ABSTRACT NUMBER: ESOC2026A1731 INCREASING UK STROKE THROMBOLYSIS RATES: A NATIONAL QUALITY IMPROVEMENT INITIATIVE

Abstract Background and aims Timely thrombolysis is key to reducing disability after stroke, yet delivery rates and door to needle times vary widely across England. The Thrombolysis in Acute Stroke Collaborative (TASC) supported stroke teams to use their own Sentinel Stroke National Audit Programme (SSNAP) data to drive safe and sustainable improvements. Methods TASC applied a measurement for improvement approach to help stroke teams interpret variation, identify opportunities, and understand the impact of local changes across the stroke pathway. Eighteen stroke teams participated across two national cohorts. Teams received coaching and mentoring to strengthen their use of local data in guiding decisions and testing change ideas. A structured webinar series supported diagnostic use of data, Plan–Do–Study–Act (PDSA) cycles, and monitoring progress over time. Results All six sites in Cohort 1 achieved measurable gains, with a 45% relative increase in thrombolysis rates (from 9.7 % to 14.1 % average). Follow-up analysis of three Cohort 1 sites, six months post-programme, showed further sustained improvements with rates averaging 16.5%. Of the 12 sites in Cohort 2, 11 saw an increase in thrombolysis rate, from an average of 11.2% to 17.5%- a 62.6% relative improvement. Many sites also demonstrated statistically significant reductions in door to needle times. Conclusions This quality improvement collaborative achieved clinically important increases in stroke thrombolysis performance in participating sites, averaging around 50% relative increases across 18 sites. This is in contrast to relatively flat thrombolysis rates over the previous decades. Conflict of interest Simon Conroy: nothing to disclose