Source for Recommendation From the 2015 AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage Initial monitoring and management of patients with ICH should take place in an intensive care unit or dedicated stroke unit with physician and nursing neuroscience acute care expertise (Class I; Level of Evidence B). Method of Reporting Per patient: documentation of whether a patient was admitted to an intensive care unit or dedicated stroke unit with physician and nursing neuroscience acute care expertise Per patient population: percentage of patients with ICH admitted to an intensive care unit or dedicated stroke unit with physician and nursing neuroscience acute care expertise Challenges to Implementation Verification of physician and nursing neuroscience care expertise Measure would require hospitals that do not have such an intensive care unit or dedicated stroke unit to transfer the patient with ICH from the ED to a hospital that has this type of intensive care unit or stroke unit. Analogous Measures Endorsed by Other Organizations For certification, TJC requires Primary Stroke Centers to have a stroke unit or designated beds for the acute care of stroke patients and Comprehensive Stroke Centers to have dedicated neuro-ICU [intensive care unit] beds for complex stroke patients that include staff and licensed independent practitioners with the expertise and experience to provide neuro-critical care 24 hours a day, 7 days a week. AHA indicates American Heart Association; ASA, American Stroke Association; ED, emergency department; ICH, intracerebral hemorrhage; and TJC, The Joint Commission. Appendix. Continued 5. 