Background: In July 2017, the VA initiated implementation “Go-Live” Training to support the VA National TeleStroke Program (NTSP). NTSP Go-Live Training incorporates systems redesign methods with iterative interprofessional whole-hospital medical simulations. Methods: A qualitative questionnaire with 4 open-ended questions was developed based on Kirkpatrick’s learning hierarchy. Participants’ responses were analyzed using direct content analysis to identify themes related to “reaction & satisfaction” with the training and “knowledge or skills acquired”. To determine learning transfer to practice, process measures (telestroke activation time and door-to-needle time) were collected in “live” facilities. Results: A total of 12 VA facilities participated in NTSP Go-Live trainings and 8 were live by 3/31/18. Of the 296 employees who participated in Go-Live training, 178 (60%) completed the questionnaire. Participants identified “process mapping”, “simulations” and “debrief sessions” as the most valuable aspect of the training. Three themes emerged based on participants’ reactions: 1) reinforced “time-is-brain”, 2) telestroke provides “opportunity to help veterans” and 3) the “hands-on experience tied it all together”. Participants’ indicated that the training “created confidence”, “instilled motivation” and stimulated “recognized value” for the NTSP. Participants indicated acquiring new knowledge and skill in how to “trouble-shoot the telestroke process”, “communicate while using tele-technology” and that “teamwork is key”. In the first 2 quarters, 93 telestroke consults were completed and 92% of all eligible patients (N=12) received thrombolytic therapy. The percent of patients with a telestroke consult initiated within 10 minutes of arrival increased from 13.5% in Quarter 1 to 31.6 % in Quarter 2, with median door to activation decreasing from 32 to 19 minutes. Median door to needle times also decreased, from 72 to 62 minutes. Conclusions: The VA’s NTSP Go-Live Training is a novel approach for implementation of telestroke care in facilities without experience administering alteplase. Moreover, the training improves provider skills/confidence as well as improving quality of acute stroke care.