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Ed.
Note: The article which appears here and in the Spring 2002
Newsletter contains excerpts of the Essentials and Standards.
The paragraphs concerning the amount of supervised practical
experience of medical staff members reflect only one in a series
of options for medical staff to fulfill the requirement. The
other options were not revised, and therefore, not reported
in this article. Please review the complete Standards to learn
more.
In
order to reflect the ongoing changes in vascular technology
and address their effects on the accreditation process, the
ICAVL Board Of Directors reviews and updates the Essentials
and Standards on a regular basis. Whether applying for first-time
accreditation or reaccreditation, the first step toward success
is an area by area review of the Standards by every member of
the laboratory staff involved in the application. The ICAVL
Web site is also a critical source of information and should
be visited regularly throughout the accreditation process.
At
the January 5, 2002 meeting of the ICAVL Board Of Directors,
the following revisions were approved. The changes are organized
by the section in which they appear in the Essentials and
Standards and for the purpose of clarity appear italicized
in this article. Only the revisions are summarized in this article.
The complete Standards should be reviewed when planning for
accreditation.
ORGANIZATION
Section 1 - Supervision and Personnel
MEDICAL
DIRECTOR
1.1
A qualified Medical Director(s) must be designated for
the facility.
1.1.2
Qualifications:
In
addition to formal didactic studies, the physician must acquire
a minimum of 8 hours of supervised practical experience observing
or participating in testing procedures, preferably in an accredited
laboratory, for each area of testing for which the physician
will interpret/direct. (See Editor's Note at the beginning
of this article regarding this requirement.) This experience
must be documented with a letter from the Medical Director of
the laboratory where the practical experience was obtained.
For
those examinations the Medical Director will interpret, there
must be documentation of interpretation for the following minimum
number of studies while under the supervision of a physician
who has already met the ICAVL criteria.
TECHNICAL DIRECTOR
1.2
A qualified Technical Director(s) must be designated for the
facility.
Comment:
The Medical Director or a member of the medical staff may serve
as the Technical Director. That individual must satisfy the
qualifications for Technical Director. 1.2.2.3
For those testing areas in which testing is provided, the Technical
Director must have performed the following minimum number of studies
in the course of their career:
- 100 cases carotid duplex ultrasound
- 100
cases transcranial Doppler
- 100
cases peripheral arterial physiologic tests (e.g., extremity
pressures, Doppler waveforms, exercise testing, reactive hyperemia)
- 100
cases peripheral arterial duplex ultrasound
- 100
cases venous duplex ultrasound
- 75
cases visceral vascular duplex ultrasound
MEDICAL
STAFF
In
addition to formal didactic studies, the physician must acquire
a minimum of 8 hours of supervised practical experience observing
or participating in testing procedures, preferably in an accredited
laboratory, for each area of testing for which the physician
will interpret. (See Editor's Note at beginning of this article
regarding this requirement.) This experience must be documented
with a letter from the Medical Director of the laboratory where
the practical experience was obtained.
For
those examinations the physician will interpret, there must
be documentation of interpretation for the following minimum
number of studies while under the supervision of a physician
who has already met the ICAVL criteria:
TECHNICAL STAFF
1.4.2.3
For those testing areas in which testing is provided, the technical
staff member must have performed the following minimum number
of studies in the course of their career:
- 100
cases carotid duplex ultrasound
- 100
cases transcranial Doppler
- 100
cases peripheral arterial physiologic tests (e.g., extremity
pressures, Doppler waveforms, exercise testing, reactive hyperemia)
- 100
cases peripheral arterial duplex ultrasound
- 100
cases venous duplex ultrasound
- 75
cases visceral vascular duplex ultrasound
Comment:
An individual that does not meet this requirement is considered
a trainee in any testing area in which this minimum case requirement
is not fulfilled.
Section
5 - Miscellaneous
PATIENT
SAFETY
5.1.3
A policy must be in place for handling acute medical emergencies
and appropriate equipment, supplies, and trained personnel must
be available to deal with medical emergencies and critically
ill patients.
EXTRACRANIAL
CEREBROVASCULAR TESTING
Section 6 - Quality Assurance
6.1.1
Procedures for regular correlation of test results with radiographic
findings must be provided. When radiographic correlation is
unavailable, surgical and pathologic correlations are acceptable.
Comment:
Correlations for a minimum of 30 internal carotid arteries are
to be provided. These studies must have been done within three
years of the application. Documentation of the correlation (i.e.
log or table) must be maintained. However, if the laboratory
is unable to obtain the minimum number of correlations, alternative
methods for QA will be considered.
PERIPHERAL
VENOUS TESTING
There
was also a revision approved by the Board Of Directors for a
change in the peripheral venous case study requirement. The
application previously stated, "For peripheral venous examinations,
enclose five representative patient examinations: one normal
and four abnormals with varying degrees of pathology."
The application will not require that at least two of the abnormal
examinations submitted demonstrate findings of deep venous thrombosis
(DVT).
A
complete copy of the Essentials and Standards can be
downloaded. Please feel free to contact the ICAVL staff via
email or telephone with
any questions.
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