Hemphill et al Performance Measures for ICH e253 Appendix. Continued 4. Admission Unit: Percentage of patients with ICH who are admitted to an intensive care unit or dedicated stroke unit with physician and nursing neuroscience acute care expertise Numerator Patients admitted to an intensive care unit or dedicated stroke unit with physician and nursing neuroscience acute care expertise Denominator Included patients: Patients with ICH admitted to an acute care hospital within 24 h of initial symptom identification Excluded patients: <18 y of age Length of stay >120 d Clear documentation for comfort care/palliative care measures established before hospital arrival Period of Assessment Day of hospital admission to hospital Sources of Data Prospective flowsheet, retrospective medical record review, electronic medical record Rationale Patients with ICH are frequently medically and neurologically unstable particularly at the time of initial presentation. Care of patients with ICH in a dedicated neuroscience intensive care unit is associated with a lower mortality rate. Stroke units have demonstrated improved long-term outcome in randomized trials. Presence of a stroke unit is a required component for Primary and Comprehensive Stroke Center certification by TJC. Source for Recommendation From the 2015 AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage Initial monitoring and management of patients with ICH should take place in an intensive care unit or dedicated stroke unit with physician and nursing neuroscience acute care expertise (Class I; Level of Evidence B). 