[Revised certification criteria for regional and national stroke units in Germany]

The revised criteria for regional and national German stroke units (SU) defined by the SU commission of the German Stroke Society come into effect on 1 July 2015. Due to the already high level of quality, various aspects only needed minor adjustments and definitions; therefore, the majority of minimum structural standards were carried forward. For medical personnel thresholds for when staff further recruitment is necessary were defined for the first time. The current evidence for endovascular thrombectomy (ET) resulted in enhanced standards for acute brain vessel imaging, network formation and timely transport between regional and national SUs with and without ET capability. It further confirmed certification criteria for national SUs that have been valid since 2012: at least two neurointerventionalists as staff members enabling ET on a 24/7 basis. Diagnostic of atrial fibrillation (AF) has been newly implemented following current evidence and internal audits on an annual basis have now become obligatory. Overall, activities to ensure and improve quality must not only be restricted to the minimally required criteria of SU certification but should also incorporate recommendations of the SU commission. The continuous further development of German SU in recent years underlines the importance of the certification procedure as a guarantee of a minimum standard and as the driving force of sustainable quality improvements.