Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient's prognosis and potential for rehabilitation. %PDF-1.4 % 0 Using the quarterly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 75 cases for the quarter. The required quarterly sample is 45 cases. lock In addition to accreditation, certification, and verification, we provide tools and resources for health care professionals that can help make a difference in the delivery of care. This Agreement will terminate upon notice if you violate its terms. Click on the link(s) below to access measure specific resources: The Joint Commission is a registered trademark of the Joint Commission enterprise. Sign up to get the latest information about your choice of CMS topics. Closed on Sundays. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. Sometimes, TPA can be given up to 4.5 hours after stroke symptoms started. The six measures are: . 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. 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 . Early rehabilitation interventions initiated following stroke can enhance the recovery process and minimize functional disability. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Fifty (50) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during the second quarter. https://manual.jointcommission.org/releases/TJC2021B/TransmissionChapterTJC.html, The Joint Commission (ASR-IP, ASR-OP, PSC, TSC, CSC), program comparison sheet with guidelines of certification requirements, Centers for Medicare & Medicaid Services (CMS), The Joint Commission Stroke Certification Programs Program Concept Comparison, Specifications Manual for Joint Commission National Quality Measures (version 2021B), Acute Stroke Ready Hospital Certification (ASRH), Standardized Performance Measures for Acute Stroke Ready Hospitals, Primary Stroke Center Certification (PSC), Standardized Performance Measures for Primary Stroke Centers, Comprehensive Stroke Center Certification (CSC), Standardized Performance Measures for Comprehensive Stroke Centers, Standardized Performance Measures for Thrombectomy-Capable Stroke Centers, Using the New Opioid eCQM to Improve Prescribing Practices and Patient Care, 2021 Quality Reporting Deadlines Calendar, 2023 Promoting Interoperability Requirements, A Guide to The Joint Commissions New Health Equity Requirements, Hospital eCQM Results Are In: A Review of the January 2023 Care Compare Refresh, [Download] 2021 Hospital IQR Program Requirements, [Download] Hybrid Measure Implementation Guide, Hemorrhagic Transformation (Overall Rate), 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, Ischemic Stroke with Procedure (Thrombolytic Therapy or Mechanical endovascular therapy). CSTK-09b Time (in minutes) from hospital arrival to skin puncture in patients with acute ischemic stroke who present directly to your hospital and undergo endovascular treatment, 6. Calculate Patient Age. Hospitals report on these measures quarterly or monthly, and compliance can affect TJC accreditation and CMS . Based on this review and discussion the workgroups identified a consensus core set for the selected clinical areas. One-hundred and forty-eight (148) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during March. One-hundred and twenty-three (123) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during March. TJC Comprehensive Stroke Performance Measures HOS-Sanford Medical Center Fargo Annual summaries for 2020 through 2022 Updated: 2/2023 3. The following sample size tables for each option automatically build in the number of cases needed to obtain the required sample sizes. By improving stroke care, our Get With The Guidelines- Stroke program benefits patients as well as hospitals. Joint Commission Clinical Measures. Return to Clinical Data Processing Flow in the Data Processing section. STK-4 Thrombolytic Therapy10. Additionally, the Collaborative developed a framework of aims and principles that informed the selection of core measure sets. 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. STK-4 Thrombolytic Therapy7. *Note: There are additional measures needed to fulfill this certification. The American Heart Association is a qualified 501(c)(3) tax-exempt organization. These core measure sets are a major step forward for alignment of quality measures between public and private payers and provides a framework upon which future efforts can be based. We keep you on track for your submission deadlines and ensure you dont miss critical dates. 