Dr Apostolos Safouris | Lessons From History

Two years ago, when you had just received the Spirit of Excellence Award, you said that the appreciation of people who recognized what you were trying to do was a great push forward.

At the time, you were strongly focused on implementation and certification.

Have you stayed on course? Are those still what you are primarily moving forward on?

Yes, it's true that I have been, uh, following this path.

It also helped a lot that I have been given the honor to be chair in the ESO Stroke Unit Certification Committee for the past two years.

We arrived at the moment that we are almost ready to have a new, a new procedure to be implemented with, uh, KPIs that will be, uh, decided through a Delphi panel from stroke experts around Europe.

So we are on our way to get also in all the good things that Angels Initiative have been doing about KPIs and, um, also other organizations like the CEPI and integrate them in our procedure.

So probably in the next months, all this project will be, uh, concrete, and of course, we've been working with Angels Initiatives to have this novel path for certified centers with Diamond and Platinum awards to be given another pathway that will be easier for them to get the ESO certification without, of course, changing anything about the core of the procedure.

And we now have the first center from Italy that, uh, will probably get the certification through this path.

So we are now at the beginning of having some fruits of this, of this effort that involved many, many people, not just me.

So I think the future is bright, but it's not gonna come so quickly.

What is slowing it down?

Well, the beauty of Europe and, uh, the problem of Europe i- are the discrepancies.

So you have many different models And you have, uh, areas of excellence and areas that are not so excellent.

It's not, I think from my experience, a matter of resources.

Of course, maybe there were the resources when the systems were built, but now I don't think that the problem are the resources.

The problem is organizational, and you have again and again the same problem, how to change something that has been organized years ago when stroke was not a thing, a stroke treatment was not a thing.

So I think the main challenges are to find a way to get those that are involved in, uh, forming the stroke networks to change ideas and to understand the reason of standardized procedures and certification of some kind, ESOS or another, to improve, uh, patient outcomes.

The main point of the ESOS Stroke Unit certification is to reduce discrepancies.

We, um, cannot go to each and every center, but we can give a healthcare improvement project to each and every center to follow that has been, uh, solidified through many years of practice when they want to upgrade the level of care they're providing, and there are many people that they want to do that.

We have a lot of centers that would not participate, not because they do not want to do this kind of upgrade in their clinical practice, but they have limitations in work hours, and they don't have the support of the head of medical department or the CEO of the hospital.

And what I'm getting on the last two years is that when they present this kind of project to the direction, they have positive feedback and support.

When they are aligned with the will of the administration, it goes very well, and they're both happy.

Both the administration because it has to show something like an excellence in stroke care project that wasn't there before, but also them as a way to solidify their protocols and form a team because that's also something that you gain from this procedure because you get people engaged, you get people from other specialties contributing to, uh, the SOPs that you're using.

You're getting people like physiotherapists, logotherapists, speech therapists, and everyone to sit around the table and formalize their procedure, so it's great from team building.