WHEN the Netcare 911 helicopter lands at Netcare Alberton Hospital carrying a suspected stroke, the pilots don’t even turn off the rotors before they open the door. Not a second is wasted before the patient is rushed to the emergency entrance of South Africa’s newest award-winning stroke-ready hospital.
The patient will remain on the ambulance stretcher throughout the neurological assessment and CT scan in the emergency department’s dedicated imaging room. Only once the treatment decision is reached will the patient be taken off the EMS monitor, signaling that the air ambulance is free to attend to its next emergency.
The same sense of urgency attends every step of the optimised stroke pathway, the culmination of a program of learning and change that officially commenced last July. Just six months later, Netcare Alberton’s stroke team collected an WSO Angels Award, becoming only the second private hospital in the country, and the first in the Netcare group, to be recognised for stroke care excellence.
Three months later Netcare Alberton would receive an even more prestigious award, and four more Netcare hospitals would be among the honours.
A new hospital sparks change
Netcare Alberton is a new hospital, reaching its first birthday around the time news of their first award became public. The multidisciplinary stroke team now had two milestones to celebrate, and they were not unconnected. Although specialist neurologist Dr David Djan’s vision for improved stroke care predates the hospital launch on 11 avril 2022, everyone agrees that the new, purpose-designed hospital provided the spark for stroke care transformation.
Netcare Alberton replaced two hospitals that previously served this suburban community south-east of Johannesburg. The group’s Union and Clinton Hospitals were decommissioned, and a new hospital constructed on the site of a former racecourse.
Soon after taking occupation of this state-of-the-art facility, Dr Djan’s team invited Angels consultants to help them dust off their stroke protocol, facilitate training across disciplines, and close the gaps along the stroke pathway. The specialist physicians ensured stroke care pathways were adopted and applied to ensure safe continuity of care for patients throughout their journey. Recognition came after they started sharing their treatment data in the stroke quality registry RES-Q, which not only helped them target areas for improvement, but made them eligible for a WSO Angels Award.
Stroke is personal
Katlego Tabana is the stroke unit manager at Netcare Alberton who on his LinkedIn profile describes himself as “very passionate about trauma, crisis and disaster nursing and medicine”. He’s in the right place. The new hospital is one of three accredited private Level 1 trauma centres in South Africa. Its 24-hour trauma centre incorporates trauma theatres, a trauma ICU, and a helicopter landing pad, and 135 of the hospital’s 427 beds are dedicated critical care beds.
It is equipped for climate emergencies too and employs several environmentally sustainable technologies including a rooftop solar plant and grey water recycling system.
For Katlego, stroke got personal last October when his mom suffered a transient ischemic attack and was treated at Netcare Alberton. “I really saw the benefit of the new pathway,” he says.
His colleague, stroke coordinator Dineo Magasela, happened into stroke care by chance only to discover how immensely rewarding it was to restore someone’s hope and see them go home to resume their prestroke life.
Emergency physician Dr Brad Rae was not yet a doctor in 2001 when his beloved grandfather died of a stroke on Christmas Eve – but it taught him how severe and devastating a stroke can be, and how critically important the minutes saved when leadership goes hand in hand with teamwork, every step of the way.
Success spreads
It’s four years since trauma nurse Zasskia Wiese lost a close relative to a misdiagnosed stroke. Last November Zasskia was appointed Netcare stroke programme manager, responsible for stroke care quality throughout the group. On her watch, communication between stroke teams and the Netcare 911 emergency medical service has improved; continuous education has led to continuous improvement, and regular reviews of stroke cases have allowed stroke teams to learn from adverse outcomes.
Alongside the Trauma Injury Prevention (TIP) programme, a requirement for Level 1 certification, they have launched SIP (Stroke Injury PPrevention) to raise community awareness of the causes and symptoms of stroke. This is particularly important in a community where wake-up strokes occur frequently among its aged population.
Proud as the Netcare Alberton team was of being the first in the group to receive a WSO Angels gold award, the fact that they had qualified for diamond status in all but one area, immediately gave them a new target.
In May 2023 it was confirmed that their quarter one performance had met the criteria for a diamond award, representing the highest standard of stroke care excellence, and that their success had spread to other hospitals in the group.
First-time winners of Gold awards for the same period included three more stroke-ready Netcare hospitals in Gauteng Province – Unitas in Centurion, Sunninghill in Sandton and Pinehaven in Krugersdorp. And Netcare Millpark, which has South Africa’s oldest private dedicated trauma unit, had joined the new kid on the block to become another proud new Diamond hospital.
