Visit Location |
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Demographics, Baseline and Follow-up |
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Medical History |
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Monthly Check-In |
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New Events Assesment |
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Quality Measures |
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Complication Assessment |
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NIH Stroke Scale |
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PHQ-9 |
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Hill-Bone Compliance |
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MoCA |
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LHE assessment - Behavioral Intervention Plan |
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LHE Assessment and Follow-Up |
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Modified Caregiver Strain Index |
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Berg Balance Index |
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Timed Up and Go |
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Functional Reach |
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Frenchay Activities Index |
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Epworth Sleepiness Scale |
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Life's Simple 7 |
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Stroke Central/Stroke Mobile Interaction Documentation |
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Barthel Index |
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Lab Assessment |
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mRS |
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STROKE EDUCATION |
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Stroke Education: Quality Measures |
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Stroke Education: HTN |
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Stroke Education: Diet |
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Stroke Education: Diabetes |
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Stroke Education: Exercise |
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Stroke Education: Signs and Symptoms |
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Stroke Education: Misc. |
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STROKE MEDICATIONS |
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Antiplatelet |
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-- |
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Anticoagulant |
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-- |
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Statin |
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-- |
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Antihypertensive |
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-- |
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Diabetic medications |
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-- |
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Labs & Biotrics |
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INR as appropriate |
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Blood Glucose |
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Weight/BMI Target < 25 |
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LDL Target < 70 mg/d |
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Diabetes Control: HBA1C < 7% |
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B/P Target < 131/81 |
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Risk Factors & Complications |
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HTN |
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DM |
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HLD |
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CHF |
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UTI |
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Pneumonia |
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Aspiration (Choking) |
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DVT |
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Skin Breakdown |
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Fall(s) with injury |
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MI |
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Depression diagnosis |
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Prescribed medications for depression |
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Fever/infection |
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A-Fib |
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Tracking |
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ER |
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Readmission for any Dx |
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Smoking Status |
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Additional Documentation |
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Document telemedicine or phone consult to Stroke Central, providers and patients, etc |
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Establish plans for post intervention follow-up |
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Monthly Summary Review |
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