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The TeleSpecialists Quality Advantage

By: | Tags: , | Comments: 0 | May 1st, 2021

Micaela Prevatke

In this blog post, TeleSpecialists’ Director of Quality Micaela Prevatke, RN, BSN, SCRN shares her experience as a former stroke coordinator and how she worked closely with TeleSpecialists’ TeleNeurologists and quality management team to greatly improve stroke care at her hospital.

In 2016 I started a new position as a stroke coordinator at a 400-bed, nonprofit hospital in Arizona. We had been utilizing telemedicine for emergent neurology since 2008. In this role as an emergency department nurse, my experience with the current telemedicine provider was not positive. The system was clunky, our Door-to-Needle times were far outside the 60-minute window, and the neurologists took a long time to respond.

As the first stroke coordinator at this facility, I quickly realized we did not have a standardized stroke alert process. After we created internal processes and protocols to improve stroke care, educated our team and EMS, and started having regular committee meetings, our Door-to-Needle times showed a minor decrease. However, there was still a disconnect between the neurology providers and our facility. We often waited weeks for their notes to be faxed to us, and even though our team had learned to identify and activate stroke alerts early, the response times and treatment times were still lacking.

I started researching alternatives to our current provider, and in 2017 I met TeleSpecialists’ CEO Nima Mowzoon, MD and Chief Strategy & Growth Officer Reece Nanfito at the International Stroke Conference. Their passion for not only the company but quality of patient care was impressive. After further researching TeleSpecialists and doing a side-by-side comparison of cost and quality, our team decided to partner with them. Dr. Mowzoon and the quality management director traveled to our hospital in Arizona and conducted a value stream mapping exercise to help further refine our stroke process and identify additional areas of improvement, along with a game plan on how to achieve our goals.

The difference TeleSpecialists made in our stroke program and patient care was astounding. From the start, TeleSpecialists’ neurologists were engaged and responsive. Their notes were placed immediately into our EMR system, and the communication with our providers was exceptional. Our patients received a quality of care I did not previously know was possible in a small city. We reduced our average Door-to-Needle times to reflect a national high quality stroke program, earning Primary Stroke Center designation and national awards.

From a quality perspective, the streamlining of care was accomplished through best practice advice and the resources that were provided to my team by TeleSpecialists. During our regular quality meetings, we reviewed cases and identified areas of opportunity. Our quality program specialist often provided resources that helped me implement these best practices. Their support was always just a phone call away, which was reassuring as a new stroke coordinator.

When my family moved out of the area, I left my position at the hospital. Fortunately, TeleSpecialists had an open position in the quality management department. I jumped at the chance to work for an organization that valued patient care and quality as much as I did. I am proud to help lead an incredible team of RNs that transform stroke programs around the country.

As a previous stroke coordinator, finding reliable resources to aid in the improvement of my program was a top priority. I am excited about TeleSpecialists’ new microsite, www.StrokeCoordinatorResources.com. It will benefit current stroke coordinators and program managers in finding resources on best practices and process improvement as well as networking with other stroke professionals. I find the Process Improvement Pathway especially useful. These resources for improving stroke programs have been compiled from the review of tens of thousands of stroke alerts and a large pool of highly trained physicians who have contributed to these recommendations.

For more information on TeleSpecialists’ comprehensive TeleNeurology coverage, or for your complimentary quality and financial assessment for TeleNeurology services, please contact us.

Nattasha Acevedo, MD

Dr. Acevedo received her medical degree from the Ponce School of Medicine in Puerto Rico and did her neurology residency at Montefiore Medical Center in New York. She went on to do a clinical neurophysiology fellowship at Emory School of Medicine in Atla nta, Georgia and then joined private practice in Fort Myers, Florida. She currently resides in San Juan, Puerto Rico. She likes running, paddle boarding and spending time with family.
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Bernadette Borte, MD

Dr. Borte received her medical degree from St. Matthew’s University School of Medicine in Grand Cayman. She completed her neurology residency at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. Her areas of interest include inpatient neurology and acute stroke. When not working, she enjoys spending time outdoors with her family. Dr. Borte joined the TeleSpecialist family in March of 2019.
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Mazen Almidani, MD