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. Stroke Core Measures Stroke 'core measures' are critical steps in a patient's hospital stay that have been established based on outcomes. Due to exclusions, hospitals selecting sample cases MUST submit AT LEAST the minimum required sample size. The Hemorrhagic sub-population is less than the minimum required quarterly sample size, so 100% of this sub-population is sampled. 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. 1 0 obj The goal is to establish broadly agreed upon core measure sets that could be harmonized across both commercial and government payers. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the (AMA is not recommending their use. Comprehensive Stroke (CSTK) (v2021A1) Home Comprehensive Stroke (CSTK) Comprehensive Stroke (CSTK) On this page: Comprehensive Stroke (CSTK) Initial Patient Population Monthly Sampling Sample Size Examples Set Measures General Data Elements Algorithm Output Data Elements Measure Set Specific Data Elements What is wrong with these people making it so complicated for us? Hospital Outpatient Quality Measure Stroke. lock A hospitals hemorrhagic stroke patient population size is 392 cases during the second quarter. The Core Quality Measure Collaborative, led by the Americas Health Insurance Plans (AHIP) and its member plans Chief Medical Officers, leaders from CMS and the National Quality Forum (NQF), as well as national physician organizations, employers and consumers, worked hard to reach consensus on core performance measures. 2 0 obj The AMA does not directly or indirectly practice medicine or dispense medical services. An official website of the United States government STK-6 Discharged on Statin Medication9. CSTK-09 Arrival Time to Skin Puncture, 8. 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. endobj Percent of ischemic stroke patients who received antithrombotic therapy by the end of hospital day two. CPT is provided as is without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Regardless of the option used, hospital samples must be monitored to ensure that sampling procedures consistently produce statistically valid and useful data. You can download it or email it to yourself to help you remember. ** The Adult Core Set includes the NCQA version of the measure, whichis adapted from the CMS measure (NQF #1879). with acute ischemic stroke in the hospital setting will submit this measure. The administration of anticoagulation therapy is an effective strategy in preventing recurrent stroke in high stroke risk-atrial fibrillation patients. endobj Researchers also have the opportunity to conduct investigator-led research projects using data from the Get With The Guidelines- Stroke program. U.S. Government Rights 3 0 obj 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. 3 0 obj Using the monthly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 25 cases for the month. ASR-OP-2a Door to Transfer to Another Hospital Overall Rate2. Time from symptom onset to stroke alert is delayed in in-hospital stroke. A hospitals Ischemic sub-population is 5 patients during February. CSTK-09 Arrival Time to Skin Puncture, 1. endobj m/P]H(ZVk[/ "+TPy9|9J1C0.ZOK_i@"$B'r~-("tNZmO}cv!eB 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. There are five major stroke measure sets. Percent of ischemic stroke patients prescribed antithrombotic therapy at hospital discharge. 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). 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). endstream endobj startxref 1 0 obj January 1, 2021: Actual Primary Completion Date : June 30, 2021: Estimated Study Completion Date : December 31, 2021: Groups and Cohorts. STK-8 Stroke Education13. Saturday: 9 a.m. - 5 p.m. CT Using the quarterly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 150 cases for the quarter. 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. 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. STK-10 Assessed for Rehabilitation. JoAnne has a background in Quality Management and has been working with hospitals on their Core Measures compliance with CMS and The Joint Commission since 2008. STK-OP-1e Ischemic Stroke; No IV Alteplase Prior to Transfer, LVO and NOT MER Eligible6. For information concerning how to perform sampling, refer to the Population and Sampling Specifications section in this manual. A hospitals Ischemic sub-population is 5 patients during the first quarter. This content does not have an Arabic version. decreased providers collection burden and cost. Using the monthly sampling table for the Ischemic sub-population, the sample size required is 20% of this sub-population, or 46 cases for the quarter (twenty percent of 228 equals 45.6 rounded up to the next whole number equals 46). Since the program's start in 2003, over 2,000hospitals have entered more than 5million patient records into the Get With The Guidelines- Stroke database. 