<?xml version="1.0"?>
<response><item key="0"><views_conditional_field>2024 Reporting Period</views_conditional_field><field_cms_id>CMS72v12</field_cms_id><field_short_name><![CDATA[<p>STK-5</p>
]]></field_short_name><field_nqf>Not Applicable</field_nqf><field_quality_id></field_quality_id><body><![CDATA[<p>Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2</p>
]]></body><field_definition><![CDATA[<div class="photoswipe-gallery"><p>None</p></div>]]></field_definition><field_initial_patient_population><![CDATA[<div class="photoswipe-gallery"><p>Inpatient hospitalization for patients age 18 and older discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during measurement period</p></div>]]></field_initial_patient_population><field_measurepopulationexclusion></field_measurepopulationexclusion><field_numerator_state><![CDATA[<div class="photoswipe-gallery"><p>Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after <a href="/glossary/hospital-inpatient" title="An inpatient hospital is an acute care facility, e.g., Subsection (d) hospitals in the 50 states or District of Columbia paid under the Inpatient Prospective Payment System, and critical access hospitals, meeting eligibility requirements for Promoting Interoperability Program payment adjustments by adopting, implementing, or updating certified EHR technology." class="glossify-tooltip-link">hospital</a> arrival</p></div>]]></field_numerator_state><field_numerator_exclusions><![CDATA[<div class="photoswipe-gallery"><p>Not Applicable</p></div>]]></field_numerator_exclusions><field_denominator_statement><![CDATA[<div class="photoswipe-gallery"><p>Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke</p></div>]]></field_denominator_statement><field_denominator_exclusions><![CDATA[<div class="photoswipe-gallery"><p>- Inpatient hospitalizations for patients who have a duration of stay less than 2 days</p><p>- Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival</p><p>- Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization</p></div>]]></field_denominator_exclusions><field_denominator_exceptions><![CDATA[<div class="photoswipe-gallery"><p>- Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after <a href="/glossary/hospital-inpatient" title="An inpatient hospital is an acute care facility, e.g., Subsection (d) hospitals in the 50 states or District of Columbia paid under the Inpatient Prospective Payment System, and critical access hospitals, meeting eligibility requirements for Promoting Interoperability Program payment adjustments by adopting, implementing, or updating certified EHR technology." class="glossify-tooltip-link">hospital</a> arrival</p><p>- Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival</p><p>- Inpatient hospitalization for patients with an INR greater than 3.5</p></div>]]></field_denominator_exceptions><field_measure_steward><![CDATA[<a href="/measure-stewards/joint-commission" hreflang="en">The Joint Commission</a>]]></field_measure_steward><field_measuredeveloper></field_measuredeveloper><field_measure_score><![CDATA[<a href="/ecqm-measure-scoring/proportion" hreflang="en">Proportion</a>]]></field_measure_score><field_score_type><![CDATA[<a href="/ecqm-type/process" hreflang="en">Process</a>]]></field_score_type><field_improvement_notation><![CDATA[<div class="photoswipe-gallery"><p>Improvement noted as an increase in rate</p></div>]]></field_improvement_notation><field_guidance><![CDATA[The "Nonelective Inpatient Encounter" 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 Inpatient Encounters include emergency, urgent, and unplanned admissions.NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).In the denominator exclusions, the intent is to only exclude patients with a total length of stay of &lt;2 days, including ED visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.]]></field_guidance><field_telehealth_eligible></field_telehealth_eligible><field_rationale><![CDATA[<div class="photoswipe-gallery"><p>The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist.</p><p>Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.</p><p>Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.</p></div>]]></field_rationale><field_stratification><![CDATA[<div class="photoswipe-gallery"><p>None</p></div>]]></field_stratification><field_riskadjustment><![CDATA[<div class="photoswipe-gallery"><p>None</p></div>]]></field_riskadjustment><field_clinicalrecommendationstat><![CDATA[<div class="photoswipe-gallery"><p>Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist</p></div>]]></field_clinicalrecommendationstat><field_addendum_notes></field_addendum_notes></item><item key="1"><views_conditional_field>2025 Reporting Period</views_conditional_field><field_cms_id>CMS72v13</field_cms_id><field_short_name><![CDATA[<p>STK-5</p>
]]></field_short_name><field_nqf>Not Applicable</field_nqf><field_quality_id></field_quality_id><body><![CDATA[<p>Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2</p>]]></body><field_definition><![CDATA[<p>None</p>]]></field_definition><field_initial_patient_population><![CDATA[<p>Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period</p>]]></field_initial_patient_population><field_measurepopulationexclusion></field_measurepopulationexclusion><field_numerator_state><![CDATA[<p>Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival</p>]]></field_numerator_state><field_numerator_exclusions><![CDATA[<p>Not Applicable</p>]]></field_numerator_exclusions><field_denominator_statement><![CDATA[<p>Equals Initial Population</p>]]></field_denominator_statement><field_denominator_exclusions><![CDATA[<p>- Inpatient hospitalization for patients who have a duration of stay less than 2 days</p><p>- Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival</p><p>- Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy</p><p>administered within 24 hours prior to arrival or anytime during hospitalization</p>]]></field_denominator_exclusions><field_denominator_exceptions><![CDATA[<p>- Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival.