The Intersocietal Accreditation Commission (IAC) provides guidelines on the minimum volume requirements for accreditation for vascular labs.The IAC-Vascular Testing Accreditation current standards recommend that the minimum volume requirements for accreditation are at least five studies in each area of testing for each technical staff member. For a lab with 15 full‐time registered technologists who do both echo and vascular testing, the IAC would require at least 75 studies in each testing area per month, including intracranial (TCD) and visceral. This is for a lab seeking accreditation in all testing areas which may seem daunting to some.
The accreditation process can cause great anxiety, but provide pure elation once accreditation is granted. Through sponsorship and support from the leading vascular testing, surgery, and imaging societies and organizations, the accrediting bodies develop and enforce Vascular Laboratory standards.
But one of the challenges for the accrediting bodies is getting everyone to agree on what those standards should be, and as time has gone on, those standards have changed significantly from time to time. This applies to the number of vascular studies required for accreditation.
We have seen the creation and evolution of the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), which eventually became the IAC, to expand accreditation services to echo, CT, MR, and a lot of other imaging modalities. Over time we have seen two organizations – the American College of Radiology (ACR) and the American Institute of Ultrasound in Medicine (AIUM) – splinter off from ICAVL to create accreditation in ultrasound and related imaging modalities. These accrediting bodies set standards for Medical and Technical Staff experience, minimum volume requirements for accreditation, the equipment used, testing and diagnostic criteria compliance, and correlation with other testing modalities, but they are all very different in the approach.
Putting aside the accreditation history, let’s talk about what these accrediting bodies do and which path you should take. If you are looking for cardiovascular accreditation and have multiple imaging services, the IAC may be the way to go. IAC focuses mainly on the processes you have in place – protocols, criteria, quality assurance – and on the cases that are submitted. If you have an ultrasound lab that provides a wide variety of ultrasound testing the ACR may be your best path. The ACR focuses mainly on equipment and experience of the personnel rather than the quality of the work, arguably. The AIUM only accredits labs for general ultrasound procedures and wouldn’t be your best bet if you are looking for cardiovascular‐focused accreditation and minimum volume requirements for accreditation are typically lower.
One of the difficulties for accrediting bodies is standardizing the practice of each testing modality, and clearly stating what those standards are. It seems that every year the accreditation standards change in one organization or another, making it difficult for lab personnel to keep up with the changes. While the diversity of opinions and philosophies of sponsoring organizations for each body is a great way to generate discussion and change, it can be difficult to for the labs to understand the language or the intent behind the changes. This is not to say that the changes are so revolutionary that your lab will never comply, rather the changes are more evolutionary, but they can still be a challenge to follow.
So how do you keep up with the changes? In most labs, the Technical and Medical Directors of your lab are usually doing studies, or doing surgery, or seeing patients – you know, taking care of business. It can be a daunting task to do your primary duties and keep up with changes, especially if your lab is not in the re-accreditation cycle at the moment. By the time you’re ready to prepare the re-accreditation documents changes may have come around that require you to change direction.
When you consider the amount of time and effort it goes into to keeping on top of the accreditation standards, during the initial and re-accreditation processes, it might be more cost effective to outsource your accreditation duties. NAVIX provides this support and will answer questions related to minimum volume requirements for accreditation. You want to find a company or individual with extensive experience with the process and with vascular testing in general. Bear in mind that in order to attain accreditation, you may have to change some of the things that you currently do, or implement policies and programs, like QA, that you may not have considered. Your Technical and Medical Staff can focus on their main duties – direct patient care – and you can have an expert prepare your application, under your supervision of course.
Back to the lab with 15 technologists…
NAVIX has a whole department dedicated to accreditation (we have more IAC accredited vascular labs than anyone else in the country), we had reviewed the new IAC standards and noticed the new recommendations about volumes. The part that we glossed over was the “In general” statement that preceded the recommendation. Running a high‐quality, high‐volume lab is the goal. IAC encourages labs with this goal to pursue accreditation and would not necessarily preclude a lab from getting accredited. We recommend that if you have a question on volume, call the IAC and get clarification.
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References
- IAC Vascular Standards (http://intersocietal.org/vascular/main/vascular_standards.htm).
- ACR Standards
- AIUM Standards (http://www.aium.org/accreditation/accreditation.aspx)