Specifications of guideline-recommended performance measures
| Performance measure of IS care | Performance measure definition for eligible patients* |
| Acute performance measures | |
| Intravenous rtPA <4.5 hours | Intravenous rtPA in patients who arrive within 3.5 hours after initial symptom onset and treated within 4.5 hours |
| Endovascular treatment <6 hours | Mechanical endovascular reperfusion therapy for acute IS caused by arterial occlusion of proximal anterior circulation within 6 hours after admission |
| Early antithrombotics | Antithrombotic therapy prescribed within 2 days of hospitalisation, including antiplatelet or anticoagulant therapy |
| DVT prophylaxis | Patients at risk for DVT (non-ambulatory) who underwent DVT prophylaxis by the end of hospital day 2, including pneumatic compression, warfarin sodium, heparin sodium or new oral anticoagulants |
| Dysphagia screening | Dysphagia screening prior to any oral intake |
| Rehabilitation assessment | Assessed for stroke rehabilitation services |
| Performance measures at discharge | |
| Antithrombotic medication | Antithrombotic therapy prescribed at discharge |
| Anticoagulation for AF | Anticoagulation prescribed at discharge for patients with AF or atrial flutter documented during the hospitalisation |
| Antihypertensive medicines for patients with hypertension | Antihypertension medication prescribed at discharge for patients with history of hypertension disease or hypertension disease documented during the hospitalisation |
| Hypoglycaemic medication for diabetes mellitus | Hypoglycaemic medication prescribed at discharge for patients with history of diabetes mellitus or diabetes mellitus documented during the hospitalisation |
| Statin for lowering LDL≥100 mg/dL | Statin prescribed at discharge if LDL≥100 mg/dL, if patient treated with lipid-lowering agent prior to admission, or LDL not documented, hypoglycaemic medication for diabetes mellitus |
| Smoking cessation | Smoking cessation intervention (counselling or medication) prior to discharge for current or recent smokers |
| Stroke education | Stroke education provided to patient and/or caregiver, including all five components: modifiable risk factors, stroke warning sign and symptoms, how to activate emergency medical services, need for follow-up and medications prescribed |
*Eligible patients are those without any medical contraindications (eg, treatment intolerance, excessive risk of adverse reaction, patient/family refusal, or terminal illness/comfort care only) documented as reasons for non-treatment for each of the applicable measures. Acute performance measures, except for the rtPA measure, exclude patients who died before the end of day 2 of the hospital stay. Performance measures at discharge exclude patients who died during hospitalisation.
AF, atrial fibrillation; DVT, deep vein thrombosis; IS, ischaemic stroke; LDL, low-density lipoprotein; rtPA, recombinant tissue plasminogen activator.