Abstract Body: Background: ICH accounts for 10% of all strokes and is deadliest and most disabling stroke subtype. Patients with anticoagulant-related hemorrhage require rapid reversal to mitigate risk of hematoma expansion. Measuring time to reversal (TTR) data can facilitate critical quality improvement efforts towards improving outcome. Increased compilation of TTR data will help inform process improvement strategies for this time sensitive metric. Methods: Twenty Comprehensive Stroke Centers participated in a learning collaborative from 2020-2022. Expanded ICH data elements were added to the American Heart Association Get With The Guidelines® (GWTG)-Stroke registries to identify gaps and facilitate quality improvement, coding definitions were reviewed to ensure data rigor. ICH data was reviewed quarterly. TTR was one of fourteen measures analyzed; TTR documentation revealed varied compliance. Findings: Over three years, 6,648 ICH patients were abstracted, of which 37.6% were reversed in < 90 minutes from arrival, TTR metric was further delineated by patient arrival mode. Percent of patients reversed in < 90 minutes when transferred from another hospital=55.6%, EMS=41.1%, and private transport=16.1%. Conclusions: Patients transferred from referring to receiving hospitals had the greatest percentage of patients reversed < 90 minutes whereas those arriving from home had the least. We identified the following factors which may be barriers to timely reversal: symptom presentation, unknown date time of last anticoagulation dose, last known well not documented, delays in imaging due to symptom presentation, administration approval, and interfacility transport delays. Consideration to adopt a quality initiative similar to door to needle in ischemic stroke may prove beneficial.