ASC Stroke Data Management & Registry Reporting 1 — Questions and Answers
Question 1: Which national registry is most commonly used by certified stroke centers to submit performance data and benchmark against peer institutions?
- NCDR CathPCI Registry
- Get With The Guidelines-Stroke (GWTG-Stroke) (Correct answer)
- National Inpatient Sample (NIS)
- Nationwide Emergency Department Sample (NEDS)
Correct answer: Get With The Guidelines-Stroke (GWTG-Stroke)
GWTG-Stroke is the American Heart Association/American Stroke Association registry used by certified stroke centers to track adherence to evidence-based stroke measures and benchmark performance.
Question 2: The door-to-needle (DTN) time metric for IV alteplase is defined as the time from which two events?
- EMS dispatch to drug infusion start
- ED arrival to start of alteplase infusion (Correct answer)
- Symptom onset to alteplase bolus
- CT scan completion to alteplase administration
Correct answer: ED arrival to start of alteplase infusion
Door-to-needle time is measured from the patient's emergency department arrival time to the initiation of IV alteplase infusion, and the target is ≤60 minutes.
Question 3: According to The Joint Commission stroke certification standards, which time metric must be documented for mechanical thrombectomy-eligible patients?
- Door-to-CT time
- Door-to-groin puncture time (Correct answer)
- Symptom onset to hospital arrival time
- Imaging-to-discharge time
Correct answer: Door-to-groin puncture time
Door-to-groin puncture time (target ≤90 minutes) is a key metric for endovascular thrombectomy cases, tracked in stroke registries and required by certification standards.
Question 4: When abstracting stroke data for registry submission, which tool score must be documented at presentation to capture neurological deficit severity?
- Modified Rankin Scale (mRS)
- Barthel Index (BI)
- NIH Stroke Scale (NIHSS) (Correct answer)
- Glasgow Coma Scale (GCS)
Correct answer: NIH Stroke Scale (NIHSS)
The NIHSS score at presentation is a required data element in stroke registries and certification standards because it quantifies initial neurological deficit severity.
Question 5: In the GWTG-Stroke registry, which discharge outcome measure is used to assess functional status at the time the patient leaves the hospital?
- NIH Stroke Scale score
- Modified Rankin Scale (mRS) (Correct answer)
- Functional Independence Measure (FIM)
- Berg Balance Scale
Correct answer: Modified Rankin Scale (mRS)
The modified Rankin Scale (mRS) at discharge is a required GWTG-Stroke data element that captures the patient's level of functional independence on a 0–6 scale.
Question 6: A stroke coordinator is abstracting a drip-and-ship case. Which arrival time should be recorded as the 'hospital arrival time' for DTN calculation at the receiving comprehensive stroke center?
- Time the patient arrived at the originating hospital
- Time the transfer was accepted by the receiving center
- Time the patient arrived at the receiving comprehensive stroke center (Correct answer)
- Time alteplase was initiated at the originating hospital
Correct answer: Time the patient arrived at the receiving comprehensive stroke center
For DTN calculation at the receiving facility, hospital arrival time is recorded as the time the patient physically arrived at the receiving comprehensive stroke center.
Question 7: Which CMS quality measure requires documentation that stroke patients were assessed for rehabilitation needs before discharge?
- STK-1: Venous Thromboembolism Prophylaxis
- STK-4: Thrombolytic Therapy
- STK-10: Assessed for Rehabilitation (Correct answer)
- STK-6: Discharged on Antithrombotic Therapy
Correct answer: STK-10: Assessed for Rehabilitation
STK-10 requires that ischemic stroke and hemorrhagic stroke patients be assessed for rehabilitation services prior to hospital discharge as part of The Joint Commission's stroke core measures.
ASC Stroke Data Management & Registry Reporting 1
Which national registry is most commonly used by certified stroke centers to submit performance data and benchmark against peer institutions?