How we do it

Establishing stroke ready hospitals

The heart of the project is to improve the quality of stroke care by training health personnel in selected hospitals in Nepal to become stroke ready hospitals. 

Initially, about 10 hospitals will be included to become a “stroke ready” hospital (at least 1 hospital in each province and 5 hospitals in the Kathmandu Valley) – please have a look at our Mapping Tool to see the coverage of the hospitals. 

In each hospital, we will create a “stroke team”, composed of radiologists, emergency physicians, intensive care physicians, emergency nurses, intensive care nurses, emergency medical service personnel and physio-, speech-, and occupational therapists.

The teams of each “stroke ready” hospital will then receive regular trainings to provide essential acute and post-acute stroke care services – and to act as fast as possible! Together, the processes of acute treatment are streamlined and the most important components of postacute stroke care and secondary prevention of recurrent stroke are defined. 

We are proud to count on the experience and support of the Angels’ Initiative.

After having successfully implemented the program in those hospitals, further hospitals will be included stepwise. The long term goal is to develop a Hub and Spoke referral model in Nepal with one comprehensive stroke center and 2-3 essential stroke care centers in each province.

Raising public awareness of strokes

When somebody has a stroke, every second that goes by is crucial. As brain tissue and neurons begin to fade away, time could not be more precious.” 

(World Stroke Day Campaign, 2021). 

Our goal is that every person in Nepal knows how important the first minutes after a stroke are! 

Our goal is that every person in Nepal knows how to recognize a stroke (BE-FAST). 

And our goal is also that everyone alarms the ambulance service or rushes to a clinic as fast as possible. 

To achieve this, we are part of the World Stroke Organization’s #Precioustime campaign this year. 

And our creativity to spread this message in Nepal knows no bounds. We will reach out to people on social media. We will use celebrities to increase our impact. We will spread the campaign on public TV, radio and daily newspapers. We will meet people in their everyday places to make them aware of #Precioustime

And beyond that, we want people to be aware that stroke is a preventable disease. People will be given knowledge about which simple lifestyle changes can already significantly reduce the risk of stroke (Have a look at the Stroke Riskometer).

To understand which concepts of public stroke education are most feasible and effective in Nepal, we will apply different concepts and analyze their effects on stroke awareness.

Establishing a national stroke registry

All stroke ready hospitals will be requested to enter data on stroke treatment in the RES-Q register for every subsequent stroke patient in a defined time (e.g. 1 quartal/year). This will create the first national hospital based surveillance on stroke therapy in Nepal.

RES-Q data will provide an evidence base for targeting gaps and define areas to be improved. The RES-Q tool is endorsed by the European Stroke Organization (ESO) and World Stroke Organization (WSO) and is used by 73 countries worldwide. Data entry requires minimal identifiable metrics of the patient (age, sex) and performance measures that allow for standardized comparison of stroke care quality (according to Bo Norrving, Stroke 2015). 

Hospitals who capture their data in RES-Q are considered for an Angels Award from the World Stroke Organization. 

 

 

Financing of stroke care / Influence

All governmental and non-governmental key stakeholders (Ministry of Health, Nepal Health Research Council, WHO) will be involved in project development and project execution. By providing a hospital- based registry on mortality and morbidity of stroke we aim to provide solutions for cost-effective and efficient stroke care in Nepal’s public health sector.

The program is accompanied by scientific evaluations to measure the impact of the program and to provide evidence-based concepts for the future.

A prospective study will analyze hospital-based treatment data to examine if the quality of stroke care has changed through training. 

Another prospective study aims to evaluate the feasibility and effectiveness of a Public Awareness Campaign on Stroke Awareness of the population in Nepal. The results of this study will be used to further develop and implement stroke education in Nepal.

Plese send me the free “Stroke Knowledge” materials: