When Angels consultant Pâmela Godoy isn’t visiting hospitals, you’re likely to find her in a ballet studio. She dances for several hours a day and adores sharing the spotlight with fellow dancers – but now and again she finds opportunities for performance far away from the stage.
When she’s conducting simulation training for stroke teams, she readily steps into the role of concerned family member or friend and enjoys bringing a character to life.
“I create a different character every time,” she says.
A “blind” simulation in June 2022, at Hospital Geral Clériston Andrade in Feira de Santana in Bahia, offered one such opportunity. No-one but Pâmela and the stroke nurse and neurologist were meant to know that the “patient” wasn’t really having a stroke and that her distraught “friend” was likewise putting on a show. But as they entered the hospital, the security guard realised he had seen her before: “Aren’t you the girl who was here doing the training about stroke?” he asked. Then the triage nurse recognised her too.
Worried she had ruined the surprise of a blind simulation, Pâmela dug deep for an absolutely convincing performance. What a remarkable coincidence, the nurse and the guard exclaimed at the conclusion, that a stroke trainer from São Paulo who just happened to be visiting their city was now rushing a stroke victim to their hospital!
Although this artful deception would later produce a good laugh, what really mattered was that on this occasion the stroke team at Hospital Geral Clériston Andrade did everything right. Their door-to-needle time was a respectable 42 minutes, and the team emerged with useful insights about what they could do even better.
“It was an amazing experience and they loved it,” Pâmela says.
Their first simulation was another turning point for a hospital whose journey to improved stroke care had been anything but smooth.
A story in two acts
Hospital Geral Clériston Andrade (HGCA) was among the first hospitals Pâmela consulted after joining Angels, and she and fellow consultant Paulo Politano had good reason for making the trip. Feira de Santana is the second-most populous city in Bahia and this large public hospital also accepts patients from over 160 surrounding municipalities. A successful consultancy could bring improved stroke care to over 4 million people.
A promising start saw 560 staff members turn up for a three-day training session in September 2018, but the fact that there wasn’t a single doctor among them should’ve have warned them of what lay ahead. The stroke improvement programme rested entirely on the shoulders of the clinical neurologist and after failing to raise the support of hospital management or his colleagues, it was he who called halt the following year. Stroke care is teamwork, Pâmela says. It was more than one person could manage alone.
The needs of more than 4 million Bahians stayed on Pâmela’s mind as duty took her to hospitals elsewhere. She made a point of keeping in touch and in February 2022 she found herself back in Feira de Santana.
“I had to be there again,” she says. “I had to be by their side, take their hand and say you can count on me, let’s do this together.”
Hospital Geral Clériston Andrade in 2022 was a very different hospital from four years earlier, and it wasn’t only the building that had had a makeover. The neurology department was now lead by enthusiastic young doctors who had developed their skills in major cities.
“That is important, that is their strength,” Pâmela says. “They’re all from this city, they went outside, collected experience and returned home to provide care.”
In May 2023, Pâmela was once again in Feira de Santana where neurologist Dr Renata Nunes, coordinating neurologist Dr Jamyllo Brito, and stroke nurse coordinator Wedja Corrêa introduced her to the best coffee in town. They had become friends and enjoyed showing their visitor from São Paulo around their city.
The agenda for this coffee shop meeting focused on quality monitoring. The hospital had applied to RES-Q in August 2022 but was still not sharing their stroke treatment data on the platform. Pâmela was convinced that once they did, they would almost certainly qualify for a WSO Angels Award.
In July Pâmela was on vacation in Los Angeles when a text appeared in the Angels-HGCA WhatsApp group: “Pâmela and Paulo, you gave us a mission, and the mission is done.” For Q2 of 2023, the stroke team at Hospital Geral Clériston Andrade had entered the data for 43 patients into RES-Q and qualified for a gold award. They would do better next time, Renata promised.
When Pâmela learned that the hospital had in fact achieved diamond status in all but one metric (anticoagulants on discharge), she reminded them that the final deadline for submitting data was still a couple of weeks away. Dr Renata’s team combed through every one of the 43 patient files to find the missing information.
Pâmela had just landed at Panama airport when there was a new message in the HGCA WhatsApp group. Below a screenshot of the hospital’s results in RES-Q, Dr Renata had written: SOMOS DIAMOND 💎 🤩🧠.
She’d explain later, Pâmela told her friends who wanted to know why she was suddenly crying.
“I was so happy and so proud,” she says. “They are amazing people; their resilience is remarkable. I told them they now had to maintain their diamond status for the sake of their patients. The patients are the main characters in this story, and they know this.”
“You’re an example to all the hospitals and to the world,” she texted back.
We have changed, we are Angels
Hospital Geral Clériston Andrade did maintain their diamond status, winning another top award in the following quarter. Pâmela cannot wait to go to Feira de Santana to hand them their certificates in person. Nothing less than a ceremony will do. She’s told them, “I could send it to you, but I want to give it into your hands and then we will make a party. Because it’s important for me, for you, for the patients, for the city.”
Dr Renata Nunes has meanwhile recorded a video in which she recounts her hospital’s journey with Angels. She says:
“Hi everyone, I’m Renata, neurologist currently working in the Hospital Geral Clériston Andrade in Feira de Santana, Bahia, and I want to share with you how we became an Angels Hospital.
“A few years ago we were visited by Pâmela Godoy, our Angels consultant, and Paulo Politano, and they challenged us to implement the stroke protocol. We accepted the challenge but unfortunately, in this moment, we had a lot of other issues that prevented us from moving forward, but the seed had been planted.
“At the end of 2021 they came to our city and during a conversation they asked us: ‘What’s going on? Why can’t we make things improve? Let’s try again from the start like this is the first time?’
“This was a game changer for me.
“The greatest milestone was when Pâmela came to spend a week with us, training everyone from the security and receptionist to the multidisciplinary team; basically everyone involved in the stroke protocol. She brought a different, inspiring motivation and energy with her.
“Today we have a stroke unit that takes care of this patient in the best possible way, a super-organised protocol and we treat our patients effectively, with agility and safety.
“Our hospital has changed and I’m very proud to say that WE ARE ANGELS. Now we can really say we are doing the best that we can.
“I want to thank the team that was part of this process and say that every visit is a boost of energy that makes us gather all of our strength to do even more and even better.
“I’m sure that we still have a lot to do and we will do it together.”