Endovascular treatment and imaging measure bundle
Measure purpose: Ensure patients who receive endovascular treatment receive optimal care and imaging.
The numerator: All patients receiving endovascular treatment who received all 6 treatment components:
- Non-contrast brain CT or MRI performed and interpreted within 45 minutes of arrival or in-hospital stroke or for patients transferred receipt of imaging (e.g., disc or via remote server/dicom viewer).
- Non-contrast brain imaging report or stroke team review directly addresses hemorrhage, mass, acute infarction.
- Documented causative intracranial large vessel (artery) occlusion (LVO) on vascular imaging.
- Groin puncture within 90 minutes of ED or transfer arrival.
- Final Thrombolysis in Cerebral Infarction (TICI) score documented.
- Time to final TICI score documented.
is divided by
the denominator: all patients aged 18 years and older who received endovascular treatment.
Exclusions are removed from the denominator:
For component 4 only:
- In-hospital stroke events
Key Phrases
Examples of key phrases you could use to meet the measure include:
Component 1:
- MRI results reviewed within 45 minutes of arrival
- Non-contrast CT results reviewed within 45 minutes of arrival
- Transfer images reviewed
Component 2:
- Hemorrhage noted (followed by appropriate clinical details)
- Mass present (followed by appropriate clinical details)
- Acute infarction documented (followed by appropriate clinical details)
Component 3:
- Causative LVO noted in imaging (followed by appropriate clinical details)
Component 4:
- Groin puncture occurred within 90 minutes of arrival
Component 5:
- Final TICI (followed by numerical/letter score)
Component 6:
- Time to final TICI score was (followed by time interval)
Measure Calculation Example
This measure utilizes an all-or-none calculation strategy. For a more comprehensive explanation of how measure bundles are calculated please view this 17-minute webinar (download).
Dr. Ocampo provides endovascular care to 5 patients (A, B, C, D, and E) aged 18 years and older between January 1 and December 31. This is the denominator.
- All five patients A, B, C, D, and E had non-contrast brain CT or MRI performed and interpreted within 45 minutes of arrival.
- Four patients A, B, D, and E had documentation the stroke team review of the imaging report directly addresses hemorrhage, mass, acute infarction. C did not.
- All five patients A, B, C, D, and E had documentation of causative LVO on vascular imaging.
- Four patients A, B, C, and E had documentation groin puncture occurred within 90 minutes of arrival.
- All five patients A, B, C, D, and E had final TICI score documented.
- Four patients A, B, C, and D had time to final TICI score documented. E did not.
Dr. Ocampo's performance rate is 60% for this measure. 3 patients (A, B, D) met the bundle/5 patients in the denominator.