Abstract Body: Introduction:
Stroke education is critical for patients and healthcare providers managing acute ischemic stroke (AIS). In our hyperacute telestroke network, most spoke centers have shown improved key performance indicators (KPIs) for IV thrombolytics. However, some spoke centers with predominantly Spanish-speaking population and staff continue to face operational hurdles hindering KPI optimization. Previous bilingual education efforts in English and Spanish have shown limited success. We hypothesize that the cultural background of staff and patients at these sites may impact these efforts. Our goal was to explore the cultural factors influencing telestroke care to design an educational initiative that addresses the cultural context of our local community, with a focus on both cultural humility and competency, to improve AIS KPIs in telestroke networks.

Methods:
We conducted a descriptive, exploratory survey to identify key factors contributing to AIS KPIs, with a focus on cultural and language challenges. First, a survey was distributed online via RedCap to Emergency Department (ED) physicians, nurses, technicians, patients, and families. Survey data was analyzed to identify key themes. Based on these findings and future focus groups, culturally tailored educational lectures will be developed and presented. Time-sensitive KPIs will be tracked pre- and post-intervention using data from the Hub center’s clinical database.

Results:
From January 1st to September 12th, 2024, these spoke sites recorded overall KPI times slightly longer than the network median: Door-to-CT 21 minutes, Door-to-CT read 40 minutes, Door-to-stroke-code page activation 26 minutes, Door-to-decision 50 minutes, and Door-to-thrombolytic 68 minutes. To date, 25 ED staff members have completed the survey. Key findings include: 68% of staff are involved in Telestroke cases at least weekly, 80% feel prepared for Telestroke cases, and 68% expressed a need for post-stroke debriefings. Barriers to care included CT delays (44%) and difficulties with the Telestroke machine (44%). Additionally, 64% of staff indicated an immediate need for translation support. Further qualitative themes and updated KPI metrics will be reported.

Conclusion:
In a culturally diverse country like the U.S., medical conditions must consider the cultural backgrounds of both patients and care providers. Integrating cultural humility and competency into stroke care can enhance understanding and improve stroke outcomes.