ICANL Incorporates the Measurement of AUC Into the Accreditation Program Print this page

Historically, Quality Improvement has been a significant element of the Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories’ (ICANL) accreditation process. As such, it is essential that facilities meet the requirements for Quality Improvement as defined within the ICANL Standards. Annually, laboratories must document assessment of quality from three areas: administrative, technical and physician performance.

In September 2009, the Intersocietal Accreditation Commission (IAC), under which ICANL is an accrediting division, announced its intention to incorporate the measurement of appropriate use of diagnostic imaging studies into each of its accreditation programs (ICAVL, ICAEL, ICANL, ICAMRL and ICACTL) within 2010. The IAC supports the premise that a patient should have the right test at the right time, with the right radiation dose. As part of this global initiative, the 2010 ICANL Standards were published inclusive of detailed requirements for Appropriate Use Criteria (AUC). ICANL applicant laboratories may use the measurement of appropriate use to fulfill the annual quality assurance requirement for both the administrative and physician performance measures.

As part of an ongoing Quality Improvement program, facilities providing nuclear cardiology and cardiac PET imaging must include the measurement of the appropriate use of radionuclide testing based on criteria published and/or endorsed by professional medical organizations. One notable example of such published criteria is the ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM Appropriate Use Criteria: “2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging.”¹

At this time, the requirement is only for nuclear cardiology testing; however, the ICANL encourages all other areas of general nuclear medicine and PET to measure appropriate use as published criteria becomes available.

Specifically, the ICANL requires that appropriate use be measured in consecutive time periods, such as 2-3 weeks, thus ensuring that at least 5 percent of the annual volume of patients referred for radionuclide testing is evaluated. For smaller volume laboratories, the ICANL Standards mandate that a minimum of 30 patients be evaluated annually. The overall results must be documented, with the percentage of appropriate, inappropriate and uncertain indication measured. It is important to note that the ICANL does not require laboratories to achieve a defined percentage or level of appropriate studies, nor will laboratories be judged based upon the results of their metrics. Rather, the purpose of requiring measurement of appropriate use is for self-education of the facility and self-assessment of areas for improvement.

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