Performance Measurement Network

Question: Patient Ambulatory At End of Hospital Day 2


This question has follow-up question(s): Is admission day counted as day 1 for STK-1?

Patient arrived in the ED and was admitted to the hospital. The patient was "up ad lib" the morning of hospital day 1 and coded (Code CVA) later that day. The Stroke Team administered t-PA and transferred the patient to ICU. Prior to the stroke, this patient was ambulatory; however, the patient was on bedrest after the stroke until the end of day 2. Which path should be selected for "Patient Ambulatory At End of Hospital Day 2", "Yes" or "No"?

Answer:

This patient was non-ambulatory by the end of hospital day two (hospital day 1 = day of arrival; day 2 = day after hospital arrival). Per the currently effective measure specifications (Stroke Performance Measurement Implementation Guide, 2nd Edition, Verson 2.a), if documentation is present in the medical record that the patient was not ambulatory by the end of hospital day 2 (e.g., patient on bedrest, or only transferring out of bed to a bedside commode or chair and otherwise immoblile), select "NO" (see algorithm page 4-8 of the guide). This case is in the measure population for STK-1. Move on through the algorithm to the decision point Comfort Measues Only.

NOTE: Effective January 1, 2010, all certified PSCs must use the measure specifications as detailed in the Specifications Manual for National Inpatient Hospital Quality Measures, Version 3.0a. STK-1 specifications will change with this version and "patient ambulatory" has been deleted from the measure algorithm because ambulation is not considered VTE prophylaxis per the VTE clinical guidelines.

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

Copyright © by the contributing authors. All material on this collaboration platform is the property of the contributing authors.
Ideas, requests, problems regarding Performance Measurement Network? Send feedback