Background Stroke is the second cause of death and disability in Latin America and one of the leading causes of hospitalization among neurological disease in Clínica Alemana de Santiago. To reduce death and disability and to improve the security in stroke management, a center certification of care process becomes instrumental to ensure the implementation and monitoring of all evidence-based care strategies to prevent harm. Our aim is to describe the process and results of a stroke center certification strategy, focusing on the procedural nuances and presenting the outcomes derived from its implementation.

Methods This is a descriptive study of the process strategy implemented in Clínica Alemana de Santiago to obtain a certification as an advanced stroke center.

The strategy was:

-Organization of a task force.

-Review of all process involved in the stroke chain of survival.

-Generation of a situational diagnosis.

-Organization of a work plan which involved personnel from all clinical services and as institutional governance to:

-Update or develop new care protocols, including at least one security indicator.

-Continuous personnel training.

- Development of an institutional quality indicator database.

-Organization of a quality improvement process based on the indicators.

-Development of educational leaflets.

-Applying to the online stroke certification program in May 2023.

Results -The task force was organized in august 2022, with the leadership of 3 stroke neurologist and the participation of staff from eleven clinical departments and the institutional quality and safety unit.

-Eleven acute stroke management protocols were reviewed and published, including an overall institutional stroke plan.

The institutional stroke triage was changed at the emergency department and its implementation monitored with continuous feedback and retraining.

-Several courses for nurses and nurse aids were held meeting the 100% of required training time in stroke.

-Graphic visual aids for stroke care were produced.

- A continuous quality of care process with 9 real time quality of care indicators added to 4 security indicators were developed and incorporated to the hospital governance Tableau platform.

-A telemedicine post-discharge follow-up by nurses was organized.

-The certification was obtained in October 2023.

Conclusion The certification process produced significant institutional improvement changes in the organization of stroke care. These included protocol reviews, personnel training, patient education and the implementation of a continuous quality and security of stroke care process with indicators monitoring, allowing us to review cases in real time and make changes to prevent harm in a continuous learning process.