Table 1

Step-by-step quality improvement

	Phase 1	Phase 2	Phase 3	Phase 4
	January 2013–February 2015	March 2015–March 2016	April 2016–August 2017	September 2017–December 2018
MRI-first policy	<4 hours from onset, in office hours	Any patient, any time	Any patient, any time	Any patient, any time
MRI sequence	DWI, MRA, FLAIR, T1, T2, T2*	DWI, MRA, FLAIR, T2*	DWI, MRA, FLAIR, T2*	DWI, MRA, FLAIR, T2*
MRI acquisition time	16 min 30 s	9 min 12 s	9 min 12 s	9 min 12 s
Rapid point-of-care examination tool	None	Implemented	Implemented	Implemented
Concomitant t-PA	t-PA in SU → Angiosuite	t-PA in SU → Angiosuite	t-PA in Angiosuite	t-PA in Angiosuite
Multidisciplinary meeting	None	None	Held once a month	Held once a month
Stent retrievers	None	None	None	Implemented

DWI, diffusion-weighted imaging; FLAIR, fluid-attenuated inversion recovery; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging; SU, stroke unit; t-PA, tissue plasminogen activator.