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Question: IV Alteplase

A patient presented to ED due to stroke like symptoms but all resolved and pt was not a TPA candidate - pt was then placed in observation and transferred to the floor. The following day pt developed stroke symptoms and TPA was given and pt was transferred to another acute care hospital. Pt was never admitted so this is an OP encounter. The IV alteplase questions states was it initiated at this hospital - which is was however it was not in the ED and it was the following day… but.. i am a bit confused as the timing for this measure will then look at when the pt left the ED for the drip and ship timing - which is not the case for this patient. Can you please clarify? Am i understanding the timing for this measure correctly? Seems like the timing would not fit the scenario for patients who do not receive TPA in the ED


Christine, This is a unique scenario which the Notes for Abstraction do not address. If IV Alteplase was initiated after the "ED Departure Time", suggest that you select "No". The measure is evaluating the time the patient spent in the ED.

Thank you for your inquiry.

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

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