Telestroke Process at a Community Hospital: A Quality Improvement Project

Published:January 27, 2023DOI:



      An updated stroke process was designed and implemented at an Acute Stroke Ready community hospital that relies on telestroke services. The objectives of the current quality improvement project were to describe the updates to the stroke process and compare pre- and postintervention data on nurse-driven elements of the process, namely telestroke notification and neurologist assessment.


      Our multidisciplinary team reviewed quality data over several months to identify areas of improvement in the stroke process. Delays in door to telestroke notification and neurologist assessment were identified. A new process was developed and implemented, including e-alert notification and storing the telestroke cart in the computed tomography suite. The study period was 14 months, with nonrandomized, convenience sample data collected for 7 months before and after intervention.


      There was a significant reduction in door to telestroke notification and neurologist assessment after implementing the new process. Door to telestroke notification and neurologist assessment were also strongly correlated.


      This project led to significant improvements in nurse-driven elements of the stroke process. It demonstrates effective implementation of e-alert and collaboration with telestroke services at an Acute Stroke Ready Hospital serving rural communities.

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      Bryce A. Kennedy is Stroke Program Coordinator, Catholic Health Initiatives Midlands Community Hospital, Catholic Health Initiatives Lakeside Hospital, Omaha, NE.


      Pamela J. Stout is Service Leader Medical/Surgical Intensive Care Unit, Methodist Fremont Health, Fremont, NE.