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What is ABNS POST?
ABNS POST (Practice and Outcomes of Surgical Therapies) is an integrated IT platform that is designed to advance the ABNS' mission of promoting safe, effective and appropriate neurosurgical care. ABNS POST allows for the submission, analysis and presentation of clinical data from practice, along with other information that is relevant to the ABNS’ evaluation and certification processes. Those processes include the ABNS oral examination, CC and recognition of focused practice(3).
The primary function of ABNS POST is to support the ABNS oral exam. ABNS candidates can use ABNS POST to collect case data for ABNS review in addition to preparing selected case presentations in PowerPoint format for the oral exam.
ABNS POST's design allows for the collection of discrete data elements describing patient variables, diagnoses, procedures, clinical decision-making and outcomes. This format allows for uniform and complete data submission, along with the development of true national benchmarks for performance and experience. These factors ensure objective and equitable reviews of presented information and mitigate the potential that candidates will have to resubmit data due to missing elements.
In addition to discrete data fields, the ABNS has retained several text field options, should ABNS candidates or other ABNS POST users wish to augment the required data with other information relevant to clinical decision-making. Some text fields are required, and others are optional. Text fields also provide candidates and other ABNS POST users a forum to provide information they feel would be useful to the review process.
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Highlights of ABNS POST:
Analysis of imaging data are critical to understanding clinical outcomes and decision-making in neurological surgery. Review of imaging data is a key component of the oral exam format. When imaging is a standard part of the clinical decision-making process, candidates will be required to submit between 1-15 case images (pre-, intra or post-operative) in ABNS POST. Images must be less than 800 kb.
ABNS POST on boarding includes four steps:
Requesting ABNS POST access Biographical information, residency training program details, NPI # and more.
Business Associate Agreement Review the business associate agreement; indicate agreement (or not).
Practice Details Includes practice details such as type, setting, description, region, state of primary practice location. Primary sub-specialty and site (s) of service.
Finish Setup
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Site of Service
For cases added to ABNS POST, please be sure to include all sites of service before entering cases. Remember to save before proceeding. This section specifies the site of service list that must be completed before selecting a site of service in an individual case.
The outline below identifies the information needed to enter a complete case.
- Case Title
- Case Overview
- Medical History and Medications
- Physical Exam
- Imaging and Testing: Include up to fifteen (15) images: preoperative, intraoperative or postoperative
- Non-surgical Management
- Diagnoses
- Surgical Management
- Pathology Results
- Surgical Outcomes: Objectives of surgery, immediately post-operative outcomes (during hospital stay), intermediate post-operative outcomes (discharge to three months) and late outcomes (3-12 months)
The amount of data input required will be variable between submitted cases—this feature is intentional.
In sections that allow for entry of variable amounts of information (e.g., medical history, imaging data), it is suggested to include the minimum (i.e. essential) information you would require to explain your clinical decision-making and justify the clinical outcome(s) to another clinical colleague regarding the specific case being described. See examples below.
Example 1:
Elderly patient presenting with large subdural hematoma after fall and undergoes emergent craniotomy, subsequently experiences a post-operative hemorrhage requiring return to OR. In this instance, medical comorbidities and likely medications that increase risk of bleeding complications (e.g. aspirin, Plavix) are relevant to both decision-making and clinical outcomes and should be included in the submission.
Example 2:
Young patient undergoes routine microdiscectomy lumbar HNP, has routine post-operative course and experiences excellent outcomes. In this instance, the presence of mild, diet-controlled DM is not likely of great significance to clinical management or outcomes and this data can be excluded.
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ABNS POST for Initial Certification
Every candidate preparing to take the oral examination must prepare and submit a case log for review.
Requirements for the case log submission are detailed below:
- 125 consecutive cases
- All cases must have been performed over a period of 18 months or less
- All cases must have three months follow-up
- Follow-up may be performed outside the 18-month window
- “Staged procedures” will count towards the total of 125
- Complication management or revision (“takeback” surgery) is considered an extension of the original operation and will not be counted towards the 125 total cases
- Clinical data must be from at least 100 unique patient encounters
- No case can be older than 24 months from the date of submission
- Cases during residency or fellowships should not be included
- Diagnostic angiograms count as major cases and should be entered into POST. However, no more than 25 consecutive diagnostic angiograms can be counted as major cases. After 25 diagnostic angiograms have been entered into POST, no more should be added. The only exception is that any patients having major complications related to angiography must be included, even if they occur after the first 25 angiograms. Remember that, without exception, all other types of major cases must be entered consecutively.
- If tracking for ABPNS and ABNS dual credential, 95 of the 125 must be cases performed on patients 21 years or younger
- If after logging the required 125 consecutive cases, there are not 95 PEDS cases add ONLY the necessary number of PEDS cases to reach the requirement of 95.
Please note: The total number of submitted surgical procedures may exceed 125 cases due to “takeback” surgeries
Once submitted, the data is reviewed by an ABNS director as part of the credentialing process for ABNS initial certification.
To request an account for ABNS initial certification, please fill out the following form:
Diagnostic angiograms count as major cases and should be entered into ABNS POST. However, no more than 25 consecutive diagnostic angiograms can be counted as major cases. After 25 diagnostic angiograms have been entered into ABNS POST, no more should be added. The only exception is that any patients having major complications related to angiography must be included, even if they occur after the first 25 angiograms. Remember that, without exception, all other types of major cases must be entered consecutively.
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