Stroke Core Measures Stroke 'core measures' are critical steps in a patient's hospital stay that have been established based on outcomes. Heart Attack), Pneumonia, and Surgical Site Infection prevention. <>
endobj
Major causes of HF are coronary artery disease, high blood pressure, and diabetes. *Note: Significant changes to this measure set begin July 1, 2021. Statin drugs are medications used to reduce serum level of lipids such as cholesterol. The American Medical Association does not agree to license CPT to the Federal Government based on the license in FAR 52.227-14 (Data Rights - General) and DFARS 252.227-7015 (Technical Data - Commercial Items) or any other license provision. 2021; 96:e1812-e1822 . Source: Medisolv Perfect Care Report (eff. PDF 2021 Core Set of Adult Health Care Quality Measures for - Medicaid STK-OP-1g Ischemic Stroke; IV Alteplase Prior to Transfer, LVO and MER Eligible**ADDED as of 7/1/2021**8. Heres a good reference document in case you get confused. If the Principal Diagnosis code falls on Table 8.1 it will be placed in the Ischemic Stroke, or sub-pop 1 and if it has a Principal Diagnosis code that falls on Table 8.2, then it will be placed in the Hemorrhagic Stroke or sub-pop-2. Using the monthly sampling table for the ischemic stroke subpopulation, the sample size required is 14 cases for the month. The following are Stroke eCQMs used by The Joint Commission. 10960 Grantchester Way, Suite 520Columbia, MD 21044. CSTK-10d Functional Status Prior to Stroke-Dependent: MER Therapy, 9. Sometimes, TPA can be given up to 4.5 hours after stroke symptoms started. "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. To address this problem, the Centers for Medicare & Medicaid Services (CMS), commercial plans, Medicare and Medicaid managed care plans, purchasers, physician and other care provider organizations, and consumers worked together through the Core Quality Measures Collaborative to identify core sets of quality measures that payers have committed to using for reporting as soon as feasible. 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. Stroke is a leading cause of serious, long-term disability in the United States. Saturday: 9 a.m. - 5 p.m. CT STK-1 Venous Thromboembolism (VTE Prophylaxis)4. 1 0 obj
Through the use of a multi-stakeholder process, the Collaborative promotes alignment and harmonization of measure use and collection across payers in both the public and private sectors. A hospitals ischemic stroke patient population size is 295 cases during March. Oh, also, I included a ton of resources and links throughout this article and a specific list of resources at the end. CSTK-05a: Hemorrhagic Transformation for Patients Treated with Intravenous (IV) Thrombolytic (t-PA) Therapy Only2. ASR-OP-2a Door to Transfer to Another Hospital Overall Rate2. OP Stroke General Data Element List General Data Element Name Collected For: Arrival Time CSTK-05b:Hemorrhagic Transformation Patients Treated with Intra-Arterial (IA) Thrombolytic (t-PA) Therapy or Mechanical Endovascular Reperfusion Therapy, 5. Hospital OQR Quality Measures and Timelines for the CY 2021 Payment Determination . PDF Quality ID #187: Stroke and Stroke Rehabilitation: Thrombolytic Therapy CSTK-10a Functional Status Prior to Stroke-Independent: IV Alteplase Only, 2. You can decide how often to receive updates. A hospitals ischemic stroke patient population size is 37 cases during the second quarter. Percent of ischemic stroke patients with an LDL greater than or equal to 70 mg/dL, or LDL not measured, or who were on a lipid-lowering medication prior to hospital arrival are prescribed statin medication at hospital discharge. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
A hospitals hemorrhagic stroke patient population size is 392 cases during the second quarter. Monthly sampling for the Ischemic sub-population: A hospitals Ischemic sub-population is 228 during March. >0SPJ*@6W/rq+ERY_X&14>k( hbbd``b` SY ~H0[@D1HI-Hp @o$xA }:.PHplp%H^'n&F&QT'340 Ji
) We can make a difference on your journey to provide consistently excellent care for each and every patient. PDF Stroke Core Stroke Measures - University of Florida Stroke - Diagnosis and treatment - Mayo Clinic Regardless of the option used, hospital samples must be monitored to ensure that sampling procedures consistently produce statistically valid and useful data. Pets and Your Health / Healthy Bond for Life, La Iniciativa Nacional de Control de la Hipertensin, Contact your local Get With The Guidelines, Get With The Guidelines Data Request Form. Stroke Core Measure Data | Fort Sanders Regional Medical Center, a Return to Clinical Data Processing Flow in the Data Processing section. 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). You receive one consultant that you can call anytime with questions or concerns. The final clinical diagnosis is used to identify the measure population. CSTK-10a Functional Status Prior to Stroke-Independent: IV Alteplase Only2. 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. 7.gbu>/u?3>kW?^n-'\\o.T(A2Y/-.>+ Get With The Guidelines - Stroke Overview - American Heart Association Here is a diagram that outlines the submission differences. x[o
?;8o b+cIC[jN_:u!s@>:H?O>/?w`}?gheqMU Understanding Stroke Measure Sets - f.hubspotusercontent30.net STK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter6. Hospitals report on these measures quarterly or monthly, and compliance can affect TJC accreditation and CMS . The next measure set we review is abbreviated ASR-IP/OP. A hospitals ischemic stroke patient population size is 495 cases during the second quarter. Comprehensive Core Stroke Measures were developed for the management of both ischemic and hemorrhagic stroke patients in hospitals equipped with clinical expertise, infrastructure, and specialized neurointerventional and imaging services needed to provide a higher level of stroke care. 2021 94.5% (307/325) 2020 91.7% (275/300) STK-2 2022 100.0% (117/117) . Using the monthly sampling table for the ischemic stroke subpopulation, the sample size is less than the minimum required monthly sample size, so 100% of the subpopulation or all 7 cases are sampled. STK-4 Thrombolytic Therapy10. Initial Population: Inpatient hospitalizations for patients age 18 and older . Written by American Heart Association editorial staff and reviewed by science and medicine advisers. The required sample size for the CSTK-01 measure is a minimum of 42 cases for the month (28 cases from Table 4 plus 14 cases from Table 5 equals 42). Stroke Core Measure - About Us - Mayo Clinic , . The primary source is the Disease-Specific Care Certification Manual, ASRH addendum. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this Agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. STK-OP-1f Ischemic Stroke; No IV Alteplase Prior to Transfer, No LVO7. Gain an understanding of the development of electronic clinical quality measures to improve quality of care. Find the exact resources you need to succeed in your accreditation journey. 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. 4 0 obj
CSTK-09 Arrival Time to Skin Puncture, 8. Section 3. Measuring Emergency Department Performance *** 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. 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. Secure .gov websites use HTTPSA CMS is already using measures from the each of the core sets. Using the monthly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size required is 28 cases for the month. <>>>
Four-hundred and twenty-eight (428) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during the second quarter. endobj
CSTK-06 Nimodipine Treatment Administered6. A hospitals hemorrhagic stroke patient population size is 60 cases during March. The required quarterly sample is 45 cases. Once a patient is qualified, he/she moves to the second part of the algorithm which tells you which sub-population he/she falls into. Claims-Based Measures by Category Claims-Based Patient Safety Measures for 2022 Claims-Based Mortality Measures for 2022 Claims-Based Coordination of Care Measures for 2022 Closed on Sundays. Especially if you use an EHR vendor right now, youll notice a huge difference. Along with award-winning software you receive a consultant that helps you with all of your technical and clinical needs. CSTK-05b:Hemorrhagic Transformation Patients Treated with Intra-Arterial (IA) Thrombolytic (t-PA) Therapy or Mechanical Endovascular Reperfusion Therapy, 2. 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 (STK) (v2021B) A hospitals Hemorrhagic sub-population is 100 during the first quarter. 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. CSTK-05 Hemorrhagic Transformation, 1. The required quarterly sample sizes for each sub-population would be 79 and 5. Today, the Core Quality Measures Collaborative (CQMC) released four updated core measure sets covering specific clinical areas as part of its mission to provide useful quality metrics as the nation's health care system moves from one that pays based on volume of services to one that pays for value. The following are the list of required chart-abstracted stroke measures for each certification program. A hospitals hemorrhagic stroke patient population size is 129 cases during March. What is wrong with these people making it so complicated for us? Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Comprehensive Stroke Arrival Time to Skin Puncture, Comprehensive Stroke Post Thrombolysis Revascularization Rate, Comprehensive Stroke Timeliness of IV Thrombolytic Therapy, Advertising and sponsorship opportunities, Percent of ischemic and hemorrhagic stroke patients who received venous thromboembolism (VTE) prophylaxis the day of or the day after hospital admission. Two-hundred and twenty-three (223) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during the second quarter. Stay up to date with all the latest Joint Commission news, blog posts, webinars, and communications. Anticoagulation therapy is a course of drug therapy in which medications are administered to a patient to slow the rate at which the patient's blood clots. Contact Us, Hours Using the monthly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size required is 20% of this subpopulation or 25 cases for the month (20% of 123 equals 24.6 rounded to the next highest whole