Functional Status Prior to Stroke-Dependent: MER Therapy, Rate of Rapid Effective Reperfusion From Hospital Arrival. The following sample size tables for each option automatically build in the number of cases needed to obtain the required sample sizes. hbspt.cta._relativeUrls=true;hbspt.cta.load(491484, '41fd9d46-8610-4a5f-a135-c143fe55a31f', {"useNewLoader":"true","region":"na1"}); By JoAnne Marino April 30, 2021 Regulatory Updates: Hospital. Applications are available at the American Medical Association Web site, www.ama- assn.org/go/cpt. Closed on Sundays. Sign up to get the latest information about your choice of CMS topics. x[6 >tK(E4.z~bK[K6IL[Ev9$g8oon_G|&"JLEE DFowJEM/7^G7Zt]kv\}{\](6t~fFKHVY4#o}Q1ps 2)bO}eYOcfY[7YO_b;x%k)ZJE,Tx[p53^\BH\T,uFN'gI8JP^fD*VbIgWb 4*nO4>nEHlE<4VujSs.i[_i]@gjBq?yrY5r>||x\n#bi\O#_5mHXG_@0-`=[05L$Ae[BvzWR?y'1XV%^m#. CSTK-05b:Hemorrhagic Transformation Patients Treated with Intra-Arterial (IA) Thrombolytic (t-PA) Therapy or Mechanical Endovascular Reperfusion Therapy, 5. View them by specific areas by clicking here. website belongs to an official government organization in the United States. <> See how our expertise and rigorous standards can help organizations like yours. Process all cases that have successfully reached the point in the Clinical Data Processing Flow which calls this Initial Patient Population Algorithm. Honestly though Stroke Outpatient versus Outpatient Stroke. 2021 94.5% (307/325) 2020 91.7% (275/300) STK-2 2022 100.0% (117/117) . ASR-IP-1: Thrombolytic Therapy (IV alteplase initiated in the ED followed by inpatient admission to the ASRH)2. Percent of acute ischemic stroke patients who arrive at this hospital within 2 hours of time last known well and for whom IV t-PA was initiated at this hospital within 3 hours of time last known well. The measure development and maintenance process is guided by expertise and advice provided by the Stroke Measure Maintenance Technical Advisory Panel (TAP). Stroke Core Measures Stroke 'core measures' are critical steps in a patient's hospital stay that have been established based on outcomes. CSTK-09 Arrival Time to Skin Puncture, 8. CSTK-11 Rate of Rapid Effective Reperfusion From Hospital Arrival10. These updated core sets are a result of months of consensus-based review and deliberation among the groups 75+ multi-stakeholder member organizations, evaluating hundreds of existing quality measures against the CQMCs rigorous criteria. All Records, Calculation, Used in calculation of the Joint Commission's aggregate data. Disclaimer of Warranties and Liabilities. In addition, the public may compare specific healthcare organizations' results on Core Measures at the CSTK-10a Functional Status Prior to Stroke-Independent: IV Alteplase Only, 2. A modified sampling procedure is required for hospitals performing quarterly sampling for STK. This is a big year for Quality. 690 0 obj <>stream 10960 Grantchester Way, Suite 520Columbia, MD 21044. The required quarterly sample size would be 100% of the patient population or 5 cases for the quarter, No sampling; 100% Initial Patient Population required. endobj To develop the core measure sets the Collaborative split into workgroups and reviewed measures currently in use by CMS and health plans as well as measures endorsed by NQF for the individual measure sets. The final clinical diagnosis is used to identify the measure population. The next measure set we review is abbreviated ASR-IP/OP. If the Length of Stay is greater than 120 days, the patient is not in the STK Initial Patient Population and is not eligible to be sampled for the STK measure set. Finally, I have listed a few more resources for you. 1 0 obj I also included the complete list of measures required for each certification. Studies at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity. Stroke Core Measure - About Us - Mayo Clinic , . % The measure development and maintenance process is guided by expertise and advice provided by the Stroke Measure Maintenance Technical Advisory Panel (TAP). One-hundred and forty-eight (148) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during March. <> Along with award-winning software you receive a consultant that helps you with all of your technical and clinical needs. There are five major stroke measure sets. The required quarterly sample is 45 cases. The following table identifies the population . https:// <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
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