Stroke

Joint Commission certified stroke centers as well as those hospitals seeking certification, are required to collect data for standardized performance measures. In addition to collecting and reporting this data, organizations are expected to use this information for ongoing performance improvement efforts.

Electronic Clinical Quality Measures (eCQMs) for Accreditation

The following are Stroke eCQMs used by The Joint Commission.

  • eSTK-2 Discharged on Antithrombotic Therapy
  • eSTK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter
  • eSTK-5 Antithrombotic Therapy by End of Hospital Day Two
  • eSTK-6 Discharged on Statin Medication

Specifications for these measures are available below:

eCQM specifications  Screen Reader Text

Chart Abstracted Measures for Accreditation

There are no Stroke chart abstracted measures applicable or available for Accreditation purposes.

Electronic Clinical Quality Measures (eCQMs) for Certification

There are no Stroke eCQMs applicable or available for Certification purposes.

Chart Abstracted Measures for Certification

These Stroke chart abstracted measures were developed in collaboration with the American Heart Association (AHA)/American Stroke Association (ASA)/Brain Attack Coalition (BAC). The measure development and maintenance process is guided by expertise and advice provided by the Stroke Measure Maintenance Technical Advisory Panel (TAP).

The following are Stroke chart abstracted measures used by The Joint Commission.

  • Acute Stroke Ready Inpatient (ASR-IP)
    • 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
  • Acute Stroke Ready Outpatient (ASR-OP)
    • ASR-OP-1 Thrombolytic Therapy: Drip and Ship
    • ASR-OP-2 Door to Transfer to Another Hospital
  • Comprehensive Stroke (CSTK)
    • 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-05 Hemorrhagic Transformation
    • CSTK-06 Nimodipine Treatment Administered
    • CSTK-07 Median Time to Revascularization
    • CSTK-08 Thrombolysis in Cerebral Infarction (TICI Post-Treatment Reperfusion Grade)
    • CSTK-09 Arrival Time to Skin Puncture
    • CSTK-10 Modified Rankin Score (mRS at 90 Days: Favorable Outcome)
    • CSTK-11 Timeliness of Reperfusion: Arrival Time to TICI 2B or Higher
    • CSTK-12 Timeliness of Reperfusion: Arrival Time to TICI 2B or Higher
  • Stroke (STK)
    • STK-1 Venous Thromboembolism (VTE Prophylaxis)
    • STK-2 Discharged on Antithrombotic Therapy
    • STK-3 Anticoagulation Therapy for Atrial Fibrillation/Flutter
    • STK-4 Thrombolytic Therapy
    • STK-5 Antithrombotic Therapy By End of Hospital Day Two
    • STK-6 Discharged on Statin Medication
    • STK-8 Stroke Education
    • STK-10 Assessed for Rehabilitation
  • Stroke Outpatient (STK-OP)
    • STK-OP-1 Door to Transfer to Another Hospital

Specifications for these measures are available below:

Chart-abstracted measures specifications  Screen Reader Text

Below are the list of measures by Certification Program.