ATCEMS Performance Dashboard > Stroke Bundle Completion per Quarter > Performance Measure Definition: Blood Glucose Check in Stroke
Performance Measure Definition: Blood Glucose Check in Stroke

Description: This is the percentage of patients exhibiting signs and symptoms of a stroke who receive a blood glucose level (BGL) assessment by EMS.
Desired Outcome: All patients exhibiting signs of a Cerebrovascular Accident (Stroke) receive a blood glucose level test before arrival at the hospital.
Relevance: Hypoglycemia (low blood glucose) can mimic a stroke. A blood glucose level assessment is a quick and accurate test that can help paramedics form an accurate impression and care plan for these patients. This is important because hypoglycemia can be reversed easily in the field.
Measure Domain: Clinical Care
Type of Measure: Process

Operational Specifications
Formula Description: Count of stroke patients who have a blood glucose level recorded in the Vital Signs section of the ATCEMS ePCR system, divided by the count of all stroke patients.
The resulting measure is expressed as a percentage.
Unit of Analysis: Patient contact
Population:
  • Numerator: Patients with a primary impression of “Stroke” and patients identified as Stroke Alerts who have a documented BGL assessment.
  • Denominator: Patients with a primary impression of “Stroke” and patients identified as Stroke Alerts.
Measure Frequency: Fiscal quarter
Minimum Population/Sample: None
Performance Standard: At least 95% of all stroke patients will have a BGL assessment recorded in the Vital Signs section of the ATCEMS ePCR system each fiscal quarter.
Acceptable Quality Level: Performance may not fall below 87% for more than two consecutive quarters or any three quarters in a year.
Interval Description: Not applicable
Reporting Value(s): Percent of patient contacts
Aggregation: Aggregate patients based on date/time of phone pickup in Communications Center for incident.
Stratification: None
Limitations: Patients for whom medics record findings in locations that are not amenable to standardized reporting tools (e.g. recording findings in narrative or comment fields instead of vital signs fields) will present as a false negative.
Related Measures: 
  • Stroke Alert Blood Glucose Assessment: This measure is generally similar to the CPI measure, but is limited to Stroke Alert patients only. As a result, the patient contact counts for this measure will be smaller, and performance results will vary from the CPI results.
Notes: None

Reporting
ATCEMS Open Performance Dashboard
City of Austin Open Data Portal
Travis County Performance Dashboard 
  • Orientation: External
  • Format: Line chart of quarter values, beginning October 2014.
  • Update Frequency: Fiscal Quarter
  • Data Source: Open Data table [EMS - Quarterly OMD Clinical Performance Indicators]


References
Office of the Medical Director, Austin/Travis County EMS System (2014). “Clinical Performance Indicator 7.5: Blood Glucose Level in Stroke Patients.”
Office of the Medical Director, Austin/Travis County EMS System (2016). “Clinical Operating Guideline M-18: Suspected Stroke, Adult.” Austin-Travis County Emergency Medical Service System Clinical Operating Guidelines version 021716.

Metadata
Development Status: Actively reporting
Definition Version: Version D
Revision Date: 2017-01-25
Revised By: David Andersen