Introduction Despite the availability of prevention and therapies of stroke, their
implementation in clinical practice, even of low-cost ones, remains poor. In 2015,
the European Stroke Organisation (ESO) initiated the ESO Enhancing and Accelerating
Stroke Treatment (EAST) program, which aims to improve stroke care quality, primarily
in Eastern Europe. Here, we describe its methods and milestones. Patients and methods
The ESO EAST program is using an implementation strategy based on a 'detecting-understanding-reducing
disparities' conceptual framework: stroke care quality is first measured (after developing
a platform for data collection), gaps are identified in the current service delivery,
and ultimately feedback is provided to participating hospitals, followed by the application
of interventions to reduce disparities. The ESO EAST program is carried out by establishing
a stroke quality registry, stroke management infrastructure, and creating education
and training opportunities for healthcare professionals. Results Program management
and leadership infrastructure has been established in 19 countries (Country Representatives
in 22 countries, National Steering Committee in 19 countries). A software platform
for data collection and analysis: Registry of Stroke Care Quality was developed, and
launched in 2016, and has been used to collect data from over 90,000 patients from
>750 hospitals and 56 countries between September 2016 and May 2019. Training in thrombolysis,
nursing and research skills has been initiated. Discussion ESO EAST is the first pan-Eastern
European (and beyond) multifaceted quality improvement intervention putting evidence-informed
policies into practice. Continuous monitoring of stroke care quality allows hospital-to-hospital
and country-to-country benchmarking and identification of the gaps and needs in health
care.
