Abstract Body: “Time is of the essence” - this is one phrase every emergency department (ED) nurse knows. This especially true for stroke where time is brain. The ED at Inspira Health recognized the need to develop solution-based workflows which enhance timely of care. The development and implementation of the Flow and Resuscitation (Resus) registered nurse (RN) roles supports our goal of getting the patient to the right place at the right time. The Flow nurse was made effective throughout the network in 2023. The Flow RN is an assignment that has a global view of real time departmental operations. This RN is responsible for rapid assessment, and all patient placement in the ED. The Flow RN is always one step ahead and prepared to facilitate physician rapid assessment and initiation of stroke pathway by bypassing a patient care room to be brought directly to computed tomography (CT). The flow RN role has helped with early recognition of stroke symptoms that may not have been obvious during transport to the ED. The Resus RN is an experienced RN well versed in managing higher acuity patient presentations such as stroke and serves as a resource to other RNs in the ED. The resus RN supports two dedicated bays for management of critical patients. The resus role is time limited. This RN assesses the patient, escorts them to CT, monitors vitals, begins the stroke workup, and collaborates with the ED physician and consulting tele-neurologist. Once the patient is stabilized and the initial stroke workup is completed, the resus RN then hands the patient off to the primary RN where care and monitoring will continue. If the patient requires thrombolytics, the Flow RN will facilitate a 1:1 assignment so the primary RN can deliver uninterrupted care, and the resus RN is available for the next critical patient’s arrival. Our progress over a thirty-six-month (2022-2024) period across the network showed an improvement of up to a 25% in the door to CT results, up to 25% in the door to needle within sixty minutes, up to 17% in the door to needle within 45 minutes and up to 47% in the door to stroke team activation. In conclusion, the creation and implementation of these positions has improved the overall response time to patients who require time sensitive care such as stroke in our EDs. The data collected over the span of thirty-six months shows a significant improvement in response time which can improve patient outcomes and offers potential continuous improvement for the years ahead.