The subsequent years corresponded to a period of rapid growth in the number of primary stroke centers and increasing total stroke treatment cases. Addressing economic barriers to treatment is important as acute stroke care complexity evolves.63 68 1.8. Establishment of Data Repositories 1.8. Establishment of Data Repositories COR LOE New, Revised, or Unchanged Participation in a stroke data repository is recommended to promote consistent adherence to current treatment guidelines, to allow continuous quality improvement, and to improve patient outcomes. I B-NR Recommendation reworded for clarity from 2013 AIS Guidelines. COR and LOE added to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Participation in a stroke data repository as one part of a quality improvement process was associated with improved IV alteplase administration after AIS,68a,68b lower in-hospital mortality68b,68c and intracranial hemorrhage rates, and an increase in the percentage of patients discharged home.53,69,69a See Table XIV in online Data Supplement 1. 1.9. Stroke System Care Quality Improvement Process 1.9. Stroke System Care Quality Improvement Process COR LOE New, Revised, or Unchanged Healthcare institutions should organize a multidisciplinary quality improvement committee to review and monitor stroke care quality benchmarks, indicators, evidence-based practices, and outcomes. The formation of a clinical process improvement team and the use of a stroke care registry are helpful for such quality of care assurances. The data repository can be used to identify the gaps or disparities in quality stroke care. Once the gaps have been identified, specific interventions can be initiated to address these gaps or disparities. I B-NR Recommendation reworded for clarity from 2013 AIS Guidelines. COR and LOE added where missing in part of recommendation. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. 