</p><p>- Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival.</p><p>- Inpatient hospitalization for patients with an international normalized ratio (INR) greater than 3.5.</p>]]></field_denominator_exceptions><field_measure_steward><![CDATA[<a href="/measure-stewards/joint-commission" hreflang="en">The Joint Commission</a>]]></field_measure_steward><field_measuredeveloper></field_measuredeveloper><field_measure_score><![CDATA[<a href="/ecqm-measure-scoring/proportion" hreflang="en">Proportion</a>]]></field_measure_score><field_score_type><![CDATA[<a href="/ecqm-type/process" hreflang="en">Process</a>]]></field_score_type><field_improvement_notation><![CDATA[<p>Improvement noted as an increase in rate</p>]]></field_improvement_notation><field_guidance><![CDATA[The "Nonelective Inpatient Encounter" 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 Inpatient Encounters include emergency, urgent, and unplanned admissions.NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).In the denominator exclusions, the intent is to only exclude patients with a total length of stay of &lt;2 days, including emergency department (ED) visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.]]></field_guidance><field_telehealth_eligible></field_telehealth_eligible><field_rationale><![CDATA[<p>The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist.</p><p>Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.</p><p>Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.</p>]]></field_rationale><field_stratification><![CDATA[<p>None</p>]]></field_stratification><field_riskadjustment><![CDATA[<p>None</p>]]></field_riskadjustment><field_clinicalrecommendationstat><![CDATA[<p>Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist</p>]]></field_clinicalrecommendationstat><field_addendum_notes></field_addendum_notes></item><item key="2"><views_conditional_field>2026 Reporting Period</views_conditional_field><field_cms_id>CMS72v14</field_cms_id><field_short_name><![CDATA[<p>STK-5</p>
]]></field_short_name><field_nqf>Not Applicable</field_nqf><field_quality_id></field_quality_id><body><![CDATA[<p>Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2</p>]]></body><field_definition><![CDATA[<p>None</p>]]></field_definition><field_initial_patient_population><![CDATA[<p>Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period</p>]]></field_initial_patient_population><field_measurepopulationexclusion></field_measurepopulationexclusion><field_numerator_state><![CDATA[<p>Inpatient hospitalizations for patients who had antithrombotic therapy administered the day of or day after hospital arrival</p>]]></field_numerator_state><field_numerator_exclusions><![CDATA[<p>None</p>]]></field_numerator_exclusions><field_denominator_statement><![CDATA[<p>Equals Initial Population</p>]]></field_denominator_statement><field_denominator_exclusions><![CDATA[<p>- Inpatient hospitalizations for patients who have a duration of stay less than 2 days</p><p>- Inpatient hospitalizations for patients with comfort measures documented day of or the day after arrival</p><p>- Inpatient hospitalizations for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy</p><p>administered within 24 hours prior to arrival or anytime during hospitalization</p>]]></field_denominator_exclusions><field_denominator_exceptions><![CDATA[<p>- Inpatient hospitalizations for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival.</p><p>- Inpatient hospitalizations for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival.</p><p>- Inpatient hospitalizations for patients with an international normalized ratio (INR) greater than 3.5.</p>]]></field_denominator_exceptions><field_measure_steward><![CDATA[<a href="/measure-stewards/joint-commission" hreflang="en">The Joint Commission</a>]]></field_measure_steward><field_measuredeveloper></field_measuredeveloper><field_measure_score><![CDATA[<a href="/ecqm-measure-scoring/proportion" hreflang="en">Proportion</a>]]></field_measure_score><field_score_type><![CDATA[<a href="/ecqm-type/process" hreflang="en">Process</a>]]></field_score_type><field_improvement_notation><![CDATA[<p>Increased score indicates improvement</p>]]></field_improvement_notation><field_guidance><![CDATA[The "Nonelective Inpatient Encounter" 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 Inpatient Encounters include emergency, urgent, and unplanned admissions.NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).In the denominator exclusions, the intent is to only exclude patients with a total length of stay of &lt;2 days, including emergency department (ED) visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.]]></field_guidance><field_telehealth_eligible></field_telehealth_eligible><field_rationale><![CDATA[<p>The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist.</p><p>Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.</p><p>Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.</p>]]></field_rationale><field_stratification><![CDATA[<p>None</p>]]></field_stratification><field_riskadjustment><![CDATA[<p>None</p>]]></field_riskadjustment><field_clinicalrecommendationstat><![CDATA[<p>Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist</p>]]></field_clinicalrecommendationstat><field_addendum_notes></field_addendum_notes></item></response>
