title: A Rural Hospital's Journey to Becoming a Certified Acute Stroke-Ready Hospital.
abstract: OBJECTIVE
  For many stroke patients, rural emergency departments are the first point of medical care to stop brain cell death. We identified a need to meet standards to improve outcomes for stroke care.
  
  
  METHODS
  An interdisciplinary Stroke Continuous Process Improvement Committee was formed. We conducted a gap analysis to address current stroke care processes. Chart audits were performed, and strategies to meet the requirements for recognition as an Acute Stroke Ready Hospital (ASRH) were implemented. The ASRH guidelines guided our certification journey.
  
  
  RESULTS
  ASRH certification was achieved. In addition, stroke care outcomes such as door-to-computed tomography results, door-to-international normalized ratio results, door teleneurology consultation, and door-to-needle time have improved.
  
  
  CONCLUSIONS
  Achieving certification makes a strong statement to the community about a hospital's efforts to provide the highest quality in stroke care services. Becoming a certified ASRH promotes quality of patient care by reducing variation in clinical processes.
authors.affiliation: Greensboro and Reidsville, NC. Electronic address: denise.rhew@conehealth.com.
authors.forename: Denise C
authors.initials: DC
authors.lastname: Rhew
authors.affiliation: Greensboro and Reidsville, NC.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Owens
authors.affiliation: Greensboro and Reidsville, NC.
authors.forename: Jessica B
authors.initials: JB
authors.lastname: Buckner
authors.affiliation: Greensboro and Reidsville, NC.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Kueider
mesh_terms: D002568:Certification / Q000379:methods*; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital / Q000592:standards*; D005343:Fibrinolytic Agents; D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D009657:North Carolina; D058996:Quality Improvement; D019035:Rural Health Services; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*; D015912:Thrombolytic Therapy; D061665:Time-to-Treatment
chemical_list: D005343:Fibrinolytic Agents
keywords: Acute ischemic stroke; Alteplase; Hemorrhagic stroke; Stroke; Stroke certification; Teleneurology