Abstract Body: Background: Door-to-thrombolytic therapy time is critical in acute stroke management, affecting treatment effectiveness and patient outcomes. Enhancing processes to minimize this time is essential for improving patient outcomes. Since 2022, our door-to-IV thrombolytic time has remained stagnant. Our current program goal is to achieve a Door to Needle (DTN) time of less than 45 minutes (min) in 80% of patients, provided there are no documented barriers beyond program's control. After considering various initiatives to reduce DTN times, the program has decided to pilot the use of meaningful recognition.

Purpose: This study aims to use meaningful multidisciplinary recognition to reduce DTN administration times, thereby improving the overall efficiency and effectiveness of acute stroke care.

Methods: Beginning January 1, 2024, the 'Lightning Award' was introduced to recognize the multidisciplinary team achieving the fastest DTN time of the month, specifically under 45 min. The multidisciplinary team consisted of emergency room physician, vascular neurology attending and resident, emergency room nurse, pharmacist, and computed tomography (C.T.) technologist. The team with the fastest DTN time was recognized during the Stroke and Emergency Department Quality Improvement Meetings, where they were presented with a certificate and a commemorative pin.

Results: Data on DTN administration times were collected from electronic health records over 8-month period (January 1 to August 1, 2024). A total of 28 cases were analyzed, revealing a median DTN time of 42 min. This represents a significant improvement compared to the median DTN time of 55 min in 2022, reflecting a 23.6% reduction in time. Furthermore, in 2022, only 29% of patients achieved a DTN time within the 45 min window. However, following the introduction of the "Lightning Award" in 2024, the proportion of patients meeting DTN within 45 min benchmark increased to 61%. This improvement highlights the positive impact of the multidisciplinary recognition initiative on optimizing stroke treatment times.

Conclusion: The "Lightning Award" initiative improved DTN times in acute stroke care, reducing the median DTN time by 23.6% and increasing the percentage of patients treated within 45 min from 29% to 61%. These findings highlight the effectiveness of multidisciplinary recognition in enhancing stroke treatment efficiency and suggest the potential for similar initiatives in other time-sensitive areas of healthcare.