Quality improvement project leads to better care of all stroke patients: Together we are stronger

Since the publication of the first IV thrombolysis trial with alteplase1 and subsequent analyses showing a strong correlation between early treatment and favorable outcome,2,3 the medical community has been focused on early identification of stroke and rapid delivery of suspected patients to the nearest alteplase-capable hospital. The importance of early stroke treatment created a need for a stroke system of care where there is a widespread network of medical facilities in which IV alteplase can be administered, and subsequent care can take place at another facility of higher level of care. The state of Minnesota has adopted this philosophy, leading to legislation aimed at ensuring the availability of stroke-ready hospitals within 30 minutes of all residents (Minnesota Statutes 144.194 [2013]). This has proved to be quite successful, increasing the percentage of population within 30 minutes from a hospital with available alteplase from 60% in 2013 to 93% in 2019.4