| Modified question | Deleted question | New required question | New optional question | Current hospital inventory (0920-1108; exp. 3/31/2019) | Requested changes | Change description | |||||||
| Original question # | Original question | Response options | Question # | Revised question | Response option | ||||||||
| 1 | A2 | What is your hospital’s Rural-Urban Commuting Area (RUCA) code? To determine this, navigate to the Rural Health Information Hub website (https://www.ruralhealthinfo.org/am-i-rural). Enter your hospital’s address in the search bar and click “locate”. Then click on the orange “run report” button in the map. Scroll down to find your hospital’s RUCA Code by census tract (e.g. 1.1) and provide this number for the inventory survey. | Open text | This question is being added to better understand the hospital capabilities in certain areas, such as the use of telemedicine consults in rural areas. | |||||||||
| 1 | A3 | Total number of inpatient discharges in the most recent calendar year | Open text | A4 | Total number of inpatient discharges (not including observation only, ED patients, ED transfers) in the most recent calendar year | Open text | The question is changed to be more specific based on clarity needed in previous responses from hospitals | ||||||
| 1 | B2b | Emergency care of hemorrhagic strokes (including diagnostic imaging and labs) | Yes No |
B2b | Emergency care of subarachnoid hemorrhagic strokes (SAH) (including diagnostic imaging and labs) | Yes No |
The question is changed to specifically ask about subarachnoid and then intracerebral stroke subtypes. | ||||||
| 1 | B2bii | Does your hospital admit most subarachnoid hemorrhagic (SAH) stroke patients? | We typically transfer SAH patients We typically admit these patients We admit or transfer depending on staff availability or other factors (please describe): _____ |
This question is added to help better determine capacity of hospitals to treat hemorrhagic stroke patients | |||||||||
| 1 | B2c | Emergency care of intracerebral hemorrhagic (ICH) strokes (including diagnostic imaging and labs) | Yes No |
This question is added to specifically ask about hemorrhagic stroke subtypes. | |||||||||
| 1 | B2ci | If yes to (B2c), does it include (select all that apply) | Initial stabilization Diagnostic imaging treatment Labs |
This question is added to specify the emergency care of intracerebral hemorragic strokes | |||||||||
| 1 | B2cii | Does your hospital admit most intracerebral hemorrhagic (ICH) stroke patients? | We typically transfer ICH patients We typically admit these patients We admit or transfer depending on staff availability or other factors (please describe): _____ |
This question is added to help better determine capacity of hospitals to treat hemorrhagic stroke patients | |||||||||
| 1 | B8 | Does your hospital provide neurointerventional treatment for stroke capability to give intra-arterial tPA or use of catheter-based neurointerventional reperfusion? | Yes No |
B7 | Does your hosptial provide neurointerventional treatment for (select all that apply) | Intra-arterial alteplase Catheter-based reperfusion/mechanical thrombectomy |
This question is modified due to emerging science supporting and interest in about thrombectomy-capable hospitals | ||||||
| 1 | C4 | Does your hospital enter EMS run sheets into the Coverdell in-hospital record? | Always Sometimes Rarely Never |
C4 | Does your hospital enter EMS run sheets into a Coverdell-specific in-hospital data collection tool (e.g., GWTG, state-based system)? | Always Sometimes Rarely Never |
This question is modified to provide additional clarity. | ||||||
| 1 | D2b | Do you follow-up with (select all that apply) | All patients discharged home A sample of patients discharged home Only cases that were treated with IV alteplase Only cases that were treated with IV alteplase and/or thrombectomy Other: (text) |
This question is added to better determine which stroke patients hospitals focus on to follow-up after discharge. | |||||||||
| 1 | D3 | Does your hospital utilize an inventory of community resources to make referrals for post-stroke needs? | Yes No |
This question is added to better understand hospitals' use of community resouces for discharged stroke patients. | |||||||||
| 1 | E2 | Is your hospital certified as a Joint Commission Acute Stroke Ready Hospital (JC ASRH), Joint Commission Primary Stroke Center (JC PSC), Joint Commission Comprehensive Stroke Center (JC CSC), or other similar organization such as Det Norske Veritas (DNV) or Healthcare Facilities Accreditation Program (HFAP)? (select all that apply) | JC ASRH JC PSC DNV PSC HFAP PSC JC CSC DNV CSC |
E2 | Is your hospital currently certified as a Joint Commission Acute Stroke Ready Hospital (JC ASRH), Joint Commission Primary Stroke Center (JC PSC), Joint Commission Comprehensive Stroke Center (JC CSC), Joint Commission thrombectomy capable stroke center (TSC) or other similar organization such as Det Norske Veritas (DNV) or Healthcare Facilities Accreditation Program (HFAP)? (select all that apply) | JC ASRH JC PSC DNV PSC HFAP PSC JC CSC DNV CSC JC thrombectomy capable stroke center (TSC) |
The question is modified to specify that this is asking about current certification. The legal values are modified to include a new level of stroke certification that is available. | ||||||
| 1 | E2a | If your hospital is certified by any one of the organizations above, what is the year of your most recent certification? | Date --/--/---- | This question is no longer needed due to the modification to the prior question | |||||||||
| 1 | E3a | If yes to (3), is your hospital designated by that entity as a stroke center or stroke capable/ready hospital? (select all that apply) | Stroke Center (State designation) Stroke Capable/Ready (State designation) Stroke Center (County/regional/local designation) Stroke Capable/Ready (County/regional/local designation) |
E3a | If yes to (3), is your hospital currently designated by that entity as a stroke center or stroke capable/ready hospital? (select all that apply) | Stroke Center (State designation) Stroke Capable/Ready (State designation) Stroke Center (County/regional/local designation) Stroke Capable/Ready (County/regional/local designation) |
The question is modified to specify that this is asking about current certification. | ||||||
| 1 | E3b | If designated in 3a, what is the date of the most recent certification? | This question is no longer needed due to the modification to the prior question | ||||||||||
| 1 | E4a | [Optional] if yes to (4), what mode does the telemedicine consult take place? (select all that apply) | Telephone Videoconference Other (please specify): |
E4a | [Optional] if yes to (4), what mode does the telemedicine consult take place? (select all that apply) | Telephone call Interactive video/videoconference Other (e.g, teleradiology), please specify: |
The legal values are modified to align with language used for the in-hospital data elements | ||||||
| 1 | E5 | Does your hospital provide stroke consultation services to other hospitals via telemedicine? | Yes, we provide telestroke consultation services and can receive patients that we have provided consultations on Yes, we provide telestroke consultation services but cannot receive patients in any cases No, we do not provide telestroke consultation services |
This question is added to further understand the capabilities of participating hospitals | |||||||||
| 1 | E5a | [Optional] If yes to (5), what mode does the telemedicine consult take place (select all that apply) | Telephone call Interactive video/videoconference Other (e.g, teleradiology), please specify: |
This question is added to further understand the capabilities of participating hospitals | |||||||||
| 1 | F2 | Who is responsible for data abstraction (select all that apply) | Physician Stroke nursing staff/stroke team member Medical records staff QI department staff Other (e.g. outsourced, other staff) |
F2 | Who is responsible for data abstraction? (select all that apply) | Physician Stroke nursing staff/stroke team member Medical records staff QI department staff Other hospital staff (please specify): ___ Outsourced |
The response options are modified to add more specificity | ||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |