Stroke is a major cause of mortality and morbidity, but outcomes can be optimised if healthcare is accessed promptly. This project uses an epidemiological approach and applies quantitative methods to investigate the quality of pre-hospital emergency care and its relationship to health outcome measures in acute stroke. This study has the potential to benefit future stroke patients and their families, high risk groups such as Maori, and the nation through reduction of mortality and disability and an increase in quality adjusted life years. With over 25 years health service experience as a registered nurse, ambulance paramedic, researcher and educator, enrolment in a PhD continues my professional development in a study directly applicable in the paramedic workplace. My clinical practice and research experience will inform my PhD study and contribute to the currently limited knowledge of pre-hospital emergency care in New Zealand and to improving outcomes in stroke.