Long-term EEG/videomonitoring (LTM) is an essential diagnostic procedure of clinical neurology and neurosurgery but LTM is technically demanding. The traditional hierarchical system of EEG laboratory management is poorly suited to performance of LTM. We designed a system in which one EEG technologist takes primary responsibility for performing LTM for one patient. This primary technologist performs most aspects of a patient's LTM and integrates the technical components of LTM into a complete procedure. When problems arise, the primary technologist organizes solutions with the assistance of the other technologists, physicians, nurses, and electrical engineers. Following institution of this system in our laboratory, measurable improvements in quality and productivity and in patient and professional satisfaction have occurred.