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Question: Initial Date/time of NIHSS teleneurologist

Hello, We are seeking clarification regarding initial date and time of NIHSS. The definition states that we are looking for documentation of NIHSS done AT THIS HOSPITAL. The definition also states the score prior to arrival by a teleneulogist can be used. Is the only scenario when this would be applicable is when the MD at the CSC (or working as a representative of the CSC performs the NIHSS using telemedicine and then the patient is transferred from an outside hospital to that CSC? Are there other times that a teleneuology NIHSS could be used for “Initial NIHSS Score Performed?”

Answer:

The scenario prompting inclusion of the bullet in the data element definition for "Initial NIHSS Score Performed" is that of NIHSS score done by teleneurology prior to transfer of the patient to your hospital for performance of the reperfusion intervention/procedure. The intent of this measure is to obtain a NIHSS score as close to initiation of the reperfusion intervention/procedure as possible. Preferrably this score should be done at the hospital performing the procedure and prior to initiation of the procedure. We recognize that in urgent situations, the patient may be assessed by telemedicine (NIHSS obtained), decision to transefer made, and the patient taken right to the interventional suite for performance of an intervention based on the telemedicine assessment. The abstraction guideline was included for this reason. Hope this helps clarify for your CSCs.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK, CSTK-01, Initial NIHSS Score Date
Manual: Current Manual (current data collection period; prior to data transmission)
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