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Using the monthly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 25 cases for the month. Patients admitted to the hospital for inpatient acute care are included in the CSTK 3-Hemorrhagic Stroke subpopulation sampling group if they have: ICD-10-CM Principal Diagnosis Code as defined in Appendix A, Table 8.2, a Patient Age (Admission Date Birthdate) 18 years and a Length of Stay (Discharge Date - Admission Date) 120 days. STK-2 Discharged on Antithrombotic Therapy13. Return to Clinical Data Processing Flow in the Data Processing section. Along with award-winning software you receive a consultant that helps you with all of your technical and clinical needs. hbspt.cta._relativeUrls=true;hbspt.cta.load(491484, '41fd9d46-8610-4a5f-a135-c143fe55a31f', {"useNewLoader":"true","region":"na1"}); By JoAnne Marino April 30, 2021 Regulatory Updates: Hospital. The Core Quality Measures Project currently includes 6 of 11 National EMS Quality Measures. Mcarbo p365 short stroke flat trigger - ywna.wikinger-turnier.de This may be achieved by administering the t-PA drug intravenously to eligible patients within three hours of stroke onset. Specifications Manual for Joint Commission National Quality Measures (v2021A1), Comprehensive Stroke (CSTK) Initial Patient Population, First Pass of a Mechanical Reperfusion Device, Highest NIHSS Score Documented Within 36 Hours Following IA Alteplase or MER Initiation, Highest NIHSS Score Documented Within 36 Hours Following IV Alteplase Initiation, IV Alteplase Prior to IA or Mechanical Reperfusion Therapy, Initial Blood Glucose Value at Hospital Arrival, Initial Blood Pressure at Hospital Arrival, Initial Platelet Count at Hospital Arrival, NIHSS Score Documented Closest to IA Alteplase or MER Initiation, NIHSS Score Documented Closest to IV Alteplase Initiation, Post-Treatment Thrombolysis in Cerebral Infarction (TICI) Reperfusion Grade, Post-Treatment Thrombolysis in Cerebral Infarction (TICI) Reperfusion Grade Date, Post-Treatment Thrombolysis in Cerebral Infarction (TICI) Reperfusion Grade Time, Reason for Not Administering Nimodipine Treatment, Reason for Not Administering a Procoagulant Reversal Agent, Appendix E - Overview of Measure Information Form and Flowchart Formats, Cover Page for the Joint Commission Manual, Joint Commission Clinical Data Processing Flow, Joint Commission National Quality Measures Data Processing, Using the The Joint Commission's National Measure Specifications Manual, National Institutes of Health Stroke Scale (NIHSS Score Performed for Ischemic Stroke Patients), Severity Measurement Performed for SAH and ICH Patients (Overall Rate), Procoagulant Reversal Agent Initiation for Intracerebral Hemorrhage (ICH ), Hemorrhagic Transformation (Overall Rate), Thrombolysis in Cerebral Infarction (TICI Post-Treatment Reperfusion Grade), Modified Rankin Score (mRS at 90 Days: Favorable Outcome), Rate of Rapid Effective Reperfusion From Hospital Arrival, Rate of Rapid Effective Reperfusion From Skin Puncture, All Records, Not collected for HBIPS-2 and HBIPS-3, All Records, Optional for HBIPS-2, HBIPS-3, All Records, Optional for All HBIPS Records. This section reviews The Joint Commission certifications and clarifies the CMS accreditation requirement. See how our expertise and rigorous standards can help organizations like yours. Domain-Specific Outcome Measures in Clinical Trials of Therapies Find evidence-based sources on preventing infections in clinical settings. The Measure Steward refers to the organization that is responsible for providing the required measure information for the measure maintenance process that occurs approximately every three years. Quarterly sampling for the two combined populations for Joint Commission certification purposes. Understanding core measures for heart-failure treatment - American Nurse OP Stroke General Data Element List General Data Element Name Collected For: Arrival Time Percent of ischemic stroke patients who received antithrombotic therapy by the end of hospital day two. Using the monthly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size is less than the minimum required monthly sample size, so 100% of the subpopulation or all 11 cases are sampled. STK-5 Antithrombotic Therapy By End of Hospital Day Two11. The annual Acute Care Hospital Quality Improvement Program Measures reference guide provides a comparison of measures for five Centers for Medicare & Medicaid Services (CMS) acute care hospital