accreditation agreement A required legal document detailing the provisions of the accreditation arrangement between the ICAVL and the applicant laboratory. The original, signed Accreditation Agreement must be submitted to the ICAVL, at the time of application submission. The ICAVL cannot release a final decision regarding the status of any applicant laboratory prior to the receipt of this complete document.

accreditation agreement addendum To ensure compliance with the regulations set forth by the Health Insurance Portability and Accountability Act (HIPAA), the Accreditation Agreement includes an addendum defining the ICAVL as a "business associate" and defining its duties and obligations as such.

application date of decision (DOD) The actual date when the Board Of Directors is convened for the purpose of reviewing the results from the application reviewers and determining an accreditation decision for the laboratory. This is the official date of the laboratory's accreditation and appears on the certificates and as the expiration date, in three years.

accreditation decisions Following the individual application review conducted independently by the two reviewers assigned to each application, the results are presented to the Board Of Directors for determination of an accreditation decision for the laboratory. Each testing area applied for is reviewed separately (i.e.: Extracranial Cerebrovascular, Intracranial Cerebrovascular, Peripheral Arterial, Peripheral Venous, and Visceral Vascular) and may be (1) granted accreditation, (2) delayed accreditation, or (3) determined to require a site visit.

application deadline A quarterly date (the first working day of March, June, September, and December) established to define each accreditation cycle. Applications received on or before each application deadline are reviewed together. These dates provide laboratories with a goal to work toward when planning for submission and allow the ICAVL to function on a cyclical basis. However, applications can be sent to the ICAVL at any time. Laboratories applying for reaccreditation must adhere to the appropriate application deadline in order to avoid a lapse in their accreditation status.

application diskette When the application is complete and all information has been entered, the laboratory is required to copy the information to a floppy disk and send it to the ICAVL office so that it can be entered into the ICAVL database. The directions to be followed when creating the disk can be located on the main menu of the application.

application review findings (ARF) Formerly known as the Critique Letter, this newly revised document provides an objective summary of the evaluations made by the application reviewers. It follows the formatting of the Essentials and Standards and provides the applicant laboratory with an opportunity to determine where specific strengths and weaknesses were identified during the detailed peer-review process.

Board Of Directors Two representatives from each of the ICAVL's eleven sponsoring organizations make up the Board Of Directors. Participating as volunteers, these clinically active physicians, technologists and sonographers provide ongoing guidance and management to the organization, represent the interests of their specific medical specialties, and participate in regularly scheduled revisions to the Essentials and Standards and corresponding Accreditation Application.

delayed accreditation One of the based upon the findings of the application review. This decision is made if components of the application do not document substantial compliance to the Essentials and Standards, and will most often require submission of additional material showing the laboratory is indeed in compliance with the Standards. This is not a denial of your accreditation.

Essentials and Standards An extensive document defining the minimal requirements for noninvasive vascular laboratories to provide high quality patient care. The Essentials and Standards are divided into the following sections: Organization, Extracranial Cerebrovascular, Intracranial Cerebrovascular, Peripheral Arterial, Peripheral Venous, and Visceral Vascular.

Hardcopy The medium used by a laboratory to document examination images and/or spectral waveforms. Case studies being submitted may be sent in with hardcopy consisting of print film, radiographic film, videotape or CD-ROM.

IAC The parent company to the ICAVL, as well as to the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL), and the Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL), each in existence to provide voluntary accreditation processes and to promote quality health care within the specific medical specialties of noninvasive vascular, echocardiography and nuclear cardiology/nuclear medicine.

ICAVL Policy The Board of Directors’ direction, or way of applying the Standards to specific situations. For example, the Standards require Technical Directors in an ICAVL accredited laboratory to be credentialed, but the Board adopted a policy giving a one-year provisional accreditation if an application has met the other requirements and the only issue is the non-credentialed Technical Director. The policies are different from the Essentials and Standards.

Notification Letter A document received by the medical and technical directors of the applicant laboratory providing notification of the accreditation decision (i.e.: accreditation granted, accreditation delayed or site visit required).

Mobile Site A laboratory site comprised of one or more units (technologist and equipment) that provides noninvasive vascular services at one or more locations and meeting the following criteria, without exception: (1) all noninvasive vascular procedures that are performed at the mobile locations are interpreted by physicians included in the application for accreditation; (2) all technologists performing any noninvasive vascular procedures at the mobile locations are included in the application for accreditation; (3) the entire mobile service has the same Medical Director and Technical Director; (4) all physicians and technologists participate together in quality assurance and education programs, including in-house conferences; and (5) the entire mobile service utilizes identical protocols.

Multiple Site Laboratory sites owned and operated by the same corporation/entity and meeting the following criteria, without exception: (1) All technologists performing any vascular testing at any of the sites are included in the application for accreditation in the Organization section; (2) all physicians interpreting any vascular examinations at any of the sites are included in the application for accreditation in the Organization section; (3) all sites have the same Medical Director and Technical Director; (4) all physicians and technologists from all sites participate together in quality assurance and education programs, including in-house conferences; (5) the Technical Director rotates to all sites a minimum of two full days per month for supervision of the technical staff, or each of the technical staff members from remote sites return to the primary site for direct supervision for one of the two full days per month requirement; (6) the sites all have identical protocols; (7) the sites all have the same diagnostic criteria; and (8) the sites all have the same level of equipment. The accreditation decision is made for all sites jointly, not for each site individually. Multiple site laboratories that are granted accreditation will receive certificates for each testing area and each site.

Primary Examination The examination performed most frequently by the laboratory for each of the testing applications (i.e., Cerebrovascular Application: carotid duplex; Peripheral Arterial Application: ABI and PVR waveforms).

Quality Assurance Log A log developed in the laboratory to track the quality assurance correlations and to be submitted in the accreditation application in lieu of radiographic or surgical reports. The log should contain dates, patient identification, non-invasive examination results, correlation exams and correlation outcome.

Quality Assurance Matrix A tool for calculating the overall accuracy of the noninvasive vascular examination findings when compared to those of the correlation exam.

Qualification Pathway The Essentials and Standards define required sets of criteria for background and training of each clinical member of the laboratory staff (i.e., Medical Director, Technical Director, Medical Staff, and Technical Staff). To be considered eligible to be a clinical staff member within the laboratory, individuals must meet one or more of these criteria.

Random Site Visit A site visit is a pre-arranged, on-site inspection of a laboratory, laboratory functions, documentation and personnel. Specifically, random site visits are performed in order for the ICAVL to compare the actual laboratory functions with the information supplied in the laboratory’s application. In essence, random site visits are the method used by the ICAVL to assess the effectiveness and accuracy of the application itself, for internal quality assurance. Every laboratory applying for accreditation is the potential recipient of a random site visit. There are two random site visits performed for each application deadline. After all of the applications have been entered into the ICAVL database for a given deadline, a computer program is run to randomly select two of the applicant laboratories from that deadline.

Relevant CME Continuing Medical Education that consists of course content addressing the principles, instrumentation, techniques or interpretation of noninvasive vascular testing.

Required Site Visit A site visit is a pre-arranged, on-site inspection of a laboratory, laboratory functions, documentation and personnel. Specifically, a required site visit is one that the ICAVL Board of Directors requires after the review of the application has been completed in order to gain additional information necessary to make the final accreditation decisions. Generally, site visits are required because the information supplied by the laboratory in the application does not reflect standard practices, or provides information that is incomplete and/or unclear, and therefore may not provide an accurate assessment of the laboratory practices.