Three years of Angels: delivering a vision of consistent improvements in stroke care, internationally

Author:Georgios Tsivgoulis, Salvatore Ascione, Andrea Zini, Estela Sanjuan, Ivette Motola, Nguyen Huy Thang
Volume Info:Volume 5 Issue 1
Article Information

Volume 5 Issue 1, pages 8-31
Received – 12 July 2019, Accepted – 18 July 2019


Second Department of Neurology, National & Kapodistrian University of Athens, Athens, Greece.


Department of Neurology Stroke Unit, Ospedale del Mare, Naples, Italy.


Department of Neurology and Stroke Center, Maggiore Hospital, IRCCS Istituto di Scienze Neurologiche di Bologna, Italy.


Vall d’Hebron Hospital, Barcelona, Spain


Center Assistant Director, and Director, Division of Prehospital & Emergency Healthcare, Gordon Center for Simulation and Innovation in Medical Education. Associate Professor of Emergency Medicine, University of Miami Miller School of Medicine, Miami, USA.


Head, Stroke Science, 115 The People Hospital, Ho Chi Minh City, Vietnam.


Corresponding Author: Georgios Tsivgoulis –


The ANGELS Initiative, in collaboration with the European Stroke Organisation (ESO) and supported by Boehringer Ingelheim, was launched in 2016 in Europe, with the original aim of establishing 1,500 European stroke-ready hospitals and improving the standard of acute stroke care and patients’ outcomes in Europe by May 2019. In the subsequent three years since launch, the ANGELS programme has expanded its sphere of influence significantly, and internationally; it now engages with stroke physicians, nurses, and emergency medical services (EMS) in more than 2,700 hospitals in 95countries. The ANGELS Initiative satellite symposium: “The ANGELS Initiative: three years and counting” was presented at the European Stroke Organization Conference ESOC) on the 22nd May 2019 in Milan. This symposium reviewed the contribution the ANGELS Initiative has made over the last three years with respect to increasing the availability and the quality of acute stroke care. The content of the symposium presentations, made by leading stroke professionals, provides insights into how a new stroke ready hospital is established, and how a regional stroke network can be achieved. The crucial roles of the specialized stroke nurse and emergency stroke services (EMS) are acknowledged, and the educational and training initiatives that have been made available for these professionals through ANGELS are reviewed. In addition, an assessment of the measurable impact the ANGELS initiative has had on the delivery and effectiveness of acute stroke care in Vietnam is reported.


Acknowledgements: The editorial assistance of Mr Rob Goodwin, Oruen Ltd, in the preparation of this article is acknowledged with thanks.


Angels Initiative, Stroke Networks, Stroke-ready Hospital, Stroke Nurses, Acute Stroke



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