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Every minute counts: How Angels Initiative saves lives by elevating hospital preparedness

The healthcare intervention programme is on a mission to improve stroke survival rates by enhancing stroke-readiness and boosting treatment quality in hospitals worldwide.

Every minute counts: How Angels Initiative saves lives by elevating hospital preparedness

Angels Initiative is a healthcare intervention programme dedicated to helping hospitals around the world achieve “stroke-ready” status. Photos: Angels Initiative

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When a person suffers a stroke, every passing minute is vital. Timely treatment, especially within the first four hours, can vastly improve survival rates and reduce the risk of long-term disability.

However, most hospitals worldwide are not “stroke-ready”. A 2019 survey across 84 countries by the World Stroke Organization (WSO), the World Health Organization and Lancet Neurology found that only 35 per cent of hospitals met the basic requirements for a stroke care centre. These requirements include having facilities for computed tomography (CT) scans and the capability to provide essential stroke treatments, such as intravenous thrombolysis and endovascular therapy.

A stroke occurs when blood flow to the brain is interrupted, depriving brain cells of oxygen and nutrients. Each minute that passes results in the death of nearly 2 million brain cells. Globally, stroke remains the second leading cause of death and disability, with low- and middle-income countries accounting for 86 per cent of stroke-related deaths.

To address critical gaps in readiness and resources, global healthcare intervention programme Angels Initiative is partnering with hospitals to improve their response times and overall treatment quality for stroke patients. “Our aim is to help hospitals become stroke-ready, enabling them to begin treating stroke patients the moment they arrive,” said Ms Sylvia Kang, regional stroke care programme lead for Angels Initiative in the ASEAN, South Korea, Australia and New Zealand (ASKAN) region.

With support from pharmaceutical company Boehringer Ingelheim, the initiative incorporates simulation exercises, best practice sharing sessions and capacity-building programmes to elevate stroke care standards. The goal: To expand access to healthcare for 50 million people in underserved communities by 2030 as part of Boehringer Ingelheim’s commitment to sustainable development.

WHAT IT MEANS TO BE STROKE-READY

Angels Initiative partners with hospitals to enhance their stroke-readiness by assessing needs and addressing resource challenges. Consultants work alongside hospital teams to set up stroke response units and develop protocols for managing stroke patients. In cases where hospitals lack resources like a full-time neurologist, Angels Initiative connects them with experts from stroke-ready hospitals and trains emergency room doctors and internists to step in when needed.

To further support stroke care professionals, the initiative offers an online learning academy with extensive resources and training modules. Annual capacity-building workshops provide hands-on, interactive training – including the Angels ASKAN Stroke Care Preceptorship, designed for doctors and nurses keen to deepen their expertise in stroke management. Combining theory with practical aspects, participants learn about stroke cases, imaging techniques and post-acute care, as well as participate in simulation exercises. “Many healthcare professionals are surprised at how reviewing patient pathways can reveal solutions to reduce door-to-treatment time,” shared Ms Kang.

Emergency responders also receive specialised training to recognise stroke symptoms early and alert hospitals in advance. “This allows the hospital or stroke unit to be fully prepared when a stroke patient arrives, so they can promptly receive a CT scan and immediate care,” said Ms Kang.

Angels Initiative and World Stroke Organization president Prof Jeyaraj Pandian (extreme left) meet with representatives from Vietnam's provincial hospitals to improve stroke-readiness.

THE IMPACT OF ANGELS INITIATIVE IN THE REGION

Since its inception in 2016, Angels Initiative has helped over 2 million patients receive care in 1,200 Angels-registered hospitals across the ASKAN region. While many of these hospitals are in metropolitan areas, the initiative has also been crucial in supporting rural hospitals, which often face limited resources.

One example is Kapit Hospital in Sarawak, Malaysia. Located in a remote area with only a single road connecting it to the nearest city, Sibu, Kapit Hospital established a stroke care unit in April under the leadership of Dr Chai Siew Yap, an internal medicine specialist.

Under the guidance of Angels Initiative, Kapit Hospital in Sarawak, Malaysia has enhanced its approach to managing stroke emergencies.

Under the guidance of Angels Initiative, the hospital conducted simulation exercises to refine its response to stroke emergencies and developed solutions to address resource limitations. As a result, Kapit Hospital has reduced its “door-to-needle” time from 60 to 50 minutes and continues to prioritise staff training to improve patient outcomes.

To motivate recognition of hospitals’ commitment to excellent stroke management and care, Angels Initiative – in partnership with WSO – launched the WSO Angels Award in 2017. So far, 515 hospitals have received this honour, including Singapore’s Changi General Hospital, National University Hospital and Singapore General Hospital (SGH).

Singapore General Hospital is the first hospital in the city-state to be awarded the WSO Angels Award for its excellence in stroke care.

THE POWER OF PUBLIC AWARENESS

Effective stroke care isn’t just about hospitals and healthcare professionals. Public awareness plays a key role in helping people recognise symptoms early and respond quickly. Ms Kang noted that many stroke patients arrive after the critical 4.5-hour treatment window. A 2016 study by Singapore’s National Neuroscience Institute found that only 41 per cent of stroke patients reached SGH and Tan Tock Seng Hospital within 3.5 hours.

“Sometimes, people mistake stroke symptoms for something minor – like muscle strain or fatigue – and may take a painkiller or go for a massage, assuming that arm weakness or numbness is just part of ageing,” shared Ms Kang.

Without timely intervention, strokes can lead to irreversible brain damage and even death. To address this, Angels Initiative has been raising community awareness using the “F.A.S.T.” method: Face (look for facial drooping), arm (check for numbness or weakness), speech (listen for slurred or impaired speech) and time (call emergency services immediately).

The FAST Heroes programme is designed to educate children ages five to nine on how to recognise stroke symptoms and call for help.

Taking a step further, Angels Initiative also introduced the FAST Heroes programme. This global educational initiative is aimed at children ages five to nine, who often spend time with their grandparents – a high-risk group for stroke. Through engaging activities, children learn to recognise stroke symptoms and call for help. To date, over 11,000 students across 250 schools in Singapore and Malaysia have participated in the programme.

“Statistics show that one in four people over 25 will experience a stroke in their lifetime,” said Ms Kang. “Recognising the signs and acting fast in an emergency could make all the difference.”

Learn how Angels Initiative is raising the standard of stroke care across Southeast Asia and beyond.

MPR-ASK-100017

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