Related Experiment Video
Updated: Jul 31, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Hyper-Acute Stroke Systems of Care and Workflow
Timothy J Kleinig1, Patrick McMullan2, Geoffrey C Cloud3,4
1Department of Neurology, Royal Adelaide Hospital, 1 Port Road, Adelaide, South Australia, 5000, Australia. timothy.kleinig@sa.gov.au.
Purpose Of Review:
Recent stroke treatment advances have necessitated agile, broad-scale healthcare system redesign, to achieve optimal patient outcomes and access equity. Optimised hyperacute stroke care requires integrated pre-hospital, emergency department, stroke specialist, radiology, neurosurgical and endovascular neurointervention services, guided by a population-wide needs analysis. In this review, we survey system integration efforts, providing case studies, and identify common elements of successful initiatives.
Recent Findings:
Different regions and nations have evolved varied acute stroke systems depending on geography, population density and workforce. However, common facilitators to these solutions have included stroke unit care as a foundation, government-clinician synergy, pre-hospital pathway coordination, service centralisation, and stroke data guiding system improvement. Further technological advantages will minimize the geographical distance disadvantages and facilitate virtual expertise redistribution to remote areas. Continued treatment advances necessitate an integrated, adaptable, population-wide trans-disciplinary approach. A well-designed clinician-led and government-supported system can facilitate hyperacute care and scaffold future system enhancements.
Related Concept Videos
Acute Coronary Syndrome IV: Interprofessional Care
Acute Coronary Syndrome V: Nursing Management
Stroke: Introduction and Types
Ischemic Stroke l: Introduction
Ischemic Stroke ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology

