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The IAC Standards and Guidelines |
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Testing Standards |
1.1A The
Medical Director must be a licensed physician, MD or DO, in the state or
jurisdiction of the facility and must be qualified to interpret noninvasive
vascular examinations.
1.1.1A Medical
Director Required Training and Experience
At the time of initial application for
accreditation or at the time of appointment as Medical Director, he/she must demonstrate an appropriate level of training and
experience by meeting one or more of the following:
1.1.1.1A Physician
Credential for Vascular Interpretation
i. Registered
Physician in Vascular Interpretation (RPVI)
ii. Certification
from the American Society of Neuroimaging (ASN)
Comment:
ASN certification is accepted for physicians who interpretextracranial and
intracranial examinations only.
1.1.1.2A Formal
Training – Completion of a
residency or fellowship that includes appropriate didactic and clinical
vascular testing experience as an integral part of the program. For those
testing areas in which training is provided, the physician must have recent
experience within the past three years in interpreting the following minimum
number of diagnostic studies under supervision:
i. extracranial
cerebrovascular – 100 cases
ii. intracranial
cerebrovascular – 100 cases
iii. peripheral
arterial physiologic – 100 cases
iv. peripheral
arterial duplex – 100 cases
v. venous
duplex ultrasound – 100 cases
vi. visceral
vascular duplex ultrasound – 75 cases
1.1.1.3A Informal
Training – The informal
training pathway allows for qualification of interpreting physicians through a
combination of Continuing Medical Education (CME) and supervised practical and
supervised interpretive experience.
i. A
minimum of 40 hours of relevant Category 1 CME credits must be acquired within
the three-year period prior to the initial application.
· 20 hours must be courses specifically designed to
provide knowledge of the techniques, limitations, accuracies and methods of
interpretations of noninvasive vascular examinations that the physician will
interpret.
· 20 hours may be dedicated to appropriate clinical
topics relevant to noninvasive vascular testing.
· Eight of the 40 hours must be specific to each testing
area the physician will interpret.
ii. The
physician must acquire a minimum of eight hours supervised practical experience
for each testing area to be interpreted; observing or participating in testing
procedures in a facility accredited for vascular testing.
Comment: Experience must be documented with a letter from the Medical Director
of the facility where the experience was obtained.
iii. The
physician must acquire experience in the interpretation of exams while under
the supervision of a physician who has already met the IAC Vascular Testing
Standard. Experience must be acquired in each of the testing areas in which the
physician will be providing interpretations for the following minimum number of
studies:
· extracranial cerebrovascular – 100 cases
· intracranial cerebrovascular – 100 cases
· peripheral arterial physiologic – 100 cases
· peripheral arterial duplex – 100 cases
· venous duplex ultrasound – 100 cases
· visceral vascular duplex ultrasound – 75 cases
Comment: Interpretive experience must be documented with a letter from the
supervising physician of the facility where the experience was obtained
indicating the dates of participation and the number of cases in each testing
area.
1.1.1.4A Established
Practice – Training and
experience will be considered adequate for a physician who has:
i. met
the medical staff credentialing qualifications;
ii. has
worked in a vascular facility for at least the past three years;
iii. has
interpreted at least the following number of diagnostic cases over the past
three years in each of the areas that he/she will interpret:
· extracranial cerebrovascular – 300 cases
· intracranial cerebrovascular – 300 cases
· peripheral arterial physiologic – 300 cases
· peripheral arterial duplex – 300 cases
· venous duplex ultrasound – 300 cases
· visceral vascular duplex ultrasound – 225 cases
Comment: A current abnormal
case study final report interpreted by each physician applying under the established
practice pathway must be submitted in the application.
1.1.2A Medical
Director Responsibilities
The Medical Director responsibilities include but are not limited to:
1.1.2.1A all
clinical services provided and the quality and appropriateness of the care
provided;
1.1.2.2A supervising
the entire operation; may delegate specific duties to appropriate staff;
1.1.2.3A approval
of the medical staff and supervision of their work;
1.1.2.4A maintaining
and assuring compliance to the Standards as outlined in this document.
Comment:
If the Medical Director is off site, he/she must have a physical presence in
the facility to participate in regular Quality Improvement (QI) meetings, case
study review conferences, personnel interviews and other facility operations.
1.1.3A Continuing
Medical Education (CME)
1.1.3.1A The
Medical Director must show evidence for maintaining current knowledge by
participating in CME courses that are relevant to noninvasive vascular testing.
