eMeasure Title

Stroke Education

eMeasure Identifier (Measure Authoring Tool) 107 eMeasure Version number 5.1.000
NQF Number Not Applicable GUID 217fdf0d-3d64-4720-9116-d5e5afa27f2c
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward The Joint Commission
Measure Developer The Joint Commission
Endorsed By None
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 2004-2015 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
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 (eg, 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 (eg, 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
Improvement noted as an increase in rate
Reference
Eames, S., T. Hoffmann, L. Worrall, and S. Read. "Stroke Patients' and Carers' Perception of Barriers to Accessing Stroke Information." [In eng]. Top Stroke Rehabil 17, no. 2 (Mar-Apr 2010): 69-78.
Reference
Furie, K. L., S. E. Kasner, R. J. Adams, G. W. Albers, R. L. Bush, S. C. Fagan, J. L. Halperin, et al. "Guidelines for the Prevention of Stroke in Patients with Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association." [In eng]. Stroke 42, no. 1 (Jan 2011): 227-76.
Reference
Goldstein, L. B., C. D. Bushnell, R. J. Adams, L. J. Appel, L. T. Braun, S. Chaturvedi, M. A. Creager, et al. "Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association." [In eng]. Stroke 42, no. 2 (Feb 2011): 517-84.
Reference
Hafsteinsdottir, T. B., M. Vergunst, E. Lindeman, and M. Schuurmans. "Educational Needs of Patients with a Stroke and Their Caregivers: A Systematic Review of the Literature." [In eng]. Patient Educ Couns 85, no. 1 (Oct 2011): 14-25
Reference
Jauch, E. C., J. L. Saver, H. P. Adams, Jr., A. Bruno, J. J. Connors, B. M. Demaerschalk, P. Khatri, et al. "Guidelines for the Early Management of Patients with Acute Ischemic Stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association." [In Eng]. Stroke (Jan 31 2013).
Reference
Lorig, K. R., D. S. Sobel, A. L. Stewart, B. W. Brown, Jr., A. Bandura, P. Ritter, V. M. Gonzalez, D. D. Laurent, and H. R. Holman. "Evidence Suggesting That a Chronic Disease Self-Management Program Can Improve Health Status While Reducing Hospitalization: A Randomized Trial." [In eng]. Med Care 37, no. 1 (Jan 1999): 5-14.
Definition
None
Guidance
Written information given to the patient is required to address each and every one of the educational components. These components are modeled 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.
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
Ischemic stroke or hemorrhagic stroke patients discharged to home, home care, or court/law enforcement
Denominator Exclusions
Patients with comfort measures documented
Numerator
Ischemic or hemorrhagic stroke patients with written 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
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)