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.