Measure Information Form
**NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE**
Measure Information Form
Measure Set: Stroke(STK)
Set Measure ID: STK-10
Performance Measure Name: Assessed for Rehabilitation
Description: Ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services.
Rationale: Each year about 700,000 people experience a new or recurrent stroke, which is the nation's third leading cause of death. Approximately two thirds of these individuals survive and require rehabilitation. Stroke is a leading cause of serious, long-term disability in the United States, with about 4.4 million stroke survivors alive today. Forty percent of stroke patients are left with moderate functional impairment and 15 to 30 percent with severe disability. More than 60% of those who have experienced stroke, serious injury, or a disabling disease have never received rehabilitation. Stroke rehabilitation should begin as soon as the diagnosis of stroke is established and life-threatening problems are under control. Among the high priorities for stroke are to mobilize the patient and encourage resumption of self-care activities as soon as possible. A considerable body of evidence indicates better clinical outcomes when patients with stroke are treated in a setting that provides coordinated, multidisciplinary stroke-related evaluation and services. Effective rehabilitation interventions initiated early following stroke can enhance the recovery process and minimize functional disability. The primary goal of rehabilitation is to prevent complications, minimize impairments, and maximize function.
Type of Measure: Process
Improvement Noted As: Increase in the rate
Risk Adjustment: No.
Data Collection Approach: Retrospective data sources for required data elements include administrative data and medical records. Some hospitals may prefer to gather data concurrently by identifying patients in the population of interest. This approach provides opportunities for improvement at the point of care/service. However, complete documentation includes the principal or other ICD-10 diagnosis and procedure codes, which require retrospective data entry.
Data Accuracy: Variation may exist in the assignment of ICD-10 codes; therefore, coding practices may require evaluation to ensure consistency.
Measure Analysis Suggestions: None
Sampling: Yes. Please refer to the measure set specific sampling requirements and for additional information see the Population and Sampling Specifications section.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Ischemic or hemorrhagic stroke patients assessed for or who received rehabilitation services.
Included Populations: Not applicable
Excluded Populations: None
Ischemic or hemorrhagic stroke patients.
Discharges with an ICD-10-CM Principal Diagnosis Code for ischemic or hemorrhagic stroke as defined in Appendix A, Table 8.1 or Table 8.2.
- Patients less than 18 years of age
- Patients who have a Length of Stay greater than 120 days
- Patients with Comfort Measures Only documented
- Patients enrolled in clinical trials
- Patients admitted for Elective Carotid Intervention
- Patients discharged to another hospital
- Patients who left against medical advice
- Patients who expired
- Patients discharged to home for hospice care
- Patients discharged to a health care facility for hospice care
- Bates, B., J. Y. Choi, P. W. Duncan, J. J. Glasberg, G. D. Graham, R. C. Katz, K. Lamberty, et al. "Veterans Affairs/Department of Defense Clinical Practice Guideline for the Management of Adult Stroke Rehabilitation Care: Executive Summary." [In eng]. Stroke 36, no. 9 (Sep 2005): 2049-56.
- Centers for Disease Control and Prevention. "Prevalence and Most Common Causes of Disability among Adults--United States, 2005." [In eng]. MMWR Morb Mortal Wkly Rep 58, no. 16 (May 1 2009): 421-6.
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- Management of Stroke Rehabilitation Working Group. VA/DoD clinical practice guideline for the management of stroke rehabilitation. Washington (DC): Veterans Health Administration, Department of Defense; 2010.
- Moodie, M., D. Cadilhac, D. Pearce, C. Mihalopoulos, R. Carter, S. Davis, G. Donnan, and Scopes Study Group. "Economic Evaluation of Australian Stroke Services: A Prospective, Multicenter Study Comparing Dedicated Stroke Units with Other Care Modalities." [In eng]. Stroke 37, no. 11 (Nov 2006): 2790-5.
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- Saka, O., V. Serra, Y. Samyshkin, A. McGuire, and C. C. Wolfe. "Cost-Effectiveness of Stroke Unit Care Followed by Early Supported Discharge." [In eng]. Stroke 40, no. 1 (Jan 2009): 24-9.
- Stroke, National Institute of Neurological Disorders and. "Post-Stroke Rehabilitation Fact Sheet." http://www.ninds.nih.gov/disorders/stroke/poststrokerehab.htm.
- "Urgency Key but Perseverance Pays Off." American Academy of Physical Medicine and Rehabilitation. http://www.zoominfo.com/CachedPage/?archive_id=0&page_id=389260562&page_url=//www.aapmr.org/condtreat/rehab/strokeusa.htm&page_last_updated=2010-07-28T02:27:25&firstName=Charles&lastName=Levy