Assuming a stepped-wedge trial of 3 groups and 4 phases, one needs 75 hospitals randomized into 3 groups of 25 hospitals, each recruiting an average of 27 patients per phase, for a total of 8147 subjects. Assuming 5% with missing endpoint data, the overall sample size increases to 29 subjects per hospital per phase, i.e. a total sample size of 8,621 subjects. Allowance will be made to include some very large hospitals (10%, 7) to recruit 50 patients per phase, and smaller hospitals (10%, 7) to recruit 10 patients per phase, in order to allow a broad range of hospitals with variable experience and systems of care for the management of ICH. This sample size provides 90% power to determine a treatment effect of a 5.6% absolute improvement in the proportion of patients experiencing a bad outcome (modified Rankin scale [mRS] scores of 3-6), from 55.6% down to 50%. This also translates to a 10% relative risk reduction (relative risk of 0.90). Various assumptions have been made including an interclass correlation coefficient (ICC) of 0.044 between sites. All analyses will be undertaken at the patient level on an intention-to-treat basis at each center using Generalised Estimating Equations (GEE) or random-effects regression to account for clustering.