Comment: To be relevant the course content must address principles,
instrumentation, techniques or interpretation of noninvasive vascular testing.
i. A
minimum of 15 hours of CME is required every three years, of which 10 hours
must be Category 1.
Comment: Facility internal Quality Improvement (QI) meetings are not eligible
as part of this CME requirement.
ii. The
CME requirement will be waived if, in the previous three years prior to the
application submission, the Medical Director has:
· completed formal training;
· acquired the RPVI credential or ASN certification;
· been employed in the facility less than one year.
(See Guidelines below for further recommendations)
1.2A A
qualified Technical Director must be designated for the facility. The Technical
Director is generally a full-time position. If the Technical Director is not
onsite full time, he/she must work a minimum of 20% of normal business hours
each month. An appropriately credentialed vascular technologist must be
appointed in the Technical Director’s absence and report to the Technical
Director. The appointed technologist must: supervise and assist others in
performing the examinations; oversee day-to-day operations; and communicate
weekly with the Technical Director to maintain compliance with the Standards.
Comment:
The Medical Director or a member of the medical staff must satisfy the
qualifications of the Technical Director to serve in that capacity.
1.2.1A Technical
Director Required Training and Experience
The Technical Director must meet the following criteria:
1.2.1.1A The
Technical Director must have an appropriate credential in vascular testing:
i. Registered
Vascular Technologist (RVT);
ii. Registered
Vascular Specialist (RVS);
iii. Registered
Technologist Vascular Sonography [RT(VS)];
iv. Registered
Diagnostic Medical Sonographer in Abdomen [RDMS (AB)] (visceral vascular
testing only);
v. American
Society of Neuroimaging (ASN) (extracranial
and intracranial testing only);
vi. Registered
Phlebology Sonographer (RPhS) (peripheral venous testing only).
1.2.1.2A For
each testing area applied for, the Technical Director must have performed the
following minimum number of studies:
i. extracranial
cerebrovascular – 100 cases
ii. intracranial
cerebrovascular – 100 cases
iii. peripheral
arterial physiologic – 100 cases
iv. peripheral
arterial duplex – 100 cases
v. venous
duplex ultrasound – 100 cases
vi. visceral
vascular duplex ultrasound – 75 cases
Comment:
If the Technical Director does not meet the testing volume requirements for any
testing section, a qualified Co-Technical Director must be appointed for those
testing sections.
1.2.2A Technical
Director Responsibilities
The Technical Director responsibilities include but are not limited to:
1.2.2.1A must
report directly to the Medical Director;
1.2.2.2A all
facility duties as delegated by the Medical Director;
1.2.2.3A supervision
of the technical and ancillary staff (may be delegated);
1.2.2.4A daily
technical operation of the facility: staffing, scheduling, record keeping;
1.2.2.5A quality
patient care;
1.2.2.7A operation
and maintenance of the equipment;
1.2.2.8A compliance
to the Standards as outlined in this document.
1.2.3A Continuing
Medical Education (CME)
1.2.3.1A The
Technical Director must show evidence of maintaining current knowledge by
participating in CME courses that are relevant to vascular testing.
Comment: To be relevant the course content must address principles,
instrumentation, techniques or interpretation of noninvasive vascular testing
examinations.
i. A
minimum of 15 hours of CME is required every three years.
Comment: Facility internal
Quality Improvement (QI) meetings are not eligible as part of this CME
requirement.
ii. The
CME requirement will be waived if:
· acquired an appropriate vascular credential within the
previous three-year period;
(See Guidelines
below for further recommendations)
1.3A A
qualified medical staff must be designated for the facility. All members of the
medical staff must be licensed physicians, MD or DO, and must be qualified to
interpret noninvasive vascular examinations.
1.3.1A Medical
Staff Required Training and Experience
At the time of initial
application for accreditation or at the time of appointment to the medical
staff, he/she must demonstrate an appropriate level of training and
experience by meeting one or more of the following:
1.3.1.1A Physician
Credential for Vascular Interpretation
i. Registered
Physician in Vascular Interpretation (RPVI)
ii. Certification
from the American Society of Neuroimaging (ASN)
Comment: ASN certification
is accepted for physicians who interpret extracranial and intracranial
examinations only.
