Background: The aims of this studywere to map the barriers to the implementation of quality indicators in the treatment of acute ischemic stroke, and the part of regional and other inequalities in those barriers. Methods: 16 staffers from hospitals in Israel’s North and Central region (doctors, nurses, technicians, quality coordinators, social workers), all closely involved in stroke care planning, were interviewed in depth. Results: The main barriers to effective stroke care are: (a) public ignorance of stroke symptoms and how to respond, and inadequate staff training; (b) resourceshortages and poor resource organization; (c) staff-patient and staff-staff communication; (d) poverty and age discrimination. Conclusion: Closing inter-regional gaps will have the greatest effect on national treatment outcome rates.There are numerous relatively low-cost but impactful investment targets.Quality indicators are interdependent: the solution is an Integrated Care Pathwaysstrategy. Information campaigns can stop stroke victims arriving late to hospital care.
