In November 2003, The Joint Commission in collaboration with the American Heart Association (AHA) / American Stroke Association (ASA) set out to develop performance measures for DSC Certification for Primary Stroke Centers, the first advanced-level certification program designed to recognize primary stroke centers that make exceptional efforts to foster better outcomes for stroke patient care. Unlike basic certification, the advanced program outlined additional clinically-specific requirements and expectations based on the Brain Attack Coalition’s Recommendations for Primary Stroke Centers and guidelines developed by the AHA/ASA and equivalent evidence-based guidelines. These guidelines provided the foundation for the identification of areas for performance measurement and the development of detailed measure specifications. Specifications for a set of ten candidate stroke measures were ultimately drafted and recommended by the Joint Commission’s Stroke Advisory Panel in early 2004. Data collection for four priority measures was initiated by certified Primary Stroke Centers in October, 2004. At the same time, a 12-month pilot test (October 1, 2004 through September 30, 2005) was conducted to assess and quantify the data collection effort, evaluate the reliability of individual data elements, measure specifications, the measurement set, and identify potential measure modifications. During the pilot test project, 30 pilot site programs submitted monthly data reports to The Joint Commission for the four priority measures, as well as the additional six measures in the set. A standardized set of ten measures for stroke patient care was finalized following the pilot test project.
The pilot test also revealed that several pilot site programs were currently participating in the American Stroke Association’s Get With The GuidelinesSM-Stroke (GWTG) program / patient management tool and/or Paul Coverdell National Acute Stroke Registry sponsored by the Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC). Efforts to harmonize the data elements of all three measure sets were initiated in May 2006. The Stroke Performance Measure Consensus Group, comprising representatives from The Joint Commission, AHA/ASA and CDC, was established and began to identify commonalities across the three data sources, align data element definitions and guidelines for abstraction. The end product is a harmonized, standardized set of 10 performance measures for stroke patient care.