Performance Measurement Network

Question: Thrombolytic contraindication in 3 hour window

How should cases be handled when a patient does not receive t-PA within the 3 hour window due to a documented contraindication (i.e. BP not within treatment range); however, t-PA is administered later within the 4.5 hour window after BP controlled?

Answer:

For purposes of reporting STK-4 measure rates to The Joint Commission, select 'No' for "IV Thrombolytic Initiation" and 'Yes' for "Reason for Not Initiating IV Thrombolytic" when a reason, such as BP control, existed within the 3 hr. timeframe. The reason preceeded IV thrombolytic initation beyond 3 hrs; therefore, the case should be excluded. A note for abstraction to this effect has been added to Version 3.3 of the specifications manual.

STK-4 uses the 3 hour timeframe. No other timeframes for t-PA administration are collected by The Joint Commission at ths time.

Question Details
Focus area(s): Measure Algorithms – Technical (chart abstracted)
Related documents: STK-04,

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