Conclusions
acute ischemic stroke
SECONDARY
Among patients with acute ischemic stroke, the implication of a problem-oriented and culturally adapted, targeted quality improvement intervention compared with usual care at the hospital level did not result in a statistically significant improvement in the rate of reperfusion therapy. However, the intervention may be effective in resource-constrained secondary hospitals. Additional randomized clinical trials are needed to confirm the efficacy of the targeted quality improvement intervention among secondary hospitals, and further analyses are needed to understand the mechanism underlying the lack of efficacy in tertiary hospitals.