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). 2023 Medisolv, Inc. All Rights Reserved. The two sub-populations must be sampled independently from each other. Obtain useful information in regards to patient safety, suicide prevention, infection control and many more. Percent of ischemic or hemorrhagic stroke patients, or their caregivers, who were given educational materials during the hospital stay addressing. Applications are available at the American Medical Association Web site, www.ama- assn.org/go/cpt. ASR-IP-1: Thrombolytic Therapy (IV alteplase initiated in the ED followed by inpatient admission to the ASRH)2. The required quarterly sample size for the CSTK-01 measure is a minimum of 84 cases (42 cases from Table 1 plus 42 cases from Table 2 equals 84). STK-1 Venous Thromboembolism (VTE Prophylaxis)4. CSTK-10a Functional Status Prior to Stroke-Independent: IV Alteplase Only2. 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. STK-6 Discharged on Statin Medication12. These Stroke chart abstracted measures were developed in collaboration with the American Heart Association (AHA)/American Stroke Association (ASA)/Brain Attack Coalition (BAC). CSTK-12 Rate of Rapid Effective Reperfusion From Skin Puncture11. Measure ID # Measure Short Name OP-23 . Learn about the development and implementation of standardized performance measures. Create your baseline by entering 30 records into the Patient Management Tool. The following are the list of required chart-abstracted stroke measures for each certification program. Especially if you use an EHR vendor right now, youll notice a huge difference. By not making a selection you will be agreeing to the use of our cookies. In addition, 36 states reported more Adult Core Set measures for FFY 2019 than for FFY 2018. CSM Using the monthly sampling table for the Ischemic sub-population, the sample size is less than the minimum required monthly sample size, so 100% of this sub-population is sampled. The Differences Between The 5 Major Stroke Measure Sets, Thrombolytic Therapy: Inpatient Admission, Antithrombotic Therapy By End of Hospital Day 2, Ischemic Stroke; IV Alteplase Prior to Transfer, LVO and MER Eligible, Ischemic Stroke; IV Alteplase Prior to Transfer, LVO and NOT MER Eligible, Ischemic Stroke; IV Alteplase Prior to Transfer, No LVO, National Institutes of Health Stroke Scale (NIHSS Score Performed for Ischemic Stroke Patients), Ischemic Stroke; IV Alteplase Prior to Transfer (Drip and Ship), CSTK-05a: Hemorrhagic Transformation for Patients Treated with Intravenous (IV) Thrombolytic (t-PA) Therapy Only, CSTK-05b: Hemorrhagic Transformation Patients Treated with Intra-Arterial (IA) Thrombolytic (t-PA) Therapy or Mechanical Endovascular Reperfusion Therapy, Thrombolysis in Cerebral Infarction (TICI Post-Treatment Reperfusion Grade), 1. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. STK-8 Stroke Education18. Appointments at Mayo Clinic Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. CSTK-10c Functional Status Prior to Stroke-Independent: MER Therapy4. ASR OP-2 Door to Transfer to Another Hospital **RETIRED Effective July 1, 2021**, 1. Specifications Manual for Joint Commission National Quality Measures (v2021A1), Comprehensive Stroke (CSTK) Initial Patient Population, First Pass of a Mechanical Reperfusion Device, Highest NIHSS Score Documented Within 36 Hours Following IA Alteplase or MER Initiation, Highest NIHSS Score Documented Within 36 Hours Following IV Alteplase Initiation, IV Alteplase Prior to IA or Mechanical Reperfusion Therapy, Initial Blood Glucose Value at Hospital Arrival, Initial Blood Pressure at Hospital Arrival, Initial Platelet Count at Hospital Arrival, NIHSS Score Documented Closest to IA Alteplase or MER Initiation, NIHSS Score Documented Closest to IV Alteplase Initiation, Post-Treatment Thrombolysis in Cerebral Infarction (TICI) Reperfusion Grade, Post-Treatment Thrombolysis in Cerebral Infarction (TICI) Reperfusion Grade Date, Post-Treatment Thrombolysis in Cerebral Infarction (TICI) Reperfusion Grade Time, Reason for Not Administering Nimodipine Treatment, Reason for Not Administering a Procoagulant Reversal Agent, Appendix E - Overview of Measure Information Form and Flowchart Formats, Cover Page for the Joint Commission Manual, Joint Commission Clinical Data Processing Flow, Joint Commission National Quality Measures Data Processing, Using the The Joint Commission's National Measure Specifications Manual, National Institutes of Health Stroke Scale (NIHSS Score Performed for Ischemic Stroke Patients), Severity Measurement Performed for SAH and