Acute stroke treatments are highly effective and very timesensitive (ie. Time is brain). One barrierto timely treatment is tpa discussion induced delay/refusals. Based onqualitative data from a safety net hospital we think this is due to: 1) lowhealth literacy of the patient population and 2) physician framing of theconversation that may overemphasize the risks. We are seeking to build patientand provider guides to expedite the discussion.