Press Release, 6 August 2019

Experts from the International Clinical Research Center at St. Anne’s University Hospital in Brno have developed a unique international register to help improve the quality of stroke patient care. In July, the register celebrated its 100,000th patient.

On the global level, cerebrovascular accidents (CVA, popularly known as stroke) are the second most frequent cause of death and the most common cause of permanent disability. In the Czech Republic, it affects approximately 25,000 people a year. However, this condition can be treated. Modern and tested diagnostic and treatment methods exist that, when implemented in a health care system, significantly help patients’ conditions. Many patients do not experience any effects. Unfortunately, the level of difference in the quality of stroke treatment in Europe is huge.

The Czech Republic has one of the best systems of acute stroke treatment and thanks to that, in many parameters, it achieves some of the best results in the world. “Nevertheless, we have to take a very close look at the weaknesses present in the Czech stroke treatment system. Also, we do not want to rest on our laurels and we want to continue improving the treatment. Unfortunately, until we measure the quality of treatment, there is no way we can improve,” explains neurologist and the Head of the Stroke Programme at St Anne’s University Hospital in Brno, Robert Mikulík. For the purpose of measuring and improving stroke treatment care on the international level, a multidisciplinary team of specialists headed by Robert Mikulík developed a register of stroke treatment quality, referred to as RES-Q. The register explores the performance and qualitative parameters of stroke patient care and maps the quality of care provided in different levels: hospitals, regions and the state.

The RES-Q register ( was originally designed for Eastern European countries. Interest in the register has sharply increased over the past two years, especially in countries outside Europe, and today, it is used by 850 hospitals in 59 countries all over the world to monitor their stroke care. The RES-Q register has reached another milestone. Just over three years since its launch, 100,000 patients have been included in the register, which makes it the largest register of its kind and the largest quality register in terms of territorial reach.

“It is an important step towards achieving a better understanding how CVA treatment is provided all over the world. Thanks to that, we can more easily find and implement new methods of providing all patients around the world with better stroke care, regardless of whether they live in an advanced or a developing country,” explains neurologist Robert Mikulík, who is the main author behind RES-Q.

The Cerebrovascular Team of the International Clinical Research Center at St Anne’s University Hospital in Brno has been analysing data entered in the register and provides all participating hospitals with feedback. “We use the data to prepare reports on the state of stroke care in a specific hospital, which also contains a comparison of that given hospital with the national average. We provide a national overview and international comparisons to professional CVA organisations,” explains Andreea Madalina Grecu, the main technical solution architect and RES-Q Manager.

“A certain amount of improvement in the provision of care is often brought about by changes in the approach taken by medical staff members or by changing the logistics in hospitals, as seen in feedback provided from the register. These are not financially demanding solutions and can be applied even in less developed countries. All stroke care providers should know their benchmark, in other words how the best ones perform and how their hospital or country ranks. Everybody tries to be better when they see a model,” emphasises Robert Mikulík, who stresses the effect of quality measuring and feedback.

“However, in many countries, important investment is needed to improve stroke care; many places lack basic diagnostic devices, staff and medication. Thanks to the data provided by the RES-Q register, health care providers and governments can receive input for reaching decisions on making investments in their health care system,” explains Mikulík.

The RES-Q register is supported by the European Stroke Organisation and the World Stroke Organization, and works with leading research groups, professional associations and initiatives focused on improving stroke care around the world. “Through these partnerships, we have been trying to transfer data from the RES-Q register into improved clinical practice and globally decrease differences in stroke care quality,” adds Grecu.

In the Czech Republic, we have succeeded in implementing a stroke care quality system thanks to the work of many physicians and nurses. This system is organised by a professional society, namely the Cerebrovascular Section of the Czech Neurological Society. The result is that the Czech Republic of all countries has one of the most comprehensive sets of information on its quality of stroke care, because all stroke centres in the country participate in the system. “We would also like to thank our partner project ANGELS Initiative, which greatly contributes to the register being used all over Europe, Asia, Africa and South America. Because of that, we can talk about the global dimension and the global impact of our register,” adds Robert Mikulík.

RES-Q Live Metrics (FNUSA-ICRC Stroke Team)
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