# Implementation of a Stroke Protocol for Emergency Evaluation and Disposition (HI-SPEED)

> **NIH NIH U01** · UNIVERSITY OF CHICAGO · 2024 · $764,610

## Abstract

Project Abstract
Nearly 800,000 people in the United States (US) each year experience acute stroke, which remains the leading
cause of adult disability and 5th leading cause of death. Despite the proliferation of stroke centers nationwide,
almost half of the US population lives beyond a 60-minute drive of a comprehensive stroke center (CSC) and
most patients are initially evaluated at a primary stroke center (PSC). While a key treatment, alteplase can be
delivered at most US hospitals, advanced diagnostics and treatments are only available at CSCs. However,
the PSC “Door-in-Door-Out” (DIDO) evaluation process for patients who need to be transferred to a CSC can
be time consuming and inefficient, contributing to inability to receive treatment. Building upon our prior work to
reduce PSC DIDO time, this proposal, “Implementation of a Stroke Protocol for Emergency Evaluation and
Disposition (I-SPEED)” seeks to (1) Implement a novel, evidence-based, multi-component DIDO intervention in
eight diverse stroke systems of care across multiple regions of the US and (2) Conduct a dual evaluation of its
effectiveness in reducing median DIDO time (primary outcome) and disability (secondary outcome) and of the
fidelity and quality of implementation. The I-SPEED study will definitively establish the effectiveness and
generalizability of a multi-component evidence-based DIDO intervention and provide information about
contextual adaptations for high-quality implementation and widespread dissemination. This study benefits from
our well-established interdisciplinary expertise in stroke, emergency and prehospital medicine, systems and
quality engineering, health services research, and strong multicenter research collaborations. Findings from I-
SPEED will have substantial implications for a wide range of hospitals and stroke systems of care worldwide.

## Key facts

- **NIH application ID:** 10897785
- **Project number:** 5U01NS131797-02
- **Recipient organization:** UNIVERSITY OF CHICAGO
- **Principal Investigator:** JANE Louise HOLL
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $764,610
- **Award type:** 5
- **Project period:** 2023-08-07 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10897785

## Citation

> US National Institutes of Health, RePORTER application 10897785, Implementation of a Stroke Protocol for Emergency Evaluation and Disposition (HI-SPEED) (5U01NS131797-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10897785. Licensed CC0.

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