ESO EAST Program bears fruit

The ESO EAST Program started in 2015 as an initiative to improve stroke care quality in the following Eastern European countries: Albania, Armenia, Azerbaijan, Bosnia, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Lithuania, Macedonia, Moldova, Poland, Romania, Russia, Serbia, Slovakia, Slovenia, Ukraine and Uzbekistan.

After selecting the ESO EAST international Steering Committee and National Representatives, several further steps were outlined: 1) establishing a leadership, i.e. setting a national steering committee to implement a stroke care improvement program in their respective countries, 2) defining stroke hospitals, 3) monitoring stroke care quality in these hospitals through quality and performance metrics collection in a registry, and 4) developing a national stroke care improvement strategy.

National Steering Committees were established in 19 ESO EAST countries, a registry for quality monitoring was developed, and quality monitoring was initiated in many hospitals throughout the participating countries.

Registry in stroke care quality: RES-Q

RES-Q was developed as tool for quality monitoring. During development, emphasis was placed on ease of data collection and availability of online feedback. Started in Eastern Europe, after 3 years RES-Q is used for monitoring stroke care quality by 1.300 hospitals in 70 countries around the world. RES-Q contains data on nearly 250.000 stroke patients with nearly half from ESO EAST countries. Since 2018, more than 25 posters showing the results of stroke care quality monitoring have been presented by ESO EAST countries at ESOCs.

European funds support further development

The ESO EAST Steering Committee constantly puts an effort into obtaining funds from European grants. In 2019 we succeeded in winning a grant from the COST Association (Cooperation in Science and Technology) to support research in stroke care quality in ESO EAST countries and beyond. Several ESO EAST delegates were elected leaders of this project, such as D. Bereczki (Hungary), C. Tiu (Romania), S. Andonova (Bulgaria), A. Arsovska (North Macedonia), M. Karlinski (Poland), and S. Groppa (Moldova) and have been able to plan complimentary training programs.

Meetings in ESO EAST countries bring opportunities

One of activities supported by the COST grant was a meeting in Moldova in September 2019, where 60 representatives discussed steps to build an evidence base in stroke care quality in Eastern Europe and identified several research projects to be conducted. This meeting was crowned by an audience with Moldavian president, Igor Dodon. ESO EAST Representatives emphasized the importance and value of focusing on improvements in stroke care in the country, and the region.

Unfortunately, many activities funded by the COST grant, such as training schools, meetings, and study stays for ESO EAST participants had to be cancelled for 2020/2021 due to the Coronavirus pandemic.

Simulation training became popular in ESO EAST countries

In 2016 we developed a simulation training program in acute stroke treatment to help stroke physicians and nurses in ESO EAST improve their knowledge and skills in providing thrombolytic treatment. In Brno, Czech Republic, we trained approximately 300 physicians and nurses from 10 ESO EAST countries. We have also supported stroke champions in Russia and Ukraine in developing their own national simulation programs in acute stroke treatment. This led to establishing stroke simulation centres in St. Petersburg (Russia) and in Poltava (Ukraine) where stroke teams from their regions are trained.

In January 2020, we published an ESO EAST Program methodology and its results in the European Stroke Journal. We believe the stroke improvement program is scalable beyond ESO EAST countries, and is valuable to many other regions facing similar challenges.

Synergy with European Stroke Action Plan is our priority

In the coming months, we are going to arrange six virtual workshops where ESO EAST delegates will be developing implementation strategies of the Stroke Action Plan for Europe 2018–2030 tailored to Eastern countries. The creation of the strategies will be facilitated by ESO EAST Steering Committee members, who are involved in the Committee for Implementing the Action Plan as well. These plans will be introduced in an all-ESO-EAST-members virtual meeting at the end of 2020 and should be implemented from the beginning of 2021.

Thanks for supporting ESO EAST

We strongly appreciate our ongoing cooperation with the ANGELS Initiative, as our synergy makes stroke care improvement in ESO EAST countries faster and more feasible.

We would like to thank our industry partners Mr. Thomas Fischer and Mr. Axel Kohlmetz for managerial advisory and their personal help to make our effort more effective. ESO EAST has been continusously supported by Ever Pharma and an unrestricted eduational grant from Boehringer Ingelheim.

Many thanks to Jennifer Thomsen and Luzia Balmer from ESO Head Office, who have been supporting ESO EAST activities.

Our ESO EAST Steering Committee would like to congratulate all ESO EAST countries for their progress in increasing stroke care quality and to thank them for their tenaciousness in implementing the ESO EAST Program.

Robert Mikulik


On behalf of Valeria Caso, Natan Bornstein, Francesca R. Pezzella, Milan R. Vosko and Veronika Svobodova – the ESO EAST Steering Committee