Accreditation and the Vascular Laboratory

37 Accreditation and the Vascular Laboratory



Sandra Katanick, RN, RVT, FSVU, CAE


The Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) has been providing voluntary accreditation for noninvasive vascular laboratories since 1991. The ICAVL was conceived during the 1989 American Institute of Ultrasound in Medicine annual conference by several visionaries in the field, including Christopher Merritt, MD; Brian Thiele, MD; D. Eugene Strandness, MD; and Anne Jones, RN, BSN, RDMS, RVT, FSVU. They realized that a multispecialty effort to standardize the field was needed because of the rapid growth of noninvasive vascular imaging and the fact that it was being performed by multiple specialties with no defined standards for training and experience, examination performance, or interpretation. This chapter will address the ICAVL history and current process for laboratory accreditation.



History and Organizational Structure


The mission of ICAVL in 1989 was to develop a program that would ensure high-quality patient care by providing a mechanism of peer review that would encourage and recognize the provision of quality noninvasive vascular diagnostic testing regardless of setting (i.e., hospital, office, clinic) or specialty. In order to do this, it was necessary to develop and maintain a process of accreditation. This consisted of the establishment of requirements for accreditation and a mechanism for the peer-review evaluation of applicant laboratories to verify that they were compliant with these accreditation requirements. The program was designed to be educational in nature, as well as to provide a mechanism for recognition of those laboratories providing quality diagnostic testing.


Following the initial meeting in 1989 with two representatives each from the American Institute of Ultrasound in Medicine, the Society for Vascular Surgery, and the Society for Vascular Ultrasound, all other professional societies with an interest in noninvasive vascular testing were invited to appoint two representatives to this new organization and share in the initial funding and commitment necessary to develop a comprehensive accreditation program for vascular laboratories. The other founding sponsoring organizations included the American Academy of Neurology / the American Society of Neuroimaging, the American College of Radiology, the International Society for Cardiovascular Surgery (North American chapter), the Society of Vascular Medicine and Biology, and the Society of Diagnostic Medical Sonographers. The initial work proposed standards for noninvasive vascular testing that encompassed the following: (1) requirements for medical and technical personnel experience, including training and a definition of their duties; (2) appropriate indications for physiologic testing and ultrasound imaging; (3) well-defined testing protocols such as acquisition techniques, including views and measurements; (4) requirements for reporting and record keeping; and (5) processes for ongoing quality assurance. Once the standards were composed, the board of directors developed an application process that could adequately assess a laboratory’s compliance with all of these standards.


In 1991, 10 laboratories were selected to pilot the application for accreditation and assist the ICAVL in assessing the adequacy of the application designed to evaluate the actual quality of the laboratory. After several edits, the final ICAVL Essentials and Standards and application package were released in late 1991.


In 1993 and 1995, several sponsoring organizations were added to provide additional expertise and perspective to the accreditation program. These organizations were the American College of Cardiology, the Joint Section on Cerebrovascular Surgery/American Association of Neurological Surgeons and Congress of Neurological Surgeons, the Society of Interventional Radiology, and the Society of Radiologists in Ultrasound.



ICAVL Accreditation as a Model


In 1996, the American Society of Echocardiography explored options for echocardiography accreditation and solicited the ICAVL to develop a program specifically for echocardiography using the ICAVL model as a template. In late 1996, the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL) was incorporated as a not-for-profit organization. The American College of Cardiology, the Society of Pediatric Echocardiography, and the Society of Diagnostic Medical Sonography were invited to participate in this program. The ICAEL piloted their application process in mid-1997 and accepted their first applications for accreditation in late 1997. It was then that the IAC (Intersocietal Accreditation Commission) was formed to provide management and oversight for these two intersocietal accreditation programs.


Following the success of the ICAVL and ICAEL, the nuclear medicine community approached the IAC to develop an accreditation program for nuclear cardiology, nuclear medicine, and positron emission tomography (PET). Following the incorporation of nuclear cardiology, the Intersocietal Commission for the Accreditation of Magnetic Resonance Laboratories (ICAMRL) was formed in 2000 for magnetic resonance imaging (MRI) and the Intersocietal Commission for the Accreditation of Computed Tomography Laboratories (ICACTL) was formed in 2006 for computed tomography (CT) examinations. At that time, the various IAC organizations decided that it would be prudent to consider a reorganization so that all accrediting bodies would fall under one umbrella that would continue to support the IAC mission of accreditation: “dedicated to promoting high quality health care by providing a peer review process of laboratory accreditation.”



IAC Merger


On April 1, 2008, following nearly18 months of reorganization planning, the IAC filed Articles of Merger in the State of Maryland. All IAC members (ICAVL, ICAEL, Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories [ICANL], ICAMRL, and ICACTL) were officially made divisions of IAC and ceased operations as independently incorporated organizations. The merger provided greater efficiency through unified accounting practices and streamlining of accreditation policies with the organization now functioning under the IAC bylaws and an IAC board of directors. These streamlined business practices enabled the individual accrediting divisions to focus on the important tasks related to recognizing and improving the provision of quality patient care through quality diagnostic imaging, thus allowing the IAC to provide increased value and services to participating laboratories.


Each of the five divisions (ICAVL, ICAEL, ICANL, ICAMRL, and ICACTL) continues to be guided by an individual division board, functions under self-approved policies and procedures, and has a significant degree of autonomy over the ongoing development of its standards, respective to the division’s accreditation programs. The sponsoring organizations of each division continue to nominate board members.


Increased participation in the accreditation program has resulted in dramatic growth, as reflected by the IAC combined staff of 40 individuals, along with a volunteer network of 98 board members and hundreds of application reviewers and site visitors.

Related posts:

Normal Cerebrovascular Anatomy and Collateral Pathways Ultrasound Assessment of Lower Extremity Arteries Ultrasound Assessment of the Vertebral Arteries Arterial Anatomy of the Extremities Duplex Ultrasound Evaluation of the Uterus and Ovaries Extremity Venous Anatomy and Technique for Ultrasound Examination

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Mar 5, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on Accreditation and the Vascular Laboratory

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