Updated: Performance measure requirements for thrombectomy-capable stroke centers
Effective July 1, 2022, Joint Commission-certified thrombectomy-capable stroke centers (TSCs) will be required to report outcome performance measure data on comprehensive stroke (CSTK) measure CSTK-10: Modified Rankin Score (mRS) at 90 Days.
Data collection for CSTK-10 will replace the currently required CSTK-02: mRS at 90 Days measure. Both measures focus on obtaining mRS data 90 days after a patient’s discharge from the hospital; however, TSCs now have processes in place to collect 90-day mRS data with aggregate performance at or above 90% for most facilities. Therefore, TSC data collection for the CSTK-02 process measure will be suspended.
The mRS is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. It is the most widely used clinical outcome measure for stroke clinical trials.
CSTK-10 is composed of four strata or submeasures. The denominator population is stratified by the type of reperfusion therapy selected to treat acute ischemic stroke. The numerator population captures the patient’s functional status — independent or dependent — prior to their stroke and based on the mRS prior to the acute stroke event. All four strata roll up to report a CSTK-10 overall rate, with a good outcome reported as an mRS of 0, 1, or 2 at 90 days.
- CSTK-10: All ischemic stroke patients treated with intravenous (IV) alteplase or who undergo mechanical endovascular reperfusion therapy and have an mRS less than or equal to 2 at 90 days (≥ 75 days and ≤ 105 days).
- CSTK-10a: Ischemic stroke patients treated with IV alteplase only and have an mRS of 0, 1, or 2 documented prior to the stroke; or no mRS documented prior to the stroke.
- CSTK-10b: Ischemic stroke patients treated with IV alteplase only and have an mRS of 3, 4, or 5 documented prior to the stroke.
- CSTK-10c: Ischemic stroke patients treated with mechanical endovascular reperfusion therapy with or without IV/intra-arterial (IA) alteplase therapy and have an mRS of 0, 1, or 2 documented prior to the stroke; or no mRS documented prior to the stroke.
- CSTK-10d: Ischemic stroke patients treated with mechanical endovascular reperfusion therapy with or without IV/IA alteplase therapy and have an mRS of 3, 4, or 5 documented prior to the stroke.
Measure specifications are detailed in the Specifications Manual for Joint Commission National Quality Measures, Version 2022A1. Questions about these measures may be sent via the Performance Measurement Network Q&A Forum.