Holder D, Leeseberg K, Giles JA, et al. - This study was undertaken to determine if a distributive stroke network (DSN), triaging low severity acute stroke patients to a primary stroke center (PSC) upon initial telestroke consultation, would safely reduce transfer denials, thereby providing additional volume to treat severe strokes at a comprehensive stroke center. A DSN was implemented in 2017, in which mild stroke patients were centrally triaged to a PSC via telestroke consultation based on a simple clinical severity algorithm, while higher acuity/severity strokes were triaged to the CSC. In comparison to the post-DSN cohort (n = 150) triaged to the PSC, the pre-DSN cohort (n = 150), triaged to the CSC had a similar rate of symptomatic intracerebral hemorrhage and discharge location. No patients who were triaged to the PSC needed subsequent transfer to the CSC. A DSN, triaging mild ischemic stroke patients from community hospitals to a PSC, safely reduced transfer denials to the CSC, allowing the CSC to treat higher acuity stroke patients with greater capacity.