quality improvement programs, including the: Hospital IQR Program Hospital Value-Based Purchasing (VBP) Program Promoting Interoperability Program hbbd``b` SY ~H0[@D1HI-Hp @o$xA }:.PHplp%H^'n&F&QT'340 Ji If the Patient Age is less than 18 years, the patient is not in the STK Initial Patient Population and is not eligible to be sampled for the STK measure set. Percent of acute ischemic stroke patients who arrive at this hospital within 2 hours of time last known well and for whom IV t-PA was initiated at this hospital within 3 hours of time last known well. endobj The following sample size tables for each option automatically build in the number of cases needed to obtain the required sample sizes. Using the quarterly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 75 cases for the quarter. JoAnne has a background in Quality Management and has been working with hospitals on their Core Measures compliance with CMS and The Joint Commission since 2008. Centers for Medicare and Medicaid Services Measures Inventory Tool This post is a guide to understanding the differences between the five major stroke measure sets. REMINDER: Stroke is now a Core Measure for CMS!!! Set the Initial Patient Population Reject Case Flag to equal No. I hope this high-level overview was helpful and can be a reference for you. STK-4 Thrombolytic Therapy7. CSTK-10c Functional Status Prior to Stroke-Independent: MER Therapy, 4. with acute ischemic stroke in the hospital setting will submit this measure. An official website of the United States government STK-OP-1h Ischemic Stroke; IV Alteplase Prior to Transfer, LVO and NOT MER Eligible**ADDED as of 7/1/2021**9. All Records, Optional for HBIPS-2 and HBIPS-3, No sampling; 100% Patient Population required, ICD-10-PCS Principal or Other Procedure Codes. Dude JA, Lohse KR, Cramer SC, Worrall BB; GPAS Collaboration Phenotyping Core. See our editorial policies and staff. 1 0 obj Especially if you use an EHR vendor right now, youll notice a huge difference. 671 0 obj <>/Filter/FlateDecode/ID[<8968A4F338E55446928FCF4A155C4BC8>]/Index[646 45]/Info 645 0 R/Length 114/Prev 86415/Root 647 0 R/Size 691/Type/XRef/W[1 2 1]>>stream CPT only copyright 2019 American Medical Association. m/P]H(ZVk[/ "+TPy9|9J1C0.ZOK_i@"$B'r~-("tNZmO}cv!eB Part 1: A review of the different stroke measure sets. PDF STROKE - American Heart Association Approximately 2-4% of patients with stroke have their event while hospitalized for another condition, with almost one half resulting from a vascular procedure. Updated eCQM Specifications and eCQM Materials for 2021 Reporting Now Using the quarterly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size required is 42 cases for the quarter. CSTK-06 Nimodipine Treatment Administered6. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Reports, http://www.qualityforum.org/CQMC_Core_Sets.aspx. Heres a good reference document in case you get confused. To search the historic measure inventory, enter one or more terms in the search box and hit enter or click the search button. IQR Measures - Centers for Medicare & Medicaid Services MjMO2n7( LBm6N.Hl#|oKP?lEF@L9ew,w\XpP{]8vxmtV}Or,kU{ `B7{"'Tf(DL[}ZEY 7'XoFo(|{%Jlv,_v}%DPnpoAucQGPy'YVJGXv:E j5(kts,?BcBKd?R . % CSTK-10a Functional Status Prior to Stroke-Independent: IV Alteplase Only2. CSTK-10d Functional Status Prior to Stroke-Dependent: MER Therapy, 9. STK-OP-1f Ischemic Stroke; No IV Alteplase Prior to Transfer, No LVO7. If the Patient Age is greater than or equal to 18 years, continue processing and proceed to Length of Stay Calculation. Nozzle assembly is comprehensively flow tested to measure flow rate, leak and seat condition to validate injection consistency. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this Agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. But hospitals see benefits as well. In addition, 36 states reported more Adult Core Set measures for FFY 2019 than for FFY 2018. 