Performance measure | 2008 | 2009 | 2010 | 2011 | 2008-2011 |
P-value |
|---|
NE | NT | % | NE | NT | % | NE | NT | % | NE | NT | % | NE | NT | % |
|---|
STK-1
| 744 | 713 | 95.8 | 803 | 783 | 97.5 | 859 | 845 | 98.4 | 949 | 934 | 98.4 | 3355 | 3275 | 97.6 | 0.98 |
STK-2
| 470 | 442 | 94.0 | 477 | 451 | 94.6 | 537 | 504 | 93.9 | 623 | 590 | 94.7 | 2107 | 1987 | 94.3 | 0.99 |
STK-3
| 77 | 62 | 80.5 | 63 | 61 | 96.8 | 77 | 75 | 97.4 | 65 | 64 | 98.5 | 282 | 262 | 92.9 | 0.81 |
STK-4*
| 70 | 63 | 90.0 | 68 | 56 | 82.4 | 93 | 81 | 87.1 | 88 | 78 | 88.6 | 319 | 278 | 87.1 | 0.99 |
STK-5
| 327 | 327 | 100 | 340 | 340 | 100 | 370 | 369 | 99.7 | 393 | 393 | 100 | 1430 | 1429 | 99.9 | 1.00 |
STK-6
| 326 | 271 | 83.1 | 331 | 285 | 86.1 | 340 | 300 | 88.2 | 409 | 355 | 86.8 | 1406 | 1211 | 86.1 | 0.96 |
STK-7**
| 680 | 663 | 97.5 | 659 | 639 | 97.0 | 710 | 639 | 90.0 | 819 | 707 | 86.3 | 2868 | 2648 | 92.3 | 0.29 |
STK-8
| 230 | 228 | 99.1 | 197 | 150 | 76.1 | 233 | 178 | 76.4 | 307 | 303 | 98.7 | 967 | 859 | 88.8 | 0.06 |
STK-9**
| 214 | 195 | 91.1 | 186 | 175 | 94.1 | 199 | 190 | 95.5 | 254 | 244 | 96.1 | 853 | 804 | 94.3 | 0.98 |
STK-10
| 635 | 607 | 95.6 | 684 | 657 | 96.1 | 735 | 709 | 96.5 | 880 | 860 | 97.7 | 2934 | 2833 | 96.6 | 0.99 |
-
NE = Number of eligible patients.
-
NT = Number of eligible patients who received treatment or intervention.
-
P-value = P-value based on Chi-square test for linear trend over four years, 2008–2011.
- * Thrombolytic Therapy Administered (STK-4) is calculated based on inclusions and exclusions criteria set by The Joint Commission (TJC), which resulted in a different number of eligible patients for tPA compared to that reported in Table 2.
-
The eligibility of patients related to diagnoses of ischemic stroke and hemorrhagic stroke: [48, 49]
- We used the standard TJC definitions for inclusion/exclusion of patients for calculations of all performance measures. Patients with diagnosis of ischemic stroke are eligible for all performance measures, but patients with diagnosis of hemorrhagic stroke are eligible for performance measures STK-1, STK-7, STK-8, STK-9, and STK-10.
-
Definition of performance measures: [48, 49]
-
STK-1 = 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.
-
STK-2 = Discharged on Antithrombotic Therapy: Ischemic stroke patients prescribed antithrombotic therapy at hospital discharge.
-
STK-3 = Anticoagulation Therapy for Atrial Fibrillation/Flutter: Ischemic stroke patients with atrial fibrillation/flutter who are prescribed anticoagulation therapy at hospital discharge.
-
STK-4 = Thrombolytic Therapy: Acute ischemic stroke patients who arrive at this hospital within 2 hours of time last known well and for whom IV t-PA was initiated at this hospital within 3 hours of time last known well.
-
STK-5 = Antithrombotic Therapy By End of Hospital Day 2: Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2.
-
STK-6 = Discharged on Statin Medication: Ischemic stroke patients with LDL greater than or equal to 100 mg/dL, or LDL not measured, or who were on a lipid-lowering medication prior to hospital arrival are prescribed statin medication at hospital discharge.
-
STK-7 = Dysphagia Screening: Patients with ischemic or hemorrhagic stroke who undergo evidence-based bedside testing protocol approved by the hospital before being given any food fluids, or medication by mouth.
-
STK-8 = 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, and warning signs and symptoms of stroke.
-
STK-9 = Smoking Cessation/Advice/Counseling: Patients with ischemic or hemorrhagic stroke with a history of smoking cigarettes, who are, or whose caregivers are, given smoking cessation advice or counseling during hospital stay. For the purposes of this measure, a smoker is defined as someone who has smoked cigarettes anytime during the year prior to hospital arrival.
-
STK-10 = Assessed for Rehabilitation: Ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services.
- ** Calculations for measures STK-7 and STK-9 are based on definitions provided in Disease-Specific Care Certification Program STROKE Performance Measurement Implementation Guide (2008) [49].
