Abstract WP191: The Hidden Architecture of Stroke Care: Insights from a Survey of Stroke Program Coordinators

Introduction: Over decades, stroke care in the U.S. has advanced with thrombolysis, thrombectomy, certification standards, and team-based systems of care. Stroke Program Coordinators (SPCs) are essential, yet their roles and support vary among institutions. Our anonymous volunteer survey evaluated responsibilities, backgrounds, and perceptions of SPCs at institutions in Kentucky. Methods: We distributed a voluntary, anonymous REDCap survey via the Stroke Care Network (Aug–Oct 2024). Questions addressed institutional demographics, responsibilities, certification, communication, and satisfaction. We excluded incomplete responses or those not from SPCs or Stroke Medical Directors (SMD). Data were analyzed descriptively. Results: Of 51 responses, 43 were analyzed (33 SPCs, 5 former SPCs, 5 SMDs) (Figure 1). Most institutions were >200 beds (44.2%). Certification included Acute Stroke Ready (27.9%), Primary (25.6%), Thrombectomy Capable (11.6%), Comprehensive (7%), and uncertified but pursuing (27.9%). The Joint Commission was the leading accreditor (58.1%). SPCs mainly had ED nursing (53.5%) and inpatient nursing (48.8%) backgrounds. Nearly half of SPCs held Bachelor of Science in Nursing degrees; 41.9% had no formal orientation to the SPC position. SPC duties included staff education, certification, quality improvement, and policy, but many also managed non-stroke tasks. While 76.7% reported happiness in their role, 60.5% cited insufficient pay (Figure 2). Regular meetings with leadership (administration or SMD) were associated with a feeling of stronger institutional support (88.4%). Interdisciplinary committees were present in 93% of sites, with high engagement from SPCs, SMDs, ED, radiology, and pharmacy. Conclusions: SPCs are vital to stroke program success. SPCs face challenges including—but not limited to—limited role orientation, role ambiguity, and insufficient compensation. Advanced certification correlated with full-time SPCs and higher satisfaction. Stroke program success depend on institutional support through various factors such as leadership engagement, protected time, fair compensation, and interdisciplinary collaboration, which may lead to SPC resilience, and lower burnout. Greater standardization of SPC roles may lead to improved stroke systems of care.