3 0 obj Using the quarterly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size required is 84 cases for the quarter. This product includes CPT which is commercial technical data, which was developed exclusively at private expense by the American Medical Association, 330 North Wabash Avenue, Chicago, Illinois 60611. Core Measure Data as of 3/2/2022. STK-6 Discharged on Statin Medication12. CMS is already using measures from the each of the core sets. To develop the core measure sets the Collaborative split into workgroups and reviewed measures currently in use by CMS and health plans as well as measures endorsed by NQF for the individual measure sets. Test your ideas. Here is a diagram that outlines the submission differences. A hospitals ischemic stroke patient population size is 295 cases during March. The measure development and maintenance process is guided by expertise and advice provided by the Stroke Measure Maintenance Technical Advisory Panel (TAP). You receive one consultant that you can call anytime with questions or concerns. Dallas, TX 75231, Customer Service CPT is provided as is without warranty of any kind, either expressed or implied, including but not limited to the implied warranties of merchantability and fitness for a particular purpose. Recommended Core Measures | CMS The median number of Adult Core Set measures reported by states is 22.5 measures for FFY 2019, up from 20 measures reported for FFY 2018 and 17 measures for FFY 2017. For information concerning how to perform sampling, refer to the Population and Sampling Specifications section in this manual. Saturday: 9 a.m. - 5 p.m. CT STK-4 Thrombolytic Therapy10. We aim to determine feasibility of implementing stroke core measures and training through blended learning modules in resource poor countries to improve stroke outcomes. . CSTK-05b:Hemorrhagic Transformation Patients Treated with Intra-Arterial (IA) Thrombolytic (t-PA) Therapy or Mechanical Endovascular Reperfusion Therapy, 5. Medisolv can help you along the way. Patient Age, in years, is equal to the Admission Date minus the Birthdate. The CSTK Initial Patient Population is unique in that it is comprised of three distinct subpopulations: ischemic stroke patients who do not undergo a reperfusion therapy (i.e., procedure), ischemic stroke patients who undergo a reperfusion therapy (IV t-PA, IA t-PA, or mechanical endovascular reperfusion (MER) therapy), and hemorrhagic stroke patients. A modified sampling procedure is required for hospitals performing quarterly sampling for STK. This Agreement will terminate upon notice if you violate its terms. Specifications Manual for Joint Commission National Quality Measures (v2021B), Stroke (STK) Initial Patient Population Algorithm Narrative, Anticoagulation Therapy Prescribed at Discharge, Antithrombotic Therapy Administered by End of Hospital Day 2, Antithrombotic Therapy Prescribed at Discharge, Education Addresses Activation of Emergency Medical System, Education Addresses Follow-up After Discharge, Education Addresses Medication Prescribed at Discharge, Education Addresses Risk Factors for Stroke, Education Addresses Warning Signs and Symptoms of Stroke, IV OR IA Alteplase Administered at This Hospital or Within 24 Hours Prior to Arrival, Reason for Extending the Initiation of IV Alteplase, Reason for No VTE Prophylaxis Hospital Admission, Reason for Not Administering Antithrombotic Therapy by End of Hospital Day 2, Reason for Not Prescribing Statin Medication at Discharge, Statin Medication Prescribed at Discharge, Appendix E - Overview of Measure Information Form and Flowchart Formats, Cover Page for the Joint Commission Manual, Joint Commission Clinical Data Processing Flow, Joint Commission National Quality Measures Data Processing, Using the The Joint Commission's National Measure Specifications Manual, Anticoagulation Therapy for Atrial Fibrillation/Flutter, Antithrombotic Therapy By End of Hospital Day Two, All Records, Not collected for HBIPS-2 and HBIPS-3, All Records, Optional for HBIPS-2, HBIPS-3, All Records, Optional for All HBIPS Records. Share sensitive information only on official, secure websites. In this post we are either referencing CMS or The Joint Commission as the Measure Stewards. Use the month and day portion of admission date and birthdate to yield the most accurate age. This is increasingly important as the health care system moves towards value-based reimbursement models. A hospitals Hemorrhagic sub-population is 100 during the first quarter. endobj Using the monthly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 50 cases for the month. Two-hundred and twenty-three (223) ischemic stroke cases had IV or IA thrombolysis or a mechanical clot removal procedure during the second quarter. The Duke Health system tracks and measures the care we provide to our patients based on these quality measures. Core measures are based on the most common condition's hospitals see, such as acute myocardial infarction (AMI), heart failure (HF), pneumonia, surgical care, children's asthma care, venous thromboembolism (VTE), stroke, and more. Measures that include patient and/or caregiver engagement Adult Recommended Core Measures Controlling High Blood Pressure Use of High-Risk Medications in the Elderly Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Use of Imaging Studies for Low Back Pain Of FSRMC patients treated with tPA, a clot-dissolver, or who underwent a procedure to retrieve a blood clot, 2.4% experienced complications, compared to the national average complication rate of 6.8%. Measure Set Stroke Measure ID # STR-1 Measure Name Prehospital Screening for Suspected Stroke Patients An injection of TPA is usually given through a vein in the arm within the first three hours. hb``` eaX`3P@7pi%It' s9MZxTPN )4 3Hr102)iq }p!>8O:nI-BFo4NB4@4@c _ R/ This means the patient passed every measure they qualified for. Medisolv Can HelpThis is a big year for Quality. The responsibility for the content of this product is with The Joint Commission, and no endorsement by the AMA is intended or implied. A hospitals Ischemic sub-population is 316 during January. sI Hospitals whose Initial Patient Population size is less than the minimum number of cases per quarter/month for the sub-population cannot sample that sub-population. hWn8,CIDE ;its8MZAt,9!%_e'Kaxs8>f9! Heres a link to TJCs full program comparison sheet with guidelines of certification requirements. Disclaimer of Warranties and Liabilities. *** AHRQ is the measure steward for the survey instrument in the Adult Core Set (NQF #0006) and NCQA is the developer of the survey administration protocol. x\_s6fE4f+[Itd2)Q" 2tIB.|Qe{r?);|_gb-rv>XS?m>`_\WNO>(b\@~f'4( L`yXS7?b!0@qp) Time from symptom onset to stroke alert is delayed in in-hospital stroke. CSTK-01 National Institutes of Health Stroke Scale (NIHSS Score Performed for Ischemic Stroke Patients)2. Today, the Core Quality Measures Collaborative (CQMC) released four updated core measure sets covering specific clinical areas as part of its mission to provide useful quality metrics as the nation's health care system moves from one that pays based on volume of services to one that pays for value. The Differences Between The 5 Major Stroke Measure Sets - Medisolv *Red Dress DHHS, Go Red AHA ; National Wear Red Day is a registered trademark. Each certification may require your hospital to submit one or more of the five measure sets we reviewed above. In addition, TJC established the Certification Measure Information Process (CMIP) tool where hospitals must manually enter their certification data for the program certifications we reviewed above (ASR, PSC, TSC and CSC). A hospitals ischemic stroke patient population size is 70 cases during March. The change in the performance measure requirements for Acute Stroke Ready Hospitals, (i.e., STK-OP-1 replacing ASR-OP-2 effective with discharges on and after July 1, 2021) can be found in several places. CSTK-05 Hemorrhagic Transformation, 1. Statin drugs are medications used to reduce serum level of lipids such as cholesterol. CSTK-01 National Institutes of Health Stroke Scale (NIHSS Score Performed for Ischemic Stroke Patients)2. Core Rulebook (disambiguation) This is a disambiguation page; that is, one that points to other pages that might otherwise have the same name.Pathfinder 2E.Expand your capabilities by selecting general feats that improve your statistics or give you. 2021; 96:e1812-e1822 . Studies suggest that antithrombotic therapy should be prescribed at hospital discharge following an ischemic stroke to reduce stroke mortality and morbidity. <> Using the quarterly sampling table for the hemorrhagic stroke subpopulation, the sample size required is 20% of this subpopulation or 78 cases for the quarter (20% of 392 equals 78.4 rounded to the next highest whole number equals 78). <>>> For an overview of data housed in the Stroke Patient Management Tool, please refer to the Stroke Case Record Form (PDF). Clinical Performance Measures for Stroke Rehabilitation: Performance Stroke Core Measure - About Us - Mayo Clinic , . Stroke patients are at increased risk of developing venous thromboembolism (deep vein blood clots). May 2021 Measure ID# Measure Short Name Measure Description STK-1 Venous Thromboembolism (VTE) This measure captures the proportion of ischemic or hemorrhagic Prophylaxis stroke patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given the day of or the day after hospital admission. STK-6 Discharged on Statin Medication9. 