Performance Measurement Network

Question: stroke symptoms next day after arrival

Hi,

In this case, the pt arrived 2/2 at 1014; with general syncope and stroke was not suspected. The time stroke was suspected was the next day 2/3 1145 when the patient lost consciousness. I entered that last known well should be "no" according to the guidelines, and the only measure elements which then greys out are those related to alteplase. There wasn't time for pt to get the medications of anti thrombotic and vte prophylaxis - when there isn't the full 2 days (of arrival and the next day after arrival ) for the patient to receive them. How do I answer these elements?

Thanks very much.

Answer:

Courtney, The "Time Last Known Well" prior to the patient's "Arrival Time" at the hospital must be abstracted for STK data reporting and not when stroke was first diagnosed. Times after the patient's arrival should NOT be used for abstraction.

Review the record for a date and time last known well prior to hospital arrival. In order to select "No" for "Last Known Well", there needs to be explicit documentation by MD/APN/PA that last known well unknown/uncertain/unclear. If date/time prior to hospital arrival are available in the medical record, select "Yes" for "Last Known Well".

Thank you for your inquiry.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK, STK-3, STK-3,
Manual: Current Manual (current data collection period; prior to data transmission)

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