Dr. Almidani is board certified in pediatrics by the American Board of Pediatrics and board certified in epilepsy, as well as neurology with special  qualification in child neurology by the American Board of Psychiatry and Neurology.  Dr. Almidani is happily married with 4 children. His oldest son has autism and his daughter has complicated seizures; both were a drive for him to become a neurologist. Dr. Almidani enjoys soccer, running and spending time with his family. He is very involved with his sons’ therapy and helping with daily challenges. He is double board certified in Pediatric and Adult Neurology and Epilepsy. He sees children and adults. He also participates in charities for children in Syria who may be underprivileged and/or affected by the war. Dr. Almidani joined TeleSpecialists in August 2020.
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Amanda Cheshire, MD

Dr. Cheshire received her medical degree from the University of Louisville School of Medicine in Louisville, Kentucky. She completed her neurology residency at the University of Cincinnati Medical Center in Cincinnati, Ohio. She did a fellowship in neurophysiology at the University of Michigan Medical School in Ann Arbor, Michigan. Dr. Cheshire is double board certified in neurology and clinical neurophysiology. She enjoys traveling, reading and music. She currently resides in Viera, Florida.  Dr. Cheshire joined TeleSpecialists in June 2019.
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Jessica Floyd, MD

Dr. Floyd completed her neurology residency at Mayo Clinic in Jacksonville, Florida followed by fellowship training in clinical neurophysiology with focus in EEG and epilepsy at the Medical University of South Carolina in Charleston, South Carolina. She has particular interest in hospital neurology and patient education as well as the blossoming specialty of lifestyle medicine. She strives to take advantage of every encounter with patients and medical staff to empower them to do their own research into how daily thoughts, choices, and habits can add up to create greater and longer-lasting brain and neurologic health for ourselves and our loved ones. She lives in Florence, South Carolina with her awesome husband of 13 plus years and three beautiful children. She is an avid yogi, astrologer, and lover of food and all things neurology! Dr. Floyd joined the TeleSpecialist family in July 2017.
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Nancy Futrell, MD

Dr. Futrell received her medical degree from the University of Utah in Salt Lake City, Utah. She also did her neurology residency at the University of Utah as well as a research fellowship in cerebral vascular disease at Jackson Memorial Hospital in Miami, Florida. She currently resides in Salt Lake City, Utah. She has authored 2 books and 50 peer reviewed papers. 
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Rebecca Jimenez-Sanders, MD

Dr. Jimenez Sanders received her undergraduate degree from Emory University, and her medical degree from the San Juan Bautista School of Medicine in Puerto Rico. She completed her neurology residency at the University of South Florida in Tampa, Florida, where she also did a specialized headache medicine and facial pain fellowship. She currently resides in Tampa, Florida with her husband and her two daughters. She is also fluent in Spanish and Italian languages, and enjoys photography, baking, boating, and biking.
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Cory Lamar, MD

Dr. Lamar received his medical degree from Meharry Medical College in Nashville, Tennessee. He completed his internship and residency at Wake Forest Baptist Health in Winston Salem, North Carolina. Following residency, he completed a clinical fellowship in neurophysiology, with a concentration in epilepsy. He currently resides in Florida and enjoys outdoor activities.
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Clifford Meyers, MD

Dr. Meyers received his medical degree from Brown University in Providence, Rhode Island and his MBA from the Simon School of Business at the University of Rochester in Rochester, New York. He completed his neurology residency at the University of Rochester, where he also did a neurophysiology fellowship. Dr. Meyers resides in Webster, New York with his wife and daughter. When not doing teleneurology, he enjoys playing sports with his wife and daughter.
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Tao Tong, MD

Dr. Tong received her medical degree from the University of Miami School of Medicine in Miami, Florida. She completed her neurology residency at Jackson Memorial Hospital in Miami, Florida, where she also did a neuromuscular/EMG fellowship.  She currently resides in College Station, Texas. Dr. Tong is married with two boys. She enjoys spending time with her family, traveling and reading.
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Shubhangi Chumble, MD

Dr. Chumble attended BJ Medical School. She is a board certified neurologist with a subspeciality interest in sleep medicine. Dr. Chumble did her residency at Howard University in Washington DC and has practiced neurology since 2001 in private and corporate settings. She lives in Melbourne, Florida and loves the sunshine state. Her hobbies include yoga, meditation, cooking , traveling and meeting new people. She also loves to do stained glass, pottery and painting. She joined TeleSpecialists in June 2019.
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