Performance Measurement Network

Question: What is the Date and Time Last Known Well?

RN documents: "Patient brought in via fire rescue. Patient started with left sided gaze and stuttering speech approx 1 hour ago. Patient also had a headache since this morning and blurrey vision for 2-3 weeks". Is this enough information to answer YES to Last Known Well?

Answer:

Without clarifying documentation, it is diffiult to determine when the patient was "Last Known Well", in other words, last known to be at their baseline state of health. Symptoms progressed about an 1 hour prior to arrival but actual date and time last known well cannot be determined, since symptoms span a 2-3 week timeframe. The patients state of health in between these symptomatic episodes are not reflected int the documentaiton provided.

Select 'No' for "Last Known Well", unless more specific documentation reflecting the patient"s baseline state of health prior to arrival is available in the medical a record.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: STK-04, Last Known Well
File:

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