1-800-AHA-USA-1 Get With The Guidelines- Stroke supports hospitals in many ways, including: Data submission and feedback reporting are performed using the American Heart Association's Get With The Guidelines Registry (IRP)(link opens in new window). The required quarterly sample sizes for each sub-population would be 79 and 5. Quarterly sampling for the Hemorrhagic sub-population for Joint Commission certification purposes: A hospitals Hemorrhagic sub-population is 392 during the first quarter. *{o7@FNhR/ The required sample size for the CSTK-01 measure is a minimum of 42 cases for the month (28 cases from Table 4 plus 14 cases from Table 5 equals 42). The core measurescan be found at: http://www.qualityforum.org/cqmc/. STK-5 Antithrombotic Therapy By End of Hospital Day Two16. Stay up to date with all the latest Joint Commission news, blog posts, webinars, and communications. An IV injection of recombinant tissue plasminogen activator (TPA) also called alteplase (Activase) or tenecteplase (TNKase) is the gold standard treatment for ischemic stroke. For the purposes of this blog, since we are focusing specifically on stroke measures, there is only one stroke measure that is used for Accreditation purposes by both CMS and TJC: OP-23. Percent of ischemic or hemorrhagic stroke patients, or their caregivers, who were given educational materials during the hospital stay addressing. If the Principal Diagnosis code falls on Table 8.1 it will be placed in the Ischemic Stroke, or sub-pop 1 and if it has a Principal Diagnosis code that falls on Table 8.2, then it will be placed in the Hemorrhagic Stroke or sub-pop-2. January 1, 2021: Actual Primary Completion Date : June 30, 2021: Estimated Study Completion Date : December 31, 2021: Groups and Cohorts. In regard to stroke, The Joint Commission has four different types of certification programs that go along with these stroke measure sets. A hospitals hemorrhagic stroke patient population size is 17 cases during March. PDF CMCS Informational Bulletin - Medicaid.gov <>/Metadata 285 0 R/ViewerPreferences 286 0 R>> 10960 Grantchester Way, Suite 520Columbia, MD 21044. *All health/medical information on this website has been reviewed and approved by the American Heart Association, based on scientific research and American Heart Association guidelines. 4= highly recommended; the outcome measure has excellent psychometric properties and clinical utility. Percent of ischemic or hemorrhagic stroke patients who were assessed for rehabilitation services. Finally, I have listed a few more resources for you. Much like we saw how cases fall into their respective sub-populations with CSTK, cases for STK use the same criteria when determining which sub-population a case will qualify for. Along with award-winning software you receive a consultant that helps you with all of your technical and clinical needs. The required quarterly sample size would be 100% of the patient population or 5 cases for the quarter, No sampling; 100% Initial Patient Population required. }J Using the monthly sampling table for the ischemic stroke with IV t-PA, IA t-PA or MER subpopulation, the sample size required is 28 cases for the month. The American Medical Association reserves all rights to approve any license with any Federal agency. Measure ID # Measure Short Name OP-23 . This link is provided for convenience only and is not an endorsement of either the linked-to entity or any product or service. endobj The two Measure Stewards (CMS and TJC) require hospitals to submit their chart-abstracted data in two different ways. 2021). All rights reserved. A hospitals hemorrhagic stroke patient population size is 200 cases during the second quarter. 3 0 obj ** The Adult Core Set includes the NCQA version of the measure, whichis adapted from the CMS measure (NQF #1879). Learn about the "gold standard" in quality. Watch the "Introduction to CMIT 2.0" video to learn more about the latest features! %PDF-1.5 The most common signs and symptoms of HF are shortness of breath on exertion; orthopnea; weight gain with edema in the feet, legs, or lower back; fatigue; and weakness. Using the quarterly sampling table for the ischemic stroke subpopulation, the sample size is less than the minimum required quarterly sample size, so 100% of the subpopulation or all 37 cases are sampled. Centers for Medicare and Medicaid Services Measures Inventory Tool A hospitals hemorrhagic stroke patient population size is 795 cases during the second quarter. The administration of anticoagulation therapy is an effective strategy in preventing recurrent stroke in high stroke risk-atrial fibrillation patients. Using the monthly sampling table for the Ischemic sub-population, the sample size is less than the minimum required monthly sample size, so 100% of this sub-population is sampled. CPT is a registered trademark of the American Medical Association. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this product. PDF Stroke Core Performance Measures HOS-Sanford Medical Center Fargo PDF California EMS System Core Quality Measures Instruction Manual Hospitals whose Initial Patient Population size is less than the minimum number of cases per quarter for the measure set cannot sample. Measure Type: OutpatientNumber of Measures Included: There are five process measures (youll see one additional measure listed below that is not reported and one additional measure that is retired starting with July 1, 2021 discharges). Pets and Your Health / Healthy Bond for Life, La Iniciativa Nacional de Control de la Hipertensin, Contact your local Get With The Guidelines, Get With The Guidelines Data Request Form. Its a nightmare trying to keep straight this wide range of acronym-filled information. Do not process cases that have been rejected before this point in the Clinical Data Processing Flow. PDF Understanding Stroke Measure Sets - f.hubspotusercontent30.net The STK Initial Patient Population sizes for a hospital are 392 and 5 patients respectively per the sub-populations for the quarter. Due to exclusions, hospitals selecting sample cases MUST submit AT LEAST the minimum required sample size. All rights reserved. Brainstorm with your team to find ways to improve your hospital's treatment rates. PDF Hospital OQR Quality Measures and Timelines for CY 2021 Payment All Records, Calculation, Used in calculation of the Joint Commission's aggregate data. means youve safely connected to the .gov website. A hospitals ischemic stroke patient population size is 7 cases during March. CSTK-10 Modified Rankin Score (mRS at 90 Days: Favorable Outcome), 1. CMS will use these mortality measures, which it reports under the Clinical Care domain, in the FY 2019 program. Length of Stay, in days, is equal to the Discharge Date minus the Admission Date. Sign up to get the latest information about your choice of CMS topics. The AMA is a third party beneficiary to this Agreement. Core Measures | CMS - Centers for Medicare & Medicaid Services The coalition was convened in 2015 by Americas Health Insurance Providers (AHIP) and the Centers for Medicare & Medicaid Services (CMS) and is housed at the National Quality Forum (NQF). There are no Stroke eCQMs applicable or available for Certification purposes. Stroke Core Stroke Measures As a Certified Stroke Center the stroke committee would like to provide physicians with updates on how we are performing on the stroke performance and quality measures. Monthly sampling for the Ischemic sub-population: A hospitals Ischemic sub-population is 228 during March. Using the monthly sampling table for the ischemic stroke subpopulation, the sample size required is 20% of this subpopulation or 26 cases for the month (20% of 129 equals 25.8 rounded to the next highest whole number equals 26). The required monthly sample is 60 cases. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Comprehensive Stroke Arrival Time to Skin Puncture, Comprehensive Stroke Post Thrombolysis Revascularization Rate, Comprehensive Stroke Timeliness of IV Thrombolytic Therapy, Advertising and sponsorship opportunities, Percent of ischemic and hemorrhagic stroke patients who received venous thromboembolism (VTE) prophylaxis the day of or the day after hospital admission. >0SPJ*@6W/rq+ERY_X&14>k( The AMA does not directly or indirectly practice medicine or dispense medical services. Using the monthly sampling table for the Hemorrhagic sub-population, the sample size required is 20% of this sub-population, or 46 cases for the quarter (twenty percent of 228 equals 45.6 rounded up to the next whole number equals 46). Return to Clinical Data Processing Flow in the Data Processing section. Q2 (April 1-June 30); Q3 (July 1-September 30); Q4 (October 1-December 31); Q1 . The CQMC is a diverse coalition of health care leaders representing over 75 consumer groups, medical associations, health insurance providers, purchasers and other quality stakeholders, all working together to develop and recommend core sets of measures by clinical area to assess and improve the quality of health care in America.

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