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Stroke and Neurovascular Reports
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Stroke and Neurovascular Reports
The Joint Commission Measures
The Joint Commission uses eight clinical performance measures (described below) for stroke care. These measures were developed in collaboration with the American Heart Association (AHA), American Stroke Association (ASA) and Brain Attack Coalition (BAC) for use by Disease-Specific Care (DSC) certified primary stroke centers. The measures were endorsed by the National Quality Forum (NQF) in July 2008, and aligned with the Centers for Medicare and Medicaid Services.
8 Stroke Core Measures
- Venous Thromboembolism (VTE) Prophylaxis — Ischemic and hemorrhagic stroke patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission.
- Discharged on Antithrombotic Therapy — Ischemic stroke patients prescribed antithrombotic therapy at hospital discharge.
- Anticoagulation Therapy for Atrial Fibrillation/Flutter — Ischemic stroke patients with atrial fibrillation/flutter who are prescribed anticoagulation therapy at hospital discharge.
- Thrombolytic Therapy — Acute ischemic stroke patients who arrive at your hospital within 2 hours of time last known well and for whom IV-tPA was initiated at your hospital within 3 hours of time last known well.
- Antithrombotic Therapy by end of Hospital Day Two — Ischemic stroke patients administered antithrombotic therapy by the end of hospital day two.
- Discharged on Statin Medication - Ischemic stroke patients with LDL greater than or equal to 100mg/dl, or LDL not measured, or who were on a lipid lowering medication prior to hospital arrival are prescribed statin medication at hospital discharge.
- Stroke Education — Ischemic or hemorrhagic stroke patients or their caregivers who were given educational materials during the hospital stay addressing ALL of the following:
- Activation of emergency medical system
- Need for follow up after discharge
- Medications prescribed at discharge
- Risk factors for stroke
- Warning signs/symptoms of stroke
- Assessed for Rehabilitation — Ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services.
Composite Measure of the Eight Stroke Core MeasuresA hospital is scored on how well it implements these “process” measures, and the scores are averaged to indicate a single composite score. In other words, the composite score is a representation of a hospital’s performance to properly treat specific conditions. The higher the score, the better a hospital adheres to the recommendations.
Note: The charts below show how the Froedtert & the Medical College Stroke & Neurovascular Program compared to other hospitals in the country.
- “All hospitals” are those participating in Get with the Guidelines-Stroke (GWTG-Stroke) developed by the American Stroke Association. GWTG-Stroke is the American Stroke Association’s process for continuous quality improvement of acute stroke treatment and ischemic stroke prevention. The program helps hospitals collect and analyze stroke data, and provides a way for physicians and hospital staff to monitor their performance. GWTG-Stroke focuses on care team protocols to ensure that patients are treated and discharged appropriately.
- “Midwest hospitals” are those participating hospitals in the Midwest region that participate with Get with the Guidelines-Stroke.
In all cases in the charts below, the higher percentage is preferred.
This Get With The GuidelinesSM (GWTG) Aggregate Data report was generated using the Outcome™ PMT® system. Copy or distribution of the GWTG Aggregate Data is prohibited without the prior written consent of the American Heart Association and Outcome Sciences, Inc. (Outcome). June 16, 2011.
This Get With The GuidelinesSM (GWTG) Aggregate Data report was generated using the Outcome™ PMT® system. Copy or distribution of the GWTG Aggregate Data is prohibited without the prior written consent of the American Heart Association and Outcome Sciences, Inc. (Outcome). June 16, 2011.
FAST — When Minutes CountMinutes count when responding to a stroke. That’s just one reason why the Froedtert & the Medical College Acute Stroke Team (FAST) is available 24 hours a day, seven days a week. This acute response team provides stroke patients with rapid access to diagnosis and treatment.
Stroke neurologists, critical care neurologists, neuroradiologists, neurosurgeons, interventional neurologists, emergency medicine physicians and nurse specialists work around the clock to beat stroke.
Clot-Busting DrugsStudies have shown that thrombolytic drugs, or clot-busters, effectively stop strokes and improve patient outcomes if specialists trained in giving the drugs are immediately available. All FAST doctors are trained to administer clot-busters and have been successfully using them since their approval in 1996. Some of these miracle drugs need to be administered intravenously within the first three hours of the onset of symptoms. It’s just another reason to act fast when stroke symptoms occur.
Tissue plasminogen activator (tPA) considered (a JCAHO measure for stroke care) — tPA is a clot-dissolving drug approved by the FDA to treat ischemic stroke (blood clots in the brain) in the first three hours after the start of symptoms. The sooner tPA or other appropriate treatment is begun, the better the chances for recovery.
Date: June 23, 2011 Last Review Date: March 4, 2013 Online Editor(s): Shannon Krause |
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