Abstract TP397: Modified Rankin Scores at 90-Days Post-Discharge

Background: The modified Rankin Scale (mRS) is a validated tool used to assess a patient’s functional status. Comprehensive Stroke Centers are required to obtain mRS scores at 90-days for acute ischemic stroke patients who received intravenous alteplase and/or endovascular stroke treatment. Purpose: To develop and implement a sustained process for obtaining mRS scores 90-days post-hospitalization for all stroke patient types discharging from the acute hospital setting. Methods: A team of front-line nurses from various departments were trained on the mRS scoring tool. A smartphrase was developed to standardize documentation. CSTK-02 criteria were used and extended to all ischemic and hemorrhagic stroke discharges regardless of treatment or intervention received. A weekly call list was generated and provided. Calls were made to patients or caregivers between 8am and 7pm on weekdays, and occasionally on weekends, depending on the department making the calls. Three attempted calls were considered compliant. If a validation error occurred during screening, additional questions were asked based on the tool algorithm to resolve the error and ensure accuracy. Calls were rotated monthly by department. Results: Between May 2017 and May 2019, 1235 patients were discharged. A total of 297 patients were unable to be screened due to various reasons. 1115 patient contacts were attempted. Of those, 84% (938 patients) were screened. A retrospective breakdown of the mRS scores was stratified: 158 (17%) scored mRS of 0, 55 (6%) scored mRS of 1, 60 (6%) scored mRS of 2, 187 (20%) scored mRS of 3, 155 (17%) scored mRS of 4, 74 (8%) scored mRS of 5, and 249 (27%) scored mRS of 6. Conclusion: Having front-line nurses conduct 90-day post-discharge phone calls to obtain mRS scores appears to be an effective sustainable method in obtaining functional outcomes for all stroke types discharging from the acute hospital setting.