At a Glance
- EEG plays a larger role in clinical care than ever before
- ABRET accreditation is confirmation of the quality of service UVA provides
- UVA Epilepsy Monitoring Unit is certified as a Level 4 Center by NAEC
- Accreditation for a Pediatric Epilepsy Monitoring Unit is rare
- UVA has implemented EEG monitoring in the critical care setting
As recent accreditations from the American Board of Registered Electrodiagnostic Technologists (ABRET) demonstrate, UVA has the technical expertise required to produce and read EEGs (electroencephalograms) at the highest level of competency. In addition to its outpatient EEG/EP Laboratory, the Health System has recently received ABRET accreditation for its Epilepsy Monitoring Unit, its Pediatric Epilepsy Monitoring Unit and its intensive care monitoring service. “Accreditation provides independent, objective verification of the quality of the services we provide in these areas,” says Mark Quigg, MD, director of the UVA EEG/Intensive Monitoring/Evoked Potential Laboratories.
A Rigorous Review
Accreditation from ABRET is a multi-part process. Perhaps the most critical element is the submission of a detailed manual of policy and procedures for each unit. The manual ensures the consistency and reproducibility of an EEG lab’s work in the range of clinical situations it would typically encounter. As such, the manual functions as a reference for current staff and as an introduction for new physicians, fellows and technicians. “The process of compiling these manuals is in many ways as valuable as the manual itself,” Quigg says. “It gave us an opportunity to think through our procedures and to make sure that we consistently follow best practices.”
Labs applying for accreditation also must demonstrate that they are staffed by qualified technologists who have met national competency standards and that they support their continuing education. Labs also submit a series of sample recordings for evaluation. “It is like having the output of your lab subject to peer review,” Quigg says.
Evolving with the Field
Thanks to advances in technology and medicine over the last decade, EEGs play a larger role in clinical care than ever before. The UVA team’s decision to pursue ABRET accreditation in these three separate areas reflects the specialization that has accompanied this evolution. For instance, EEGs now play an even more prominent role in treatment of patients with epilepsy than in the past. The UVA Epilepsy Monitoring Unit, dedicated primarily to adults, has already been certified as a Level 4 center by the National Association of Epilepsy Centers. The ABRET accreditation, by concentrating on electrophysiology, complements that NAEC recognition, which is a broader assessment of clinical care.
UVA established a separate Pediatric Epilepsy Monitoring Unit five years ago, recognizing that pediatric epileptic care is technically and, because children are a protected group, socially more challenging. Although the number of pediatric groups is slowly growing, the ABRET accreditation UVA has attained is relatively rare.
Implementing EEG monitoring in the critical care setting has proven even more challenging. “We have recognized that critical care monitoring is a subspecialized field that makes unique technical demands,” Quigg says. “We are obtaining EEGs from much sicker patients while maintaining a 24-hour capacity to acquire and interpret them.” Currently, the UVA ICU-EEG program is one of the only ABRET-accredited programs in the Commonwealth.
“There is no point in taking the trouble to demonstrate rigor to these accreditation institutions if an institution is not already doing rigorous work,” Quigg says. “Our ABRET accreditations are one way of highlighting the lengths we go to provide outstanding care for our patients.”
Among the senior faculty leading the EEG efforts at UVA are: Nathan Fountain, MD, current president of the National Association of Epilepsy Centers (NAEC); Howard Goodkin, MD, PhD, one of the country’s leader in pediatric epilepsy; Jaideep Kapur, MD and Edward Bertram, MD, international leaders in epilepsy research; as well as Mark Quigg, MD, the director of UVA EEG/Intensive Monitoring/Evoked Potential Laboratories, who is an exam writer for the EEG boards.
To refer a patient to UVA, call 800.552.3723.