Acute stroke is one of the leading causes of death and disability in the United States. Early detection and treatment of ischemic stroke in the emergency department (ED) may significantly decrease disabilities from acute stroke. Most patients do not arrive to the ED within the recommended timeframe for successful treatment. Implementing a standardized protocol for the management of acute stoke in the outpatient setting will help aid in effective and efficient pre-hospital management of acute stroke. The outpatient stroke protocol will be implemented in all outpatient care centers and urgent care clinics of Kings Daughters Medical Center. Staff will be educated prior to implementing the protocol though an interactive online education module that utilizes standardized patients. After the staff has been educated, the protocol will be implemented in all 42 outpatient clinics. Each encounter that uses the protocol will be recorded as well as ED arrival times and recombinant human tissue-type plasminogen activator (tPA) rates. This data will be compared to historical data from the same six month period one year prior to see if any statistically significant change has occurred.