This is how you move a building in three steps:
One, cut openings in the foundation and install steel beams for structural support. Two, install hydraulic jacks under the structure and connect them to a system that monitors pressure and keeps the building level. Three, jack it up, install platforms on wheels below, and commence the slow crawl to its new destination.
In 1975, the people of Most, a town near the northwestern border of the Czech Republic, had to move their Gothic church more than 800 meters to a new location to make way for a coal-mining operation. The Church of the Assumption of the Virgin Mary weighed 12,700 tons. At an average speed of 2,16 cm per minute, she reached her destination after 28 days, bringing pride to the Czech government and winning Most a mention in the Guinness Book of World Records.
It was, at the time, the heaviest building ever to have been moved on wheels.
Hearing this you might ask to yourself, if a town can do that, what else might they be capable of? Which brings us to the story of Hospital Most, and how to become an award-winning stroke centre in three steps.
Bước 1: Find your stroke champion.
Before Dr Ján Macko came to Hospital Most, he was lead physician of the stroke unit at nearby Hospital Chomutov where, having heard of the ESO Angels Awards programme, he put his weight behind a campaign to optimize the stroke pathway and improve outcomes for stroke patients. As a result Hospital Chomutov won three consecutive diamond awards, and in 2020 Dr Macko accepted an offer to join Hospital Most which was, at the initiative of the regional healthcare provider Krajská zdravotní, a.s., to re-establish its stroke programme.
Arriving in September 2020, Ján Macko was told he had until March 2021 to create a stroke protocol and assemble and train a stroke team. With the backing of the chief neurologist, Dr Stanislav Slavík, and generous support from his colleague, Dr Jozef Sirovič, he got to work straightaway, sharing his experience with his new colleagues and rolling out an education programme that included Angels stroke nurse certification training for every nurse in the neurology ICU.
The emergency nursing staff, as the first point of contact for patients, likewise received instruction in using the FAST test to detect stroke, and what actions to perform after alerting the neurologist on call. Dr Macko was leaving no stone unturned.
Bước 2: Practice, practice, practice.
With a certified stroke centre accreditation still pending, the new stroke unit at Hospital Most was ready for full action by February 2021, one month earlier than planned. Official sanction from the ministry of health came in October, the same month Angels consultant Robert Havalda was invited to conduct a simulation that was to be a test of teamwork and time.
“They were already quite fast,” says Martin Liptay who stepped into Robert’s shoes last September. “But they still managed to reduce their door-to-needle time from 25 to 15 minutes.”
Over the next year, five young physicians were trained to provide acute diagnostics and therapy within the stroke unit, and gradually integrated with the stroke team. When at the start of 2023 the first of them was ready to start treating stroke patients independently, it was Martin who traveled up to Most for a fresh round of simulation training.
Martin together with Dr Macko had prepared two scenarios – one in which the patient arrived via EMS with preno