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CSS Core Performance Indicators

Canadian Stroke Strategy Core System Indicators 2010

  1. Proportion of the population aware of 2 or more signs of stroke.
  2. The proportion of patients in the population that has any identified risk factors for stroke including: hypertension, obesity, smoking history, low physical activity, hyperlipidemia, diabetes, atrial fibrillation and carotid artery disease.
  3. The emergency department admission volumes for patients with ischemic stroke, intracerebral hemorrhagic stroke, subarachnoid hemorrhage, and transient ischemic attack.The hospital inpatient admission volumes for patients with ischemic stroke, intracerebral hemorrhagic stroke, subarachnoid hemorrhage, and transient ischemic attack.
  4. Total acute inpatient hospital length of stay (active LOS + ALC = total).^*Total inpatient rehabilitation hospital length of stay (active LOS + days waiting – service interruptions = total).
  5. Stroke death rates for 7-day in-hospital stroke fatality;  30 day all cause mortality;  one-year all cause mortality, for patients with ischemic stroke, intracerebral hemorrhagic stroke, subarachnoid hemorrhage, and transient ischemic attack .*
  6. Proportion of acute stroke and TIA patients that are discharged alive that are then readmitted to hospital with a new stroke or TIA diagnosis within 90 days of index acute care discharge. ^*

Canadian Stroke Strategy Core Clinical Indicators 2010

  1. Proportion of acute ischemic stroke patients who arrive at hospital within 3.5 hours of stroke symptom onset.
  2. Proportion of all ischemic stroke patients who receive acute thrombolytic therapy.*
  3. Proportion of all thrombolyzed ischemic stroke patients who receive acute thrombolytic therapy within one hour of hospital arrival. *
  4. The proportion of all acute stroke patients who are managed on a designated geographically defined integrated, acute, and/or rehabilitation stroke unit at any point during hospitalization.*Median total time spent on a stroke unit for each patient during inpatient stay. ^
  5. Proportion of stroke patients who receive a brain CT/MRI within 24 hours of hospital arrival. +
  6. Proportion of patients with documentation of an initial dysphagia screening during admission to ED or acute inpatient care or inpatient rehabilitation. ^*
  7. Proportion of acute ischemic stroke and TIA patients who receive acute antiplatelet therapy within the first 48h hours of hospital arrival. ^+
  8. Proportion of stroke patients with a rehabilitation assessment within 48 hours of hospital admission for acute ischemic stroke and within 5 days of admission for hemorrhagic stroke. +
  9. Proportion of acute ischemic stroke patients discharged on antithrombotic therapy unless contraindicated. *
  10. Proportion of acute ischemic stroke patients with atrial fibrillation who are treated with anti-coagulant therapy unless contraindicated. +
  11. Proportion of patients with TIA who are investigated and discharged from the emergency department who are referred to organized secondary stroke prevention services.+Percentage of patients referred to organized secondary stroke prevention services who are seen within 72 hours
  12. Wait time from ischemic stroke or TIA symptom onset to carotid revascularization. +
  13. Distribution of discharge locations (dispositions) for acute stroke patients from acute inpatient care to:  home (with and without services); inpatient rehabilitation (General or specialized); long term care; and to palliative care (each stratified by stroke type and severity). *
  14. Wait times for inpatient stroke rehabilitation services from stroke onset to rehabilitation admission.+Wait times for outpatient stroke rehabilitation services from stroke onset to outpatient rehabilitation admission.
  15. Distribution of discharge locations (dispositions) from inpatient rehabilitation to: home (with and without services); acute care (for acute medical issues or as repatriation to home community); and to long term care (each stratified by stroke type and severity).

Proportion of all stroke patients with documentation of education provided for patient, family and/or caregivers during acute inpatient care or inpatient rehabilitation stay. !+

^     New core indicator – previously part of larger set of CSS best practice indicators, and/or part of Accreditation indicator set and elevated to core indicator for 2010

*     CSS core indicators that are also mandatory indicators for the Accreditation Canada Stroke Distinction Program

+      CSS core indicators that are also optional indicators for the Accreditation Canada Stroke Distinction Program

!       Indicator on documentation of patient education is considered a developmental indicator that will be monitored closely for data quality and validity prior to being considered as a part of the CSS core indicator set.

For additional indicators associated with each stroke best practice recommendation, please refer to the CSS Performance Measurement Manual, found at www.canadianstrokestrategy.com