https://doi.org/10.1177/1544316718794330
Journal for Vascular Ultrasound
2018, Vol. 42(3) 116–119
© 2018, Society for Vascular Ultrasound
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DOI: 10.1177/1544316718794330
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Scientific Research
Introduction
Multiple professional societies, including the Society for
Vascular Ultrasound, support accreditation as a component of
vascular laboratory quality and safety. The Intersocietal
Accreditation Commission (IAC) began accrediting vascular
testing laboratories in 1990. As of December 31, 2016, there
were 1634 accredited vascular testing facilities located at 2922
sites throughout the United States, Canada, and Puerto Rico.
These accredited laboratories perform extracranial cerebrovas-
cular (n = 1452), peripheral venous (n = 1190), peripheral
arterial (n = 1157), visceral vascular (n = 358), and intracra-
nial cerebrovascular (n = 79) studies.
The accreditation process is designed to be educational
through a process of self-examination and feedback following
independent clinical peer review of application materials.
Laboratories must meet minimum quality Standards and
undergo evaluation of organizational structure, reporting, and
imaging processes.
1
Quality is assessed based on adherence to
published Standards as ascertained by review of reports and
diagnostic study images by trained IAC clinical application
reviewers. If the laboratory is found to be in substantial compli-
ance with the Standards, accreditation is granted for 3 years.
However, if items of noncompliance are identified, accredita-
tion is delayed until all items of noncompliance are rectified.
2
The IAC Vascular Testing Accreditation Standards require
each laboratory to use published, validated diagnostic criteria
for each type of test performed. Diagnostic criteria must state
how velocity measurements, spectral Doppler waveform anal-
ysis, and images (for duplex studies) and segmental limb pres-
sures and Doppler or plethysmographic waveforms (for
physiological testing studies) are used for interpreting the
examination results. Physician interpretations must strictly
adhere to the laboratory-specific diagnostic criteria for each
testing area as submitted with the accreditation application.
This study is a continuation of a previous IAC study that
only evaluated 6 months of data to ascertain which testing areas
794330JVU XX X 10.1177/1544316718794330Journal for Vascular UltrasoundFarrell et al
research-article 2018
1
Intersocietal Accreditation Commission, Ellicott City, MD, USA
2
University of Maryland School of Medicine, Baltimore, USA
3
Vascular Surgery Associates of Richmond, VA, USA
4
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH, USA
Corresponding Author:
Mary Beth Farrell, Intersocietal Accreditation Commission, 6021 University
Blvd, #500, Ellicott City, MD 21043, USA.
Email: farrell@intersocietal.org
Reasons for Delay of Accreditation for
Vascular Testing Laboratories Applying
for Accreditation by Intersocietal
Accreditation Commission
Mary Beth Farrell
1
, Marge Hutchisson
1
, Michael Lilly
2
,
Melissa A. Vickery
3
, and Heather L. Gornik
4
Abstract
The Intersocietal Accreditation Commission (IAC) vascular testing accreditation process is designed to be educational through
a process of self-examination and feedback from peer review. Accreditation is awarded based on compliance with published
Standards. The objective of this study was to identify the most common reasons for accreditation delay and noncompliance
with the published Standards among vascular laboratories applying for IAC accreditation. The IAC database was used to
extract laboratory data and findings of application review for vascular laboratories applying for accreditation in 2016. Most
laboratories applying for accreditation (88.7%, 535/603) had 1 or more accreditation delay issues that had to be rectified before
accreditation was granted. The most common not compliant findings included reporting issues, discordant findings between
the test documentation and final impression, poor image quality, diagnostic criteria issues, and missed diagnostic findings. Most
laboratories corrected identified issues (82.2%, 440/535) within 90 days. IAC accreditation recognizes a laboratory as having
met minimum quality Standards. For vascular laboratories reviewed by IAC, most accreditation issues were due to deficiencies
in reporting, documentation, and image quality.
Keywords
accreditation, vascular imaging, quality, reporting, diagnostic criteria