Abstract DP376: Transforming Stroke and Neuroscience Care in Central Appalachia: A Rural Hospital System’s Journey (2020-2025): A Comprehensive Evaluation of Programmatic Expansion, Quality Initiatives, and Outcomes

In 2020, a hospital system launched a dedicated neuroscience service line, appointing both a service line director and a medical director to drive strategic integration and continuous improvement in neurological care. Shortly after, teleneurology and telestroke services were introduced, extending specialized neurological care to emergency departments, inpatient units, and ambulatory clinics across 14 hospitals and more than 90 clinics in Central Appalachia. These virtual-care platforms provided real-time expert consultations, rapid assessments, and timely interventions—significantly increasing access to advanced neurological care, especially for remote communities. The transformation relied on technological innovation, robust quality improvement measures, and workforce development. Key initiatives included the implementation of advanced artificial intelligence (Viz.ai) for rapid stroke detection and triage, standardized clinical protocols, and an education matrix ensuring all staff received uniform, evidence-based training. Data-driven quality improvement was anchored by a dedicated data abstractor, the integration of the Get With The Guidelines® (GWTG) Stroke program, and monthly meetings of stroke coordinators for collaboration and best practice sharing. Professional development, mentorship, and retention strategies were prioritized for stroke coordinators, resulting in high stability, consistent program leadership, and strong multidisciplinary teamwork. At the onset in 2020, only five hospitals held Acute Stroke Ready Hospital (ASRH) certification. By 2025, all 14 hospitals earned stroke care certification—two as Primary Stroke Centers and 12 as Acute Stroke Ready Hospitals—ensuring comprehensive regional coverage for emergency stroke care. Notably, by 2025, 12 out of these 14 facilities were recognized with GWTG Stroke Quality Awards from the American Heart Association/American Stroke Association, reflecting sustained excellence in quality and outcomes. Through coordinated leadership, innovative technology, standardized protocols, and investment in workforce development, the hospital system transformed neurological care delivery—achieving equity, consistency, and superior outcomes in stroke care across its rural, multi-hospital network.