1.3.1.2A Formal
Training – Completion of a residency or fellowship that includes
appropriate didactic and clinical vascular testing facility experience as an
integral part of the program. For those testing areas in which training is
provided, the physician must have recent experience within the past three years
in interpreting the following minimum number of diagnostic studies under
supervision:
i. extracranial
cerebrovascular – 100 cases
ii. intracranial
cerebrovascular – 100 cases
iii. peripheral
arterial physiologic – 100 cases
iv. peripheral
arterial duplex – 100 cases
v. venous
duplex ultrasound – 100 cases
vi. visceral
vascular duplex ultrasound – 75 cases
1.3.1.3A Informal
Training – The informal
training pathway allows for qualification of interpreting physicians through a
combination of Continuing Medical Education (CME) and supervised practical and supervised
interpretive experience.
i. A
minimum of 40 hours of relevant Category 1 CME credits must be acquired within
the three-year period prior to the initial application.
· 20 hours must be courses specifically designed to provide
knowledge of the techniques, limitations, accuracies and methods of
interpretations of noninvasive vascular examinations the physician will
interpret.
· 20 hours may be dedicated to appropriate clinical
topics relevant to vascular testing.
· Eight of the 40 hours must be specific to each testing
area the physician will interpret.
ii. The
physician must acquire a minimum of 8 hours supervised practical experience for
each testing area to be interpreted; observing or participating in testing
procedures in a facility accredited for vascular testing.
Comment:
Experience must be documented with a letter from the Medical Director of the
facility where the experience was obtained.
iii. The physician must acquire experience in the
interpretation of examinations while under the supervision of a physician who
has already met the IAC Vascular Testing Standard. Experience must be
acquired in each of the testing areas in which the physician will be providing
interpretations for the following minimum number of studies:
· extracranial cerebrovascular – 100 cases
· intracranial cerebrovascular – 100 cases
· peripheral arterial physiologic – 100 cases
· peripheral arterial duplex – 100 cases
· venous duplex ultrasound – 100 cases
· visceral vascular duplex ultrasound – 75 cases
Comment:
Interpretive experience must be documented with a letter from the supervising
physician of the facility where the experience was obtained indicating the
dates of participation and the number of cases in each testing area.
1.3.1.4A Established
Practice – Training and experience will be considered adequate for a
physician who has:
i. met
the medical staff credentialing qualifications;
ii. has
worked in a vascular facility for at least the past three years;
iii. has
interpreted at least the following number of diagnostic cases over the past
three years in each of the areas that he/she will interpret:
· extracranial cerebrovascular – 300 cases
· intracranial cerebrovascular – 300 cases
· peripheral arterial physiologic – 300 cases
· peripheral arterial duplex – 300 cases
· venous duplex ultrasound – 300 cases
· visceral vascular duplex ultrasound – 225 cases
Comment: A current abnormal
case study final report interpreted by each physician applying under the established
practice pathway must be submitted in the application.
1.3.2A Medical
Staff Responsibilities
Medical staff responsibilities include but are not limited to:
1.3.2.1A interprets
and/or performs clinical studies in accordance with privileges approved by the
Medical Director and in compliance with the Standards outlined in this
document.
1.3.3A Continuing
Medical Education (CME)
1.3.3.1A Each
medical staff member must show evidence of maintaining current knowledge by
participating in CME courses that are relevant to vascular testing.
Comment: To be relevant the course content must address principles,
instrumentation, techniques or interpretation of noninvasive vascular testing.
i. A
minimum of 15 hours of CME is required every three years, of which 10 hours
must be Category 1.
Comment: Facility internal Quality Improvement (QI) meetings are not eligible
as part of this CME requirement.
ii. The
CME requirement will be waived if, in the previous three years prior to the
application submission, the medical staff member has:
· completed formal training;
· acquired the RPVI credential or ASN certification;
· been employed in the facility less than one year.
(See Guidelines
below for further recommendations)
1.4A A
qualified technical staff must be designated for the facility.
1.4.1A Technical
Staff Required Training and Experience
1.4.1.1A For
each testing area applied for, the technical staff member must have performed
the following minimum number of studies:
i. extracranial
cerebrovascular – 100 cases
ii. intracranial
cerebrovascular – 100 cases
iii. peripheral
arterial physiologic – 100 cases
iv. peripheral arterial duplex – 100 cases
v. venous duplex ultrasound – 100 cases
vi. visceral vascular duplex ultrasound – 75 cases
Comment:
An individual who does not meet the testing volume requirements for any testing
section is considered a trainee.
