eMeasure Title Stroke Education
eMeasure Identifier
(Measure Authoring Tool)
107 eMeasure Version number 2
NQF Number 0440 GUID 217fdf0d-3d64-4720-9116-d5e5afa27f2c
Measurement Period January 1, 20xx through December 31, 20xx
Measure Steward Joint Commission
Measure Developer Joint Commission
Endorsed By National Quality Forum
Description
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.
Copyright
Measure specifications are in the Public Domain

LOINC(R) is a registered trademark of the Regenstrief Institute.

This material contains SNOMED Clinical Terms (R) (SNOMED CT(c) ) copyright 2004-–2010 International Health Terminology Standards Development Organization. All rights reserved.
Disclaimer
None
Measure Scoring Proportion
Measure Type Process
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
There are many examples of how patient education programs for specific chronic conditions have increased healthful behaviors, improved health status, and/or decreased health care costs of their participants. Clinical practice guidelines include recommendations for patient and family education during hospitalization as well as information about resources for social support services. Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies. The type of stroke experienced and the resulting outcomes will play a large role in determining not only the course of treatment but also what education will be required. Patient education should include information about the event (e.g., cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient’s prognosis and potential for rehabilitation.
Clinical Recommendation Statement
Some clinical trials have shown measurable benefits in patient and caregiver outcomes with the application of education and support strategies. Patient education should include information about the event (e.g., cause, treatment, and risk factors), the role of various medications or strategies, as well as desirable lifestyle modifications to reduce risk or improve outcomes. Family/caregivers will also need guidance in planning effective and realistic care strategies appropriate to the patient’s prognosis and potential for rehabilitation.
Improvement Notation
An increase in rate
Reference
Duncan et al, Stroke Rehabilitation Clinical Practice Guidelines Stroke. 2005;36:e100-e143.
Reference
Evans RL, Matlock AL, Bishop DS, Stranahan S, Pederson C. Family intervention after stroke: Does counseling or education help?, Stroke 1988;19:1243-1249.
Reference
Kaiser Permanente Clinical Practice Guidelines for Acute Stroke, Kaiser Permanente Medical Group, 1998.
Reference
Lorig KR, Sobel DS, Stewart AL, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial. Medical Care 1999;37:5-14.
Reference
Post Stroke Rehabilitation, Clinical Practice Guideline No.16, Agency for Health Care Policy and Research (now known as Agency for Healthcare Research and Quality), 1995.
Definition
None
Guidance
The unit of measurement for this measure is an inpatient episode of care. Each distinct hospitalization should be reported, regardless of whether the same patient is admitted for inpatient care more than once during the measurement period. In addition, the eMeasure logic intends to represent events within or surrounding a single occurrence of an inpatient hospitalization.

The facility location arrival datetime and facility location departure datetime are coupled with the emergency department visit value set. They intend to represent arrival date/time at the emergency department and the discharge date/time from the emergency department, respectively.

Written information given to the patient is required to address each and every one of the educational components. These components are modeled in in the population criteria and data criteria as communication from provider to patient :activation of emergency medical system, follow-up after discharge, medications prescribed at discharge, risk factors and signs and symptoms, and are intended to be specific to stroke.

The “Non-elective admissions” value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the “Inpatient encounter” value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions, including patients admitted for observation.
Transmission Format
None
Initial Patient Population
Ischemic stroke or hemorrhagic stroke patients discharged home.
Denominator
Ischemic stroke or hemorrhagic stroke patients discharged home.
Denominator Exclusions
Patients less than 18 years of age
Patients who have a length of stay greater than 120 days
Patients with comfort measures only documented
Patients admitted for elective carotid intervention
Numerator
Ischemic or hemorrhagic stroke patients with documentation that they or their caregivers were given educational material addressing all of the following:
1. Activation of emergency medical system 
2. Follow-up after discharge
3. Medications prescribed at discharge
4. Risk factors for stroke
5. Warning signs and symptoms of stroke.
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
Measure Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex.

Table of Contents


Population criteria

Data criteria (QDM Data Elements)

Reporting Stratification

Supplemental Data Elements




Measure Set
eMeasure Stroke (eSTK)