Cognitive impairment following stroke

Measure purpose: Ensure patients have a validated cognitive screening following stroke.

The numerator:  all stroke patients with documentation indicating a validated cognitive screening* was completed or attempted (*See measure specifications for complete list of screening tools.)

is divided by

the denominator:  all patients aged 18 years and older with a diagnosis of ischemic stroke, nontraumatic spontaneous intracerebral hemorrhage and spontaneous subarachnoid hemorrhage discharged from acute care alive

Exclusions are removed from the denominator:

• Clinically infeasible to administer a screening.
• Patients with a post-stroke screen indicating intact cognitive function.

Key Phrases

 Examples of key phrases you could use to meet the measure include:

• MOCA followed by numerical score
• MMSE followed by numerical score
• Cognistat administered
• ACE-R results reviewed

Measure Calculation Example

Dr. Nilsson treated 100 patients between January 1 and December 31 with a diagnosis of ischemic stroke, non-traumatic spontaneous intracerebral hemorrhage and spontaneous subarachnoid hemorrhage discharged from acute care alive. This is the denominator.

Three patients had a post-stroke screen indicating intact cognitive function and in four patients it was clinically infeasible to administer a valid cognitive screening. These seven (3+4) patients are removed from the denominator as they meet exclusions.

Of the remaining 93 patients, Dr. Nilsson documented validated cognitive impairment screening for 41 patients.

Quality of patient care = 41/(100-7). Dr. Nilsson has a score of 44.1% for this measure.