This article was first published in the Fall 2020 issue of Critical Connections. This article highlights a local stroke team’s treatment algorithm, which includes a clinical pharmacist. Recombinant tissue plasminogen activator (tPA) has been in use for approximately 25 years. However, although it is the standard of care, less than 15% of all ischemic stroke patients receive it. Its use has been limited because it can be administered only within 3 hours (per Food and Drug Administration label) or 4.5 hours (per professional societies and European labeling) of symptom onset. Therefore, the prompt preparation, dispensing, and administration of tPA have been focal points of process improvement for decades. Here we highlight our local stroke team’s treatment algorithm. Our stroke team includes a clinical pharmacist. Critical Connections is the critical care industry’s only newsmagazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team. Authors: Ryan Hakimi, DO, MS, FNCS, NVS, RPNI Michael Wagner, PharmD, BCCCPRyan Hakimi, Michael Wagner, PharmD, BCCCP