1.4.1.2A The
technical staff must have an appropriate level of training and experience by meeting
one or more of the following criteria:
i. Credential
– An appropriate credential in vascular testing:
· Registered
Vascular Technologist (RVT);
· Registered
Vascular Specialist (RVS);
· Registered
Technologist Vascular Sonography [RT(VS)];
· Registered
Diagnostic Medical Sonographer in Abdomen [RDMS (AB)] (visceral vascular
testing only);
· American Society
of Neuroimaging (ASN) (extracranial and intracranial testing only);
· Registered
Phlebology Sonographer (RPhS) (peripheral venous testing only).
ii. Provisional Staff
· New graduates of a vascular testing program who are employed in an
accredited facility must obtain an appropriate credential within one year from
the date of graduation and must be listed in the application as provisional
technical staff who are eligible for credentialing and must only work under
direct supervision of a credentialed vascular sonographer.
· Individuals
employed in an accredited facility who are cross-training in vascular testing
or working to fulfill clinical experience pre-requisites for a credentialing
examination must obtain an appropriate credential within two years from the
start date of training. These individuals must be listed in the application as
provisional technical staff who are eligible for credentialing, and must only
work under direct supervision of a credentialed vascular sonographer.
1.4.2A Technical
Staff Responsibilities
Technical staff responsibilities include but are not limited to:
1.4.2.1A reporting
to the Technical Director;
1.4.2.2A performing
clinical examinations and other assigned tasks.
1.4.3A Continuing
Medical Education (CME)
1.4.3.1A The
technical staff must show evidence of maintaining current knowledge by participating
in CME courses that are relevant to vascular testing.
Comment: To be relevant the course content must address principles,
instrumentation, techniques or interpretation of noninvasive vascular testing.
1.4.3.2A A
minimum of 15 hours of CME is required every three years.
Comment: Facility internal Quality Improvement (QI) meetings are not eligible
as part of this CME requirement.
1.4.3.3A The
CME requirement will be waived if:
i. the technologist is considered a provisional staff member,
OR
ii. acquired
an apprioriate vascular credential within the previous three-year period.
(See Guidelines
below for further recommendations)
1.5A Ancillary
personnel (clerical, nursing, transport, etc.) necessary for safe and efficient
patient care must be provided.
1.5.1A The
Medical Director must ensure that support services are appropriate and in the
best interest of patient care.
1.5.2A Clerical
and administrative support must be sufficient to ensure efficient facility
operational record keeping.
1.5.3A Nursing
and ancillary services must be sufficient to ensure quality patient care.
1.1A
Medical Director – Continuing Experience
· The monthly volume should be sufficient to maintain
proficiency in examination interpretation.
· In general, the Medical Director should interpret a
minimum of five noninvasive vascular examinations per month per area of
testing.
· The total volume of interpretations may be combined
from sources other than the applicant facility.
Comment:
Lower volumes than those recommended here should not dissuade a facility that
is otherwise compliant from applying for accreditation.
1.2A
Technical Director – Continuing Experience
· The monthly volume should be sufficient to maintain
proficiency in examination performance.
· In general, the Technical Director should perform a
minimum of five noninvasive vascular examinations per month per area of
testing.
· The total volume of cases may be combined from sources
other than the applicant facility.
Comment:
Lower volumes than those recommended here should not dissuade a facility that
is otherwise compliant from applying for accreditation.
1.2.3A
Technical Director – Continuing Medical Education
· At least one hour of the 15 CME should be relative to
work-related musculoskeletal disorders (MSD).
1.3A
Medical Staff – Continuing Experience
· The monthly volume should be sufficient to maintain
proficiency in examination interpretation.
· In general, the medical staff should interpret a
minimum of five noninvasive vascular examinations per month per area of
testing.
· The total volume of interpretations may be combined
from sources other than the applicant facility.
Comment: Lower volumes than those recommended here should not dissuade a
facility that is otherwise compliant from applying for accreditation.
1.4A
Technical Staff – Continuing Experience
· The monthly volume should be sufficient to maintain
proficiency in examination performance.
· In general, the technical staff should perform a
minimum of five noninvasive vascular examinations per month per area of
testing.
The total volume of cases may be combined from sources
other than the applicant facility.
Comment:
Lower volumes than those recommended here should not dissuade a facility that
is otherwise compliant from applying for accreditation.
1.4.1.2Ai
Though the Standards include multiple pathways by which a technical staff
member may document experience and training, the IAC encourages that all staff
members acquire an appropriate credential in vascular testing.
1.4.1.2Aii The
program should be accredited by the Commission for Accreditation of Allied
Health Education Programs (CAAHEP) in collaboration with the Joint Review
Committee on Education in Diagnostic Medical Sonography (JRC-DMS) and/or the
Joint Review Committee on Education in Cardiovascular Technology (JRC-CVT) or
the Canadian Medical Association (CMA).