Sample Documents (Vascular Testing)
The IAC is pleased to include sample documents to assist facilities in providing quality care to their patients. These documents meet or exceed the requirements of the Standards, and they may be used to develop facility policies and reporting forms, whether your facility is seeking accreditation or simply working to standardize or improve current practices.
Please Note: The following documents are SAMPLES only. Protocols submitted with the application must be customized to reflect current practices of the facility.
- Patient Complaint Policy (27KB)
- Patient Confidentiality Policy (61KB)
- Primary Source Verification Policy (37KB)
- Ergonomics Policy (89KB)
- Medical Director Attestation for Consultant Use [SAMPLE] (58KB)
*Facilities are required to attach a letter from the facility's Medical Director (on the facility's letterhead) providing the consultants permission to complete the application for accreditation on the facility's behalf.
Site Visit Documents
- IAC Quality Improvement (QI) Self-Assessment Tool
Created to help your facility employ and document continuous process improvement, this free tool provides a mechanism for facilities to meet the quality measures required by the Standards.
- Sample QI Policy
- Sample QI Evaluation Forms (Use of these evaluation forms will meet all the required IAC Vascular Testing Quality Improvement Standards)
- Extracranial Cerebrovascular
- Intracranial Cerebrovascular
- Peripheral Arterial
- Peripheral Venous
- Visceral Vascular
- Sample QI Meeting Minutes (58KB)
- Protocol for Performing Extracranial Cerebrovascular Duplex Examinations(66KB)
- Protocol for Performing Lower Extremity Arterial Duplex Examinations (27KB)
- Protocol for Performing Lower Extremity Duplex Examinations for DVT (13KB)
- Protocol for Lower Extremity Arterial Physiologic Segmental Pressures and Waveforms (80KB)
- Protocol for Performing Lower Extremity Reflux Examinations for Venous Insufficiency (99KB)