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Stroke and Stroke Rehabilitation: Thrombolytic Therapy

This measure captures the proportion of acute ischemic stroke patients who arrive at this hospital within 2 hours of time last known well for whom IV t-PA was initiated at this hospital within 3 hours of time last known well

Date Reviewed: April 7, 2014

Measure Info

MIPS 187NQF 0437CMS 187NQF Endorsed
Measure Type: 
Process
Measure Steward: 
The Joint Commission
Clinical Topic Area: 
Stroke

Care Setting: 
Inpatient
Outpatient
Data Source: 
Electronic Health Records
Paper Medical Records
Registry

NQF 0437: “STK 04: Thrombolytic Therapy” ACP believes that the measure specification requires further clarification. It is not clinically specific regarding the indications for treatment. There is evidence that the harms of thrombolytic therapy may outweigh the benefit in some cases, especially if the full exclusion criteria published by the National Institute of Neurological Disorders and Stroke and others are not followed. This should be made explicit in the measure exclusion criteria. There also are specific qualifications hospitals must meet in order to provide tPa. The absence of such conditions should also be noted as an exclusion criterion. There may also be regional variations in the availability of qualifying institutions, potentially making this measure inapplicable to all physicians in some areas.