A transient ischemic attack (TIA) occurs when there is a temporary disruption of blood supply to the brain. Damage from a TIA is temporary and reversible, but the experience is an important warning symptom for stroke, which is a major cause of death and long-term disability. Patients have a five to ten per cent risk of having a stroke within a week of a transient ischemic attack. Patients with TIA symptoms often go to the emergency department for evaluation, but there is no universally accepted strategy for managing TIA in B.C. Emergency Departments (EDs). A major challenge has been the lack of a system for determining which patients are at high risk for having a stroke and warrant urgent investigation and treatment. Dr. Devin Harris is evaluating the effectiveness of a clinical guideline for standardizing TIA care in EDs. This evidence-based guideline is being implemented as a pilot project in six B.C. emergency departments and will then be expanded to all 92 EDs in the province. Devin is examining physician adherence to the guideline and the impact on patient outcomes. This information will be used to develop a model for predicting which patients are at high risk of stroke after TIA, leading to better preventive and treatment options.