Performance Measurement Network

Question: Thrombolytic therapy administered at satellite ED prior to hospital arrival

We are a multi-hospital system with a satellite ED. The patient is given IV t-PA at the satellite ED, then transferred to our main facility and admitted for continued care. It is considered one episode of care (all satellite ED documentation will be included in the inpatient medical record). How should the IV thrombolytic question be answered? The t-PA was not administered at the main hospital facility (i.e. 'this hospital'). Which path should be selected for "IV Thrombolytic Therapy Administered": "Yes", "No", or "NC"?

Answer:

The key differentiator is "one episode of care". If considered one episode of care (i.e. one single admission), and the satellite ED documentation is included with the medical record for the inpatient admission, then the satellite is an extension of the main hospital. t-PA administration at the satellite is the same as administration at the main facility. Select "Yes" for t-PA administration. Otherwise, this case will not be captured in the measure population, since the satellite ED is not a primary stroke center and not collecting/submitting stroke data.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK, STK-4
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