Providing alteplase decision-making support via telephone consultation to community physicians is feasible and safe and may be considered when a hospital has access to neither an in-person stroke team nor a telestroke system. IIb C-LD New recommendation. The advantages of telephone consultations for patients with acute stroke syndromes are feasibility, history of use, simplicity, availability, portability, short consultation time, and facile implementation.61 See Table XIII in online Data Supplement 1. 1.7. Organization and Integration of Components 1.7. Organization and Integration of Components COR LOE New, Revised, or Unchanged All hospitals caring for stroke patients within a stroke system of care should develop, adopt, and adhere to care protocols that reflect current care guidelines as established by national and international professional organizations and state and federal agencies and laws. I C-EO Recommendation unchanged from 2013 Stroke Systems of Care. COR and LOE added to conform with ACC/AHA 2015 Recommendation Classification System. Different services within a hospital that may be transferring patients through a continuum of care, as well as different hospitals that may be transferring patients to other facilities, should establish hand-off and transfer protocols and procedures that ensure safe and efficient patient care within and between facilities. Protocols for interhospital transfer of patients should be established and approved beforehand so that efficient patient transfers can be accomplished at all hours of the day and night. I C-EO Recommendation unchanged from 2013 Stroke Systems of Care. COR and LOE added to conform with ACC/AHA 2015 Recommendation Classification System. Mechanical thrombectomy requires the patient to be at an experienced stroke center with rapid access to cerebral angiography, qualified neurointerventionalists, and a comprehensive periprocedural care team. Systems should be designed, executed, and monitored to emphasize expeditious assessment and treatment. Outcomes for all patients should be tracked. 