Bolstering Programs for Stroke Certification

How Kandu supports disease specific certification and credentialing

Stroke speciality programs are designed to ensure high quality care that supports the transition from hospital to home. Quality standards for speciality programs are critical for elevating patient care and safety, satisfying state mandates and payer reimbursement requirements. Third party organizations often regulate these programs which drive continuous quality improvement through its respective certification standards. 

Organizations like The Joint Commission (TJC) and Det Norske Veritas (DNV) have a distinct set of standards to assess a hospital system’s quality of care. TJC standards are known for being rigorous and detail-oriented, with an emphasis on care procedures and facility protocols. DNV certification takes a collaborative approach, focusing on improvement plans in alignment with internationally recognized quality management requirements. Similarly, the Commission on Accreditation of Rehab Facilities (CARF) specializes in quality benchmarks for rehabilitation facilities.

Quality Standard Key Performance Indicators

Each respective stroke program’s standards are designed to address quality across the continuum of care, addressing everything from stroke-specific treatments and hospital protocol, to addressing secondary risk prevention, follow up care, lifestyle modification, and support for patients’ care partners. To maintain compliance with these certifications, hospitals must carefully track and document patient care throughout the recovery journey. 

Hospital systems are well positioned to track key performance indicators while a patient is in the hospital including specialized stroke therapeutics, staffing requirements, and initiating next steps in care corresponding with DNV primary stroke center QM.7 CR1-CR3 and TJC stroke CSTK measures. However, hospital systems face significant challenges in tracking and adequately addressing post-discharge outcomes for improved stroke care. Data surrounding patient discharge, corresponding with DNV primary stroke center QM.7 CR4, PC.1, PC.6, PC.10 and TJC stroke STK-2,3,6, 8, such as ensuring continuity of care, follow up, medication adherence, social determinants of health impact on resource acquisition and goal setting are challenging to collect. Strategic third party partnerships can help hospital systems to fill in the patient gaps in care.   

To maintain compliance with Joint Commission and DNV standards, hospitals rely on a combination of meticulous documentation in electronic medical record (EMR) systems designed to track key data points for certification, and automated alerts to track compliance with protocols. Clearly defined, timestamped acute-specific protocols such as door-to-needle time within 60 minutes of arrival, IV thrombolytic therapy, or access to timely neuroimaging, can be tracked by a hospital’s EMR alerts and automations. 

Data tracking of standards surrounding care coordination, adequate follow up care and education can be difficult as it requires hospital follow-up with patients, outpatient clinics, and out of network providers– which does not neatly track into a hospital’s automated EMR tracking. Dr. Jeff Wertheimer, Neuropsychologist and Director of Physical Medicine and Rehabilitation at Cedar Sinai Medical Center highlighted the gap in tracking of post-acute quality metrics required for certification, stating “When you have a freestanding hospital - even if it's a rehabilitating unit within another busy acute Medical Center - what we're going to find is that transition from anticipating discharge, going to discharge, and that transition from hospital to the Community setting there’s going to be a big gap”. 

To help close this gap, hospitals can partner with third party providers to improve tracking of post-acute metrics, easing the burden on hospital systems and enabling more effective monitoring of acute-stroke data. This proactive approach helps ensure adherence to TJC and DNV standards, which saves time, reducing risks of accreditation loss, Medicare reimbursement penalties, fines, and costly corrective actions.

To help close this gap, hospitals can partner with third party providers to improve tracking of post-acute metrics, easing the burden on hospital systems and enabling more effective monitoring of acute-stroke data. This proactive approach helps ensure adherence to TJC and DNV standards, which saves time, reducing risks of accreditation loss, Medicare reimbursement penalties, fines, and costly corrective actions.