To evaluate the impact of resident-driven initiatives in identifying and addressing workflow inefficiencies during the establishment of a newly recognized Comprehensive Stroke Center (CSC).

Single-center quality improvement (QI) study with a pre–post design at a newly certified stroke center (June-August 2025), including revascularized patients treated with intravenous thrombolysis (IVT) or endovascular procedures. June served as the pre-intervention period (n=9), while July-August comprised the post-intervention period (n=8). Residents and the stroke team evaluated workflows via post-code debriefs, review of door-to-imaging (DIT) and door-to-needle (DTN) times, and interdisciplinary feedback. Solutions were implemented with nursing, radiology, and emergency medicine. Metrics were tracked and compared pre- and post-intervention using descriptive statistics.

Resident engagement in QI efforts plays a critical role in strengthening stroke systems of care, improving workflow without the need for additional resources. By identifying seemingly minor inefficiencies, residents drive changes that significantly improve performance metrics. Incorporating these feedback loops promotes a culture of continuous improvement, highlights the workforce’s value beyond direct patient care, and, with larger samples and longer follow-up, may translate into better patient outcomes.