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In reviewing trends from 2008, seventy percent of the ICACTL applicant laboratories received a
delay status when applying for accreditation. Although the problems that result in a delay can often be easily corrected, the disappointment and additional demands placed upon laboratory staff might be avoided by identifying the potential issues prior to application submission.

WHAT IS DELAYED ACCREDITATION?

After the review of a laboratory’s accreditation application, the Board of Directors renders an accreditation decision. One of three decisions is made: Accreditation Granted (full or provisional), Accreditation Delayed, or Site Visit Required. A delayed decision means that there are significant issues, deficiencies or lack of adherence to The ICACTL Standards that must be addressed by the laboratory before ICACTL accreditation can be granted. Delay of the laboratory’s application requires that additional material be sent to further demonstrate adherence to The ICACTL Standards and/or to provide the adequate documentation necessary for a complete application review.

MOST COMMON REASONS FOR DELAY

The chart below illustrates a list of the most frequent reasons an accreditation decision is delayed, with the following sections providing specifics, as well as several ways to help prevent a delay in your laboratory’s accreditation.

INCOMPLETE FINAL REPORTS

82% of the applications received in 2008 were delayed for issues related to final reports.

In general, the report must contain sufficient information so that any health care professional has access to adequate information regarding the indications for the examination, the type of examination performed and the results of the diagnostic study. The ICACTL Standards state that all physicians interpreting CT examinations in the laboratory must agree on a standardized report format.

The following components are required by The ICACTL Standards (Section 5, Part II - CT Testing) and are listed below in order of most frequent deficiencies noted:

• Date of interpreting physician signature/verification
• Clinical indication for the performance of the CT exam
• Amount and type of contrast administered, if applicable
• Adequate description of test (inclusive of examination and pulse sequences used)
• Manual or electronic interpreting physician signature
• Appropriate follow-up of incidental findings
• Standardized reports
• Date of examination
• Overview and summary of findings
• Comparison with previous related studies, where available

**All interpreting physicians must meet the training and experience guidelines as outlined within The ICACTL Standards, Organization Part I, and must be listed within the application as a member of the medical staff.

QUALITY ASSURANCE / QUALITY CONTROL DELAYS

79% of the applications received in 2008 were delayed for issues related to quality assurance/quality control.

An integral component of the ICACTL process is the laboratory’s responsibility to develop and implement an ongoing compre-hensive quality assurance (QA) program. The program should be a continuous process of education, evaluation, corrective action, development and implementation with the ultimate goal of providing quality patient care. A Quality Assurance Committee should be assigned to oversee and monitor the assessment of the quality assurance program. Applicant laboratories are required to perform daily and periodic quality control (QC) testing, have routine preventive maintenance, an acceptance test at installation, and an annual medical physicist survey. The annual survey must include an evaluation of the image quality, patient dose and verification of the shielding of the CT room. Two months of quality assurance testing performed by the operators, the current preventive maintenance, the acceptance test, and the physicists’ surveys must be submitted with the application for review. The quality control tests performed and the results of the tests must be specified in the submitted documents. One of the main reasons for delay in this area is incomplete documentation of the quality assurance/quality control tests requested. The ICACTL Standards related to quality assurance/quality control tests can be found in Part I, Organization, Section 7, Technical and Interpretive Quality Assessment (QA). It is recommended to have the physicist review the guidance documents on www.icactl.org, prior to performing the evaluation. There are two guidance documents published on the ICACTL website; one related to image quality and the other related to the verification of the radiation shielding.

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