TABLE 2.

Barriers and Facilitators to Implementing Primary Stroke Center (PSC) Policy

Barriers	Facilitators
Determining the standards for PSC certification	Statewide or regional champions for stroke systems of care
Lack of coordination between emergency medical dispatch and emergency medical services and health care delivery systems	Stakeholder communication
Lack of neurology specialists for the acute stroke team	Statewide programs focused on improving the quality of stroke care
Intrastate and interstate barriers to telemedicine	Stroke care policies focused on quality
Complexity at the hospital and health care delivery system level	Stroke policies informed by the medical community
The complexity of public administration and government entity coordination of health care delivery	Stroke policies flexible to local context
	Prehospital care coordination
	Sharing data across the continuum of health care delivery
	Hospital competition for market share