Reaccreditation: Raising The Bar [continued]

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Testing Applications And Case Studies

Though the procedures specific to each area of testing differ, the most common reasons for delay in each particular testing application are generally very similar.

• TESTING PROTOCOLS - Testing protocols submitted with the application must reflect the most current requirements of the Standards as well as define the contemporary practice of the laboratory. Protocols included with applications are often vague or outdated and do not clearly define the procedures being carried out in the laboratory. This often becomes evident to the application reviewers when they are evaluating the submitted case studies.
• QUALITY ASSURANCE - At the time of reaccreditation, it is mandatory that the application include documentation of the quality assurance correlation performed in the laboratory for the previous three-year accreditation cycle. The minimum number (located in section 5 of the Organization standard) of quality assurance correlations must be clearly identified by submitting documentation that includes dates, patient identification, non-invasive exam results and correlation outcome. If the laboratory finds that meeting the ICAEL quality assurance standards is difficult to achieve through use of the recommended comparison modalities (i.e.: angiography, nuclear, surgical pathology, catheterization), alternative methods will be considered and may assist in avoiding a delayed accreditation decision for a particular testing area due to limited quality assurance information.
• FINAL REPORTS - Final reports submitted with the case studies must include the content and meet the standards for reporting, as written in Section 3 of the Organization Standards.
• DIAGNOSTIC CRITERIA - Lack of adherence to the laboratory's diagnostic criteria is often a reason for delay in a reaccreditation application. It is required that all medical staff members interpreting examinations in the laboratory adhere to one standardized criteria. The final report must document adherence to the specific categories of disease, as written in the criteria; sub-setting, generalization and estimations should be avoided. Again, compliance to this standard becomes evident to the application reviewers when they are evaluating the submitted case studies.
• CASE STUDIES - A primary factor resulting in the delay of reaccreditation applications is incomplete documentation and overall poor quality of submitted case studies. The cases must include all of the hardcopy documentation required by the Standards, while demonstrating good testing techniques. Again, a thorough and regular review of the ICAEL Standards, the laboratory's protocols, diagnostic criteria and quality assurance will assist in assuring that testing procedures are being performed and documented in a standardized method, in compliance with the requirements of the ICAEL process.

Laboratories that receive notification that their reaccreditation application has been delayed are often surprised and frustrated with the results of the application review. Previous granting of accreditation does not ensure that the laboratory will automatically be granted accreditation at the time of reaccreditation. It is the philosophy of the ICAEL that with each reaccreditation cycle, the applicant laboratory should be coming ever closer to being in compliance with every one of the ICAEL Standards, thus offering the best possible quality of echocardiography testing available to its patients.

While this expectation of the laboratories seeking ICAEL reaccreditation is high, it has enabled the ICAEL process to gain recognition as the gold standard in the field and for ICAEL accredited laboratories to be highly regarded.

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