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Abstract DP202: The Missing Link: Strengthening the Chain Between EMS and Stroke Education
Abstract   Peer reviewed

Abstract DP202: The Missing Link: Strengthening the Chain Between EMS and Stroke Education

Kristen Ronosky, Chris Hackett, Robert Druga and Shannon Bucci
Stroke (1970), v 57(Suppl_1), DP202
Feb 2026
DOI: https://doi.org/10.1161/str.57.suppl_1.DP202

Abstract

Stroke Quality improvement Emergency medical services (EMS) Stroke quality and outcomes
Background: Timely and effective stroke care begins in the prehospital setting. EMS providers play a pivotal role in early stroke recognition, pre-hospital notification, and rapid transport-yet often operate independently from hospital-based stroke teams. This disconnection can lead to variations in protocol adherence, delays in communication, and missed opportunities for feedback and shared learning. Strengthening the educational link between EMS and the hospital stroke teams is essential to streamline care, reduce delays, and improve outcomes for patients experiencing an acute ischemic stroke. Methods: A collaborative, stroke-specific education model was implemented at a Primary Stroke Center in January 2025 to improve EMS-hospital alignment. Key components included: An EMS stroke newsletter featuring stroke case reviews, metrics, and clinical tips was distributed to all regional EMS agencies on a quarterly basis. To improve stroke response, we implemented in-person site visits for performance feedback on stroke alerts and provided EMS education sessions with simulations and stroke scale refreshers. Pre- and post-learning knowledge assessment of best practices for pre-hospital stroke care was utilized to assess EMS knowledge of hospital workflows, protocols, and perceptions of overall communication between the hospital and EMS. Data were compared prior to (January - June 2024) and after (January -June 2025) educational implementation. Results: EMS engagement grew significantly from 14% to 41% of all (400) providers attending at least one training session. EMS indicated high satisfaction with case reviews and basic pathophysiology which improved their confidence to provide prehospital stroke care. Additional qualitative feedback from EMS and hospital staff noted stronger interprofessional relationships, citing improved mutual respect, communication, and shared goals. Pre-hospital stroke alerts increased from before to after education implementation (20 to 30) for a 50% increase. The volume of stroke patients increased from before to after education (30 to 43) for a 43.3% increase. Conclusions: Closing the education gap between EMS and hospital stroke team enhances communication, protocol alignment, and acute stroke care delivery. Improved prenotification and activation increased allowing for earlier stroke team mobilization.

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