What does this research mean for the field?

By 2025, all 14 hospitals in the system achieved stroke care certification, with 12 recognized by GWTG Stroke Quality Awards for excellence in care. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The aim is to evaluate the impact of a dedicated neuroscience service line and teleneurology services on stroke care delivery in Central Appalachia.

February 2, 2026

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

Key Result

By 2025, all 14 hospitals in the system achieved stroke care certification, with 12 recognized by GWTG Stroke Quality Awards for excellence in care.

Key Points

The aim is to evaluate the impact of a dedicated neuroscience service line and teleneurology services on stroke care delivery in Central Appalachia.
Launched a neuroscience service line with appointed directors.
Introduced teleneurology and telestroke services across multiple hospitals.
Implemented artificial intelligence for stroke detection and triage.
Created standardized clinical protocols and education matrices for staff training.
Facilitated regular meetings among stroke coordinators for best practices.
Achieved stroke certification for all 14 hospitals by 2025.
Recognized 12 hospitals with GWTG Stroke Quality Awards.
Increased access to neurological care in remote communities.
Enhanced workforce stability and multidisciplinary collaboration in stroke care.

Structured PICO

Population

A rural hospital system in Central Appalachia comprising 14 hospitals and over 90 clinics

Intervention

Programmatic expansion including a dedicated neuroscience service line, teleneurology/telestroke services, AI for stroke detection (Viz.ai), standardized clinical protocols, and integration of the Get With The Guidelines (GWTG) Stroke program

Comparator

Baseline status in 2020 (prior to full programmatic expansion)

Outcome

Hospital stroke care certification status and receipt of Get With The Guidelines Stroke Quality Awards

Implementation of a comprehensive neuroscience service line with telestroke and AI capabilities successfully expanded stroke certification and quality of care across a rural 14-hospital network.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

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.