ICH Patients (Overall Rate), Procoagulant Reversal Agent Initiation for Intracerebral Hemorrhage (ICH ), Hemorrhagic Transformation (Overall Rate), Thrombolysis in Cerebral Infarction (TICI Post-Treatment Reperfusion Grade), Modified Rankin Score (mRS at 90 Days: Favorable Outcome), Rate of Rapid Effective Reperfusion From Hospital Arrival, Rate of Rapid Effective Reperfusion From Skin Puncture, All Records, Not collected for HBIPS-2 and HBIPS-3, All Records, Optional for HBIPS-2, HBIPS-3, All Records, Optional for All HBIPS Records. In addition, the public may compare specific healthcare organizations' results on Core Measures at the A hospital may choose to use a larger sample size than is required. Mayo Clinic does not endorse any of the third party products and services advertised. Measure 6a is new and is being pilot tested in 2009. %PDF-1.7 For information concerning how to perform sampling, refer to the Population and Sampling Specifications section in this manual. ) These measures specify best clinical practice in four areas: Heart Failure, Acute Myocardial Infarction (AMI, i.e. 2 0 obj In addition, TJC established the Certification Measure Information Process (CMIP) tool where hospitals must manually enter their certification data for the program certifications we reviewed above (ASR, PSC, TSC and CSC). CSTK-10b Functional Status Prior to Stroke-Dependent: IV Alteplase Only, 3. Below are the list of Stroke measures by Certification Program. The required quarterly sample is 45 cases. The Core Quality Measures Project currently includes 6 of 11 National EMS Quality Measures. A hospitals hemorrhagic stroke patient population size is 200 cases during the second quarter. CPT only copyright 2019 American Medical Association. Hospital OQR Quality Measures and Timelines for the CY 2021 Payment Determination . Regulatory/AccreditationExamples would include the Center for Medicare & Medicaid Services (CMS) required core measures (e.g., fibrinolytic therapy received within 30 minutes of emergency department (ED) arrival, aspirin at arrival) and documentation of Joint Commission standard achievement. The Measure Steward refers to the organization that is responsible for providing the required measure information for the measure maintenance process that occurs approximately every three years. To begin, I will clarify the two Measure Stewards we are reviewing today (there are many other Measure Stewards out there). Calculate the Length of Stay. These Stroke chart abstracted measures were developed in collaboration with the American Heart Association (AHA)/American Stroke Association (ASA)/Brain Attack Coalition (BAC). Its a nightmare trying to keep straight this wide range of acronym-filled information. stream 2021; 97: . >0SPJ*@6W/rq+ERY_X&14>k( 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). We help troubleshoot technical and clinical issues to improve your measures. *** 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. Arrhythmia means that the heart's normal beating rhythm is interrupted. A hospitals ischemic stroke patient population size is 70 cases during March. <>>> The following links provide you with information available on past, present and future versions of the specification manuals, including release notes, measure information forms, data dictionaries, missing and invalid data, population and sampling, data transmission, tools and resources, and appendices. Information in this course pertains to 01/1/13 - 12/31/13, version 4.2 of the Specifications Manual. CSTK-10 Modified Rankin Score (mRS at 90 Days: Favorable Outcome), 1. This may be achieved by administering the t-PA drug intravenously to eligible patients within three hours of stroke onset. Test your ideas. Domain-specific outcomes for stroke clinical trials: what the modified Rankin isn't ranking. The coalition was convened in 2015 by Americas Health Insurance Providers (AHIP) and the Centers for Medicare & Medicaid Services (CMS) and is housed at the National Quality Forum (NQF). Find more information on our content editorial process. There are no Stroke eCQMs applicable or available for Certification purposes. The numerator options included in this 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. 3= recommended; the outcome measure has good psychometric . Chart-abstracted measures specificationsScreen Reader Text. The primary goal of rehabilitation is to prevent complications, minimize impairments, and maximize function. 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. 2011-2021 6.7L Ford Power Stroke; 2008-2010 6.4L Ford Power Stroke; 2003-2007 6.0L Ford Power Stroke; .

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