Templates › Inspections › SEO page

Run: Stroke Code Activation Time Audit

Stroke code activation time audit template for reviewing door-to-CT, door-to-needle, and door-to-puncture timing. Use it to spot delays, document causes, and...

Fill this out, get a PDF emailed to you. No account required. Want to run it with your team and track results? Sign up free →

Case Identification and Stroke Code Activation

Stroke code activation time documented critical (required)

Activation time is recorded in the chart or stroke log with a clear timestamp.

Yes No N/A

Last known well time documented critical (required)

Last known well or symptom onset time is documented and clinically plausible.

Yes No N/A

Stroke code activation appropriateness

Activation criteria were met based on presenting symptoms and triage findings.

Initial NIHSS documented

Baseline neurologic severity score is documented when applicable per local stroke workflow.

Yes No N/A

Imaging Workflow

Door-to-CT time (minutes) critical (required)

Time from ED arrival to CT start or CT completion, per local metric definition.

CT completed without avoidable delay critical (required)

No preventable delay occurred in transport, scanner availability, or patient preparation.

Yes No N/A

CT interpretation time documented

Time to radiology or stroke team interpretation is documented.

Yes No N/A

Imaging workflow delay category

Primary reason for any imaging delay.

Thrombolytic Treatment Timing

Door-to-needle time (minutes) critical (required)

Time from ED arrival to thrombolytic administration.

Eligibility decision documented before treatment critical (required)

Contraindications, inclusion criteria, and treatment decision are documented before administration.

Yes No N/A

Medication preparation and administration delay reason

Primary cause of any delay between decision and administration.

Thrombolysis administered per protocol critical (required)

Dose, route, and monitoring steps followed local stroke protocol.

Yes No N/A

Endovascular Therapy Timing

Door-to-puncture time (minutes) critical (required)

Time from ED arrival to arterial puncture for endovascular therapy.

Transfer or interventional team activation documented critical (required)

Activation of the interventional team or transfer pathway is documented with timestamps.

Yes No N/A

Delay source for puncture workflow

Primary reason for any delay to puncture.

Pre-puncture checklist completed

Required pre-procedure checklist items were completed before puncture.

Yes No N/A

Documentation and Quality Review

All key timestamps documented critical (required)

Arrival, activation, CT, treatment, and puncture timestamps are complete and internally consistent.

Yes No N/A

Variance or delay documented with cause

Any delay beyond target is explained with a specific cause and contributing factors.

Yes No N/A

Case routed for quality review if target missed

Cases exceeding local targets are escalated to stroke quality review or committee follow-up.

Yes No N/A

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Generated with MangoApps Templates — browse 250+ free