eMeasure Title

Assessed for Rehabilitation

eMeasure Identifier (Measure Authoring Tool) 102 eMeasure Version number 5.2.000
NQF Number 0441 GUID 7dc26160-e615-4cc2-879c-75985189ec1a
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward The Joint Commission
Measure Developer The Joint Commission
Endorsed By National Quality Forum
Description
Ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services
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 - 2015 International Health Terminology Standards Development Organization. All rights reserved.
Disclaimer
These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.
Measure Scoring Proportion
Measure Type Process
Measure Item Count
Encounter, Performed: Non-Elective Inpatient Encounter
Stratification
None
Risk Adjustment
None
Rate Aggregation
None
Rationale
Each year about 700,000 people experience a new or recurrent stroke, which is the nation's third leading cause of death. Approximately two thirds of these individuals survive and require rehabilitation. Stroke is a leading cause of serious, long-term disability in the United States, with about 4.4 million stroke survivors alive today. Forty percent of stroke patients are left with moderate functional impairment and 15 to 30 percent with severe disability. More than 60% of those who have experienced stroke, serious injury, or a disabling disease have never received rehabilitation. Stroke rehabilitation should begin as soon as the diagnosis of stroke is established and life-threatening problems are under control. Among the high priorities for stroke are to mobilize the patient and encourage resumption of self-care activities as soon as possible. A considerable body of evidence indicates better clinical outcomes when patients with stroke are treated in a setting that provides coordinated, multidisciplinary stroke-related evaluation and services. Effective rehabilitation interventions initiated early following stroke can enhance the recovery process and minimize functional disability. The primary goal of rehabilitation is to prevent complications, minimize impairments, and maximize function.
Clinical Recommendation Statement
A considerable body of evidence indicates better clinical outcomes when patients with stroke are treated in a setting that provides coordinated, multidisciplinary stroke-related evaluation and services. Effective rehabilitation interventions initiated early following stroke can enhance the recovery process and minimize functional disability.
Improvement Notation
Improvement noted as an increase in rate
Reference
Management of Stroke Rehabilitation Working Group. VA/DoD clinical practice guideline for the management of stroke rehabilitation. Washington (DC): Veterans Health Administration, Department of Defense; 2010.
Reference
Bates, B., J. Y. Choi, P. W. Duncan, J. J. Glasberg, G. D. Graham, R. C. Katz, K. Lamberty, et al. "Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care: Executive Summary." [In eng]. Stroke 36, no. 9 (Sep 2005): 2049-56
Reference
Duncan, P. W., R. Zorowitz, B. Bates, J. Y. Choi, J. J. Glasberg, G. D. Graham, R. C. Katz, K. Lamberty, and D. Reker. "Management of Adult Stroke Rehabilitation Care: A Clinical Practice Guideline." [In eng]. Stroke 36, no. 9 (Sep 2005): e100-43.
Reference
Ottenbacher, K. J., and S. Jannell. "The Results of Clinical Trials in Stroke Rehabilitation Research." [In eng]. Arch Neurol 50, no. 1 (Jan 1993): 37-44.
Reference
"Outcomes in Stroke Rehabilitation." Topics in Stroke Rehabilitation 12, no. 4 (Fall 2005): 1-10, 11-19, 20-27, 28-36, 37-49.
Definition
None
Guidance
The "Non-elective 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 admissions include emergency, urgent and unplanned admissions.
Transmission Format
TBD
Initial Population
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
Denominator
Initial Population
Denominator Exclusions
Patients with comfort measures documented
Patients discharged to another hospital
Patients who left against medical advice
Patients who expired
Patients discharged to home for hospice care
Patients discharged to a health care facility for hospice care
Patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.
Numerator
Ischemic or hemorrhagic stroke patients assessed for or who received rehabilitation services
Numerator Exclusions
Not Applicable
Denominator Exceptions
None
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 Variables)

Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables


Measure Set
eMeasure Stroke (eSTK)