The facility shall: Participate, in a manner approved by the EMS Board, in a stroke registry that includes the data elements tracked by the Centers for Medicare and Medicaid Services and the American Heart/American Stroke Get With the Guidelines®-Stroke Registry; Have participated in the stroke registry and maintained a stroke log for a minimum of 6 months prior to time of requesting an application; Demonstrate ongoing participation in the stroke registry; Authorize the stroke registry to provide the hospital data to MIEMSS for health oversight activities in a manner approved by the EMS Board; Establish at least two outcome objectives that: Are time-specific; Are measurable; Reflect tracking and trending of performance measures and indicators; and Are reviewed in annual comparison studies; Maintain a stroke log which includes at a minimum the following information for each entry: The number of times the stroke team was activated; The stroke team’s response time to the acute stroke patient; The on-call neurologist’s response time for consultation to the acute stroke patient; The type or types of diagnostic tests and acute treatment utilized; The patient’s diagnosis; Door to IV fibrinolytic time; Patient complications; Arrival and departure/transfer times; and Disposition of the patient; Monitor its IV fibrinolytic complications, which includes symptomatic intracerebral hemorrhage and serious life-threatening systemic bleeding; Establish at least one stroke center quality assurance medical review committee which shall be a medical review committee under Health Occupations Article, §1-401, Annotated Code of Maryland, as a committee established in the Maryland Institute for Emergency Medical Services Systems which, at least three times a year: Meets; Reviews practice patterns; and Modifies practice patterns as appropriate; In cases where the administration of fibrinolytics is appropriate: Administer the fibrinolytic within 60 minutes from the time the patient arrives at the emergency department for greater than or equal to 50 percent of eligible patients; Demonstrate progress towards administering fibrinolytics within 60 minutes from the time the patient arrives at the emergency department for greater than or equal to 75 percent of eligible patients; and Demonstrate progress towards reducing time of administration of fibrinolytics to 45 minutes for greater than or equal to 50 percent of eligible patients; Incorporate into their quality assurance process progress reports about: Specific acute stroke treatment benchmarks; Outcomes data on patients transferred for a higher level of care; and Stroke treatment quality improvement goals; and Provide MIEMSS with documentation of quality management of the stroke program for review, including, if appropriate: Problem identification; Problem analysis; An action plan; Implementation of the plan; and Re-evaluation of the plan.