What is Neuromonitoring?
Intraoperative Neurophysiological Monitoring and Mapping (IONM) involves the use of physiological tests that identify nervous system structures and evaluate their function during surgery. IONM significantly reduces the risk of iatrogenic injury to the nervous system, thereby optimizing surgical outcomes. The types of surgical procedures during which IONM is employed vary greatly and include: brain, spine, ENT, orthopedic and vascular surgery. Neuromonitoring is typically performed by a team consisting of an on-site neurophysiologist and a remote, consulting physician. Through the use of telemedicine, the team remains in direct communication throughout the surgical procedure. The team works together to interpret the results of the physiologic tests and communicate the functional status of the nervous system to the operating surgeon in real time.
Credentials & Qualifications
Neurophysiologists are presently credentialed on a two-tier system: Technical and Professional.
Technical Board Certification:
The American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET) offers technical certification in intraoperative neurophysiology. Eligibility is limited to individuals having monitored at least 150 surgical procedures, and candidates must pass a written examination. Certified individuals use the letters CNIM after their name. Technical personnel must practice under the indirect and real-time supervision of physician.
Professional Board Certifications:
The American Board of Neurophysiologic Monitoring (ABNM) offers professional board certification in intraoperative neurophysiology. It is the only professional board certification dedicated entirely the specialty of IONM. Eligibility is limited to individuals with a doctoral degree (PhD, AuD, DC, MD, DO or similar), formal education in neurophysiology and neuroanatomy, and a minimum of 2 years’ experience in monitoring over 300 procedures across 6 different surgical categories. Candidates must pass two examinations: Part I is a written examination, and Part II is an oral examination. Certified individuals are Diplomates of the Board and use the letters D.ABNM after their name to indicate so.
The American Audiology Board of Intraoperative Monitoring (AABIOM) is recognized by the American Speech-Language-Association (ASHA) as a legally-independent subspecialty entity in the profession of Clinical Audiology. Eligibility is limited to licensed audiologists with a Certificate of Clinical Competence in Audiology (CCC/A), and experience monitoring over 250 procedures across 3 different surgical categories. Candidates must pass a written examination. Board-Certified Specialists use the letters BCS-IOM after their name to indicate so. These individuals are capable of performing IONM independently; however, real-time physician consultation is mandated in some states.
SPN utilizes a team approach to neurophysiology based on the advances of technology and telemedicine. 100% of our cases utilize a real-time connection to a remote physician, who are available for consultation and direct communication with the neurophysiologist.
There are several medical boards that list intraoperative neurophysiology within their scope of practice. These boards include: American Board of Clinical Neurophysiology (ABCN), American Board of Electrodiagnostic Medicine (ABEM), and American Board of Psychiatry and Neurology (ABPN).
Quality Assurance & Risk Management
Our Quality Assurance and Risk Management (QARM) program is at the core of our commitment to excellence in patient care and clinical standards. Our QARM program was an integral part of our Joint Commission accreditation and continues to evolve as one of the top programs of its kind in the IONM field nationwide. Intricate attention to completion of medical records by our neurophysiologists, providing ongoing feedback to our clinical staff, tracking all adverse events and root cause analyses, reviewing all IONM reports for accuracy and content, and promoting quality across the industry is are only some of the responsibilities of our QARM committee. Moreover, our QARM program provides continuous reports of all completed IONM procedures to our partner healthcare facilities and actively collaborates with them in enhancing the review process. The QARM committee at SPN constantly works on improving its processes and procedures to be more comprehensive and works to oversee all aspects of the clinical performance of our neurophysiologists and neurologists.
In-Service and Grand Rounds
Neuromonitoring reduces risk and optimizes surgical outcomes, but it also adds another layer of complexity to the operating room. As a hospital administrator, you know that effective team management requires one to have a clear understanding of the role that each member of a team plays. Likewise, the roles and responsibilities of neurophysiologists who visit your facility should be clear to your staff. At Safe Passage Neuromonitoring, we take great pride in our unique ability to educate clinicians at all levels about the nuances of intraoperative neurophysiology. Toward this end, we routinely deliver lectures to physicians, nurses and preoperative staff throughout the country. Our goals are to ensure team cohesiveness, maximize OR safety and improve your clinicians’ overall understanding of neuromonitoring and its role in the operating room. Our neurophysiologists are among the best in the world, and we’re more than happy to share our expertise with you. From in-service presentations to grand rounds lectures, we cover it all, and we can easily tailor presentations to the needs of your staff.
Joint Commission Accreditation
The Joint Commission Vision states that all people always experience the safest, highest quality, best value health care across all settings. We at Safe Passage share that vision. Patients and healthcare providers understand that Joint Commission accreditation is a known quality indicator, and we proudly display the Gold Seal. We embrace these standards as we know that patient safety and quality of care issues are the basis of the Joint Commission standards and initiatives.
Local Teams & "PlusOne" Assignments
We treat hospitals and surgeons as partners in patient care, and strive to build long-term, dedicated clinical teams to service our clients. Our neurophysiologists rarely travel beyond their "home" region to minimize disruptions in patient care and customer service. We go one step further with our "PlusOne" policy. In select hospitals where emergent add-on volume is unpredictable, SPN staffs an additional standby neurophysiologist who is ready to take on additional volume.
Secure EMR Technology & Reporting
At SPN, our HIPPA security officer and our IT department, in collaboration with our clinical and operational team, diligently work to ensure that our technology and EHR are continually compliant with all external and internal regulations and standards. Like an assembly line, our medical records and reporting platform are constantly updated to improve on an already strong system. Our systems are ICD-10 ready, and our reporting turnaround time is second to none.
Dedicated Client Services Team & Access to Leadership
Safe Passage supports every client with a dedicated support team. In addition to a team of dedicated clinicians, every client hospital and surgeon is supported by an Area Manager, Regional Director and Clinical Leadership team. Our Client Services team handles administrative and contractual matters and our operations support staff manages scheduling, credentialing and daily requests. If that’s not enough, our CEO, Medical Director and the entire leadership team are just a phone call away. We believe our clients and patients should always have a direct line to the company at all levels, inside or outside the operating room.