Performance Measure Definition: Stroke Alert Bundle Completion
Description: This is the percentage of Stroke Alert patients who receive the full bundle of interventions from ATCEMS personnel.
The Stroke Bundle consists of four components:
- Completion and correct documentation of a Cincinnati Prehospital Stroke Scale (CPSS) assessment;
- Completion and correct documentation of a Blood Glucose Level (BGL) assessment;
- Scene interval less than 15 minutes; and
- Transport to an appropriate Stroke Center.
Desired Outcome: All patients identified as meeting Stroke Alert criteria receive the full bundle of prehospital interventions.
Relevance: Guidelines from the American Stroke Association state that “the primary goals of EMS assessment and management [of stroke patients] are rapid evaluation, early stabilization, neurological evaluation, and rapid transport and triage to a stroke-ready hospital.” Measuring Stroke Alert Bundle compliance helps us ensure that we are meeting these guidelines.
Measure Domain: Clinical Care
Type of Measure: Process
Formula Description: Count of Stroke Alert patients whose record indicates completion of all components of the bundle, divided by the count of all Stroke Alert patients [based on ATCEMSS criteria].
Unit of Analysis: Patient contacts
- Numerator: Patients identified as Stroke Alerts who have documented completion of all components of the Stroke Alert bundle.
- Denominator: Patients identified as Stroke Alerts.
Measure Frequency: Quarterly
Minimum Population/Sample: None
Performance Standard: At least 90% of all Stroke Alert patients will have documented completion of all components of the Stroke Alert bundle 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 that meet performance criteria
Aggregation: Temporal aggregations (month, hour of day, etc.) are based on the date/time of earliest recorded call pickup.
Limitations: This indicator is limited to those patients contacted by ATCEMS outside a clinical setting.
Patients for whom medics record interventions 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: None
ATCEMS Open Performance Dashboard
- Dashboard Performance Goal: Stroke Treatment Bundle
- Orientation: External
- Format: Line chart for current and previous fiscal year.
- Update Frequency: Monthly
- Data Source: Open Data table [EMS – Quarterly Clinical Measures - Stroke Alert]
City of Austin Open Data Portal
- Medium: Data table
- Table Name: EMS - Quarterly Clinical Measures - Stroke Alert
- Columns: Count – Stroke Alerts; Count – Stroke Alert Bundle Completed; Percent – Stroke Alert Bundle Completed
- Aggregation Level: Fiscal Quarter
- Update Frequency: Quarterly
Office of the Medical Director, Austin/Travis County EMS System (2016). “Clinical Guideline M-18: Suspected Stroke, Adult.” Austin-Travis County Emergency Medical Service System Clinical Operating Guidelines version 021716.
Office of the Medical Director, Austin/Travis County EMS System (2016). “Clinical Standard CS-34: Stroke Alert Criteria.” Austin-Travis County Emergency Medical Service System Clinical Operating Guidelines version 021716.
Development Status: Pilot measure
Definition Version: Version A
Revision Date: 2017-01-30
Revised By: David Andersen