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Dr. Yuriy Flomin: We hope to gain a momentum in setting up modern stroke facilities

Top Ukrainian stroke care expert and observer of IRENE COST Action tells us more about the latest development in his home country.

What is the main recent achievement in stroke care quality in Ukraine?

From my perspective, major recent achievements in stroke care quality improvement in Ukraine include publishing the Directive of the Ministry of Health of Ukraine of 25.09.2020 № 2203 "On approval of the procedure for organizing the provision of medical care to patients with suspected acute stroke in the system of Emergency Medical Services" and development of Regional Stroke Pathways. The Directive mandates that the EMS define the time of stroke onset, whether or not the patient is in “therapeutic window”, and, if so, notify the nearest Acute Stroke-Ready Hospital and take the patient there as fast as possible. Regional Stroke Pathways are developed and approved by regional health authorities so that most patients in a region are delivered by the EMS to one of the Acute Stroke-Ready Hospitals, Stroke Units or Stroke Centers that have signed a Contract with the National Health Service of Ukraine. The National Health Service refunds the costs of acute stroke care, including IV tPA and EVT, provided in contracted hospitals and collects some data on stroke care quality. Apart from that, on April 9, 2021 the first stroke patient was delivered from a rural mountain area to a Stroke Center in Lviv by a helicopter.

Are there any obstacles that you are facing right now?

Despite a number of steps in the right direction, unfortunately, setting up stroke systems of care across Ukraine has been slow, and at present few patients have access to high-quality stroke care capable of improving the outcomes such as IV tPA, EVT and Stroke Unit Care.

What are your plans for the future?

Currently we are working on the strategic document named ‘Stroke Care Development Concept for Ukraine in 2021-2030’ as a road map for Stroke Action Plan for Europe 2018-2030 implementation in our country. We hope that approval of the Concept by the Cabinet of Ministers of Ukraine will help join the efforts and gain momentum in setting up a network of modern stroke facilities in Ukraine. In addition to that, we are working to translate into Ukrainian a set of Canadian Stroke Best Practices Recommendations which will be distributed throughout the country to serve as clinical guidelines and plan to create a set of e-modules for training Physicians, Nurses and Health-Allied Professionals in stroke best practices.

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