number equals 25). In this post we are either referencing CMS or The Joint Commission as the Measure Stewards. The required quarterly sample is 45 cases. The responsibility for the content of this product is with The Joint Commission, and no endorsement by the AMA is intended or implied. Percent of ischemic stroke patients who received antithrombotic therapy by the end of hospital day two. This may be achieved by administering the t-PA drug intravenously to eligible patients within three hours of stroke onset. Return to Clinical Data Processing Flow in the Data Processing section. PDF California EMS System Core Quality Measures Instruction Manual 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$a-4>b(L Clinical Measures Outcomes | Cleveland Clinic Learn about the "gold standard" in quality. But hospitals see benefits as well. Core Measures | CMS - Centers for Medicare & Medicaid Services IQR Measures - Centers for Medicare & Medicaid Services If the Patient Age is less than 18 years, the patient is not in the STK Initial Patient Population and is not eligible to be sampled for the STK measure set. PDF Stroke Performance Measures - Centers for Disease Control and Prevention x\_s6fE4f+[Itd2)Q" 2tIB.|Qe{r?);|_gb-rv>XS?m>`_\WNO>(b\@~f'4(
L`yXS7?b!0@qp) Monday - Friday: 7 a.m. 7 p.m. CT 671 0 obj
<>/Filter/FlateDecode/ID[<8968A4F338E55446928FCF4A155C4BC8>]/Index[646 45]/Info 645 0 R/Length 114/Prev 86415/Root 647 0 R/Size 691/Type/XRef/W[1 2 1]>>stream
A hospital may choose to use a larger sample size than is required. You can download it or email it to yourself to help you remember. Hospital Core Measures Defined - ESO A hospitals Hemorrhagic sub-population is 3 patients during the first quarter. }J Using the quarterly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 150 cases for the quarter. The American Heart Association is a qualified 501(c)(3) tax-exempt organization. Test your ideas. A hospitals ischemic stroke patient population size is 129 cases during March. Using the quarterly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size required is 20% of this subpopulation or 45 cases for the quarter (20% of 223 equals 44.6 rounded to the next highest whole number equals 45). Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. %PDF-1.5
<>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Early rehabilitation interventions initiated following stroke can enhance the recovery process and minimize functional disability. ruTv?U J4lUBex(a8{g$CHj ~>-z I&8:+hlvM(XdvY;D|BOl,Yu'D> YR9Gbl6GrJ8'},^V)\i/0 Gg:} >!81I88{'swe )I6v#{$&YymLyn\tl S3r6.o?x@q$_1A=U$H3%QUx . STK-8 Stroke Education18. 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. %PDF-1.5
Start STK Initial Patient Population logic sub-routine. You, your employees and agents are authorized to use CPT only as contained in The Joint Commission performance measures solely for your own personal use in directly participating in healthcare programs administered by The Joint Commission. Stroke Core Performance Measures HOS-Sanford Medical Center Fargo Annual summaries for 2020 through 2022 Updated: 2/2023 . Joint Commission Clinical Measures. Researchers also have the opportunity to conduct investigator-led research projects using data from the Get With The Guidelines- Stroke program. A hospitals ischemic stroke patient population size is 200 patients during March. Applications are available at the American Medical Association Web site, www.ama- assn.org/go/cpt. We consistently hear from our clients that the biggest differentiator between Medisolv and other vendors is the level of one-of-one support. Hospital Outpatient Quality Measure Stroke. 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 . Neurology. CSTK-10c Functional Status Prior to Stroke-Independent: MER Therapy, 4. 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). To search the historic measure inventory, enter one or more terms in the search box and hit enter or click the search button. 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. This is a big year for Quality. Diesel Fuel Injector - 2004.5-2007 Ford 6.0L Power Stroke STK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter9. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. A hospitals Hemorrhagic sub-population is 316 during February. ASR-OP-2b Hemorrhagic Stroke3. 2023 American Heart Association, Inc. All rights reserved. The psychometric properties of the measures are reviewed using a modified EDGE (Evidence Database to Guide Effectiveness) template (a format recommended by the APTA EDGE task force). Set the Initial Patient Population Reject Case Flag to equal Yes. Measure 6a is new and is being pilot tested in 2009. Percent of ischemic stroke patients prescribed antithrombotic therapy at hospital discharge. The Centers for Medicare & Medicaid Services (CMS) has posted the electronic clinical quality measure ( eCQM) specifications for the 2021 reporting period for Eligible Hospitals and Critical Access Hospitals, and the 2021 performance period for Eligible Professionals and Eligible Clinicians. 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. 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.
Request Appointment Quality and Mayo Clinic Arizona Florida Minnesota Event reporting Quality measures Quality rankings Stroke Core Measure Loading chart. PDF Hospital Outpatient Quality Reporting Stroke Measure Set - RWHC Disclaimer of Warranties and Liabilities. Medisolv can help you along the way. Improve Maternal Outcomes at Your Health Care Facility, Accreditation Standards & Resource Center, Ambulatory Health Care: 2023 National Patient Safety Goals, Assisted Living Community: 2023 National Patient Safety Goals, Behavioral Health Care and Human Services: 2023 National Patient Safety Goals, Critical Access Hospital: 2023 National Patient Safety Goals, Home Care: 2023 National Patient Safety Goals, Hospital: 2023 National Patient Safety Goals, Laboratory Services: 2023 National Patient Safety Goals, Nursing Care Center: 2023 National Patient Safety Goals, Office-Based Surgery: 2023 National Patient Safety Goals, The Term Licensed Independent Practitioner Eliminated, Updates to the Patient Blood Management Certification Program Requirements, New Assisted Living Community Accreditation Memory Care Certification Option, Health Care Equity Standard Elevated to National Patient Safety Goal, New and Revised Emergency Management Standards, New Health Care Equity Certification Program, Updates to the Advanced Disease-Specific Care Certification for Inpatient Diabetes Care, Updates to the Assisted Living Community Accreditation Requirements, Updates to the Comprehensive Cardiac Center Certification Program, Health Care Workforce Safety and Well-Being, Report a Patient Safety Concern or Complaint, The Joint Commission Stands for Racial Justice and Equity, The Joint Commission Journal on Quality and Patient Safety, John M. Eisenberg Patient Safety and Quality Award, Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity, Continuing Education Credit Information FAQs, Measures for Acute Stroke Ready Center Certification, Measures for Primary Stroke Center Certification, Measures for Thrombectomy Capable Stroke Center Certification, Measures for Comprehensive Stroke Center Certification, eSTK-2 Discharged on Antithrombotic Therapy, eSTK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter, eSTK-5 Antithrombotic Therapy by End of Hospital Day Two, ASR-IP-1 Thrombolytic Therapy: Inpatient Admission, ASR-IP-2 Antithrombotic Therapy By End of Hospital Day 2, ASR-IP-3 Discharged on Antithrombotic Therapy, ASR-OP-1 Thrombolytic Therapy: Drip and Ship, CSTK-01 National Institutes of Health Stroke Scale (NIHSS) Score Performed for Ischemic Stroke Patients, CSTK-02 Modified Rankin Score (mRS) at 90 Days, CSTK-03 Severity Measurement Performed for SAH and ICH Patients, CSTK-04 Procoagulant Reversal Agent Initiation for Intracerebral Hemorrhage (ICH), CSTK-06 Nimodipine Treatment Administered, CSTK-08 Thrombolysis in Cerebral Infarction (TICI) Post-Treatment Reperfusion Grade, CSTK-10 Modified Rankin Score (mRS) at 90 Days: Favorable Outcome, CSTK-11 Rate of Rapid Effective Reperfusion From Hospital Arrival, CSTK-12 Rate of Rapid Effective Reperfusion From Skin Puncture, STK-1 Venous Thromboembolism (VTE) Prophylaxis, STK-2 Discharged on Antithrombotic Therapy, STK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter, STK-5 Antithrombotic Therapy By End of Hospital Day Two, STK-OP-1 Door to Transfer to Another Hospital, STK-VOL-1 Eligible Ischemic Stroke Patients Who Receive Mechanical Endovascular Reperfusion Therapy. Electronic Clinical Quality Measures (eCQMs) for Accreditation, Chart Abstracted Measures for Accreditation, Electronic Clinical Quality Measures (eCQMs) for Certification. Measure Type: InpatientNumber of Measures Included: 3 process measuresCertification Requirement: The Joint Commissions Disease-Specific Care Certification, Measure Type: OutpatientNumber of Measures Included: 2 process measuresCertification Requirement: The Joint Commissions Disease-Specific Care Certification, Door to Transfer to Another Hospital**RETIRED Effective July 1, 2021**, Note: All Joint Commission certified acute stroke ready hospitals, as well as those seeking initial certification, will be required to collect the STK-OP-1 Door to Transfer to Another Hospital measure for discharges on and after July 1, 2021.