Current Commentary Implementation of a National Nuchal Translucency Education and Quality Monitoring Program Mary E. D’Alton, MD, Karin M. Fuchs, MD, Alfred Abuhammad, MD, Beryl Benacerraf, MD, Richard Berkowitz, MD, Howard Cuckle, MD, Richard Depp, MD, James Goldberg, MD, Daniel O’Keeffe, MD, Lawrence D. Platt, MD, Jean Lea Spitz, RDMS, MPH, Gregory Toland, MS, and Ronald Wapner, MD, for the Nuchal Translucency Quality Review Program In 2004, leaders in first-trimester aneuploidy screening and a multidisciplinary group of experts established the Nuchal Translucency Quality Review Program, a national program to standardize education, credentialing, and quality monitoring of nuchal translucency. Since its inception, the program has credentialed more than 6,600 physician and ultrasonographer participants and collected more than 2.4 million nuchal translucency measurements. Ongoing quality monitoring is conducted through statistical analysis comparing the distribution and standard deviation of participants’ nuchal translu- cency measurements against those obtained from a stan- dard referent curve. Results of these analyses are distributed to participants quarterly and are used to track each participant’s performance and to trigger perfor- mance improvement activities or mandatory remediation. This program could serve as a template for future educa- tion and credentialing programs that include partnerships with academic leaders, national professional organiza- tions, and industry. (Obstet Gynecol 2014;123:149–54) DOI: 10.1097/AOG.0000000000000058 O ver the past decade, the measurement of nuchal translucency has become widely used in first- trimester screening for fetal aneuploidy in the United States. The experience in clinical trials by the Fetal Medicine Foundation 1 and by the U.S. trials, Bio- chemistry, Ultrasound, Nuchal Translucency 2 and First and Second Trimester Evaluation of Risk, 3 demonstrated the importance of precision and need for ongoing quality assurance in nuchal translucency measurements. Small differences in measurement have the potential to significantly alter an individu- al’s risk estimate for aneuploidy and increase the chance for false-positive or false-negative diagnoses. A multidisciplinary group of physicians collabo- rated to develop an education and quality review program that translated nuchal translucency screening from research trials to an effective nationally available clinical application. In 2005, the Nuchal Translucency Quality Review Program was launched as the first nationwide clinical training and ongoing quality review program for nuchal translucency screening in the United States. This article describes the salient features of the program including its infrastructure, educational pro- grams, quality monitoring, and remediation strategies as well as highlighting the lessons learned since its creation. FROM CLINICAL RESEARCH TO CLINICAL APPLICATION In 2004, the leaders of the Biochemistry, Ultrasound, Nuchal Translucency 2 and First and Second Trimester From the Departments of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York, and Eastern Virginia Medical School, Norfolk, Virginia; the Departments of Obstetrics and Gynecology and Radiology, Harvard Medical School, Boston, Massachusetts; Emeritus Reproductive Epidemiology, University of Leeds, Leeds, United Kingdom; the Society for Maternal-Fetal Medicine, Washington, DC;San Francisco Perinatal Associates, San Francisco, and the Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and the University of Oklahoma Health Sciences Center and the Perinatal Quality Foundation, Oklahoma City, Oklahoma. Corresponding author: Karin M. Fuchs, MD, Department of Obstetrics and Gynecology, Columbia University Medical Center, 622 W 168th Street, PH16-66, New York, NY 10032-3725; e-mail: kmf2121@columbia.edu. Financial Disclosure The authors did not report any potential conflicts of interest. © 2013 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins. ISSN: 0029-7844/14 VOL. 123, NO. 1, JANUARY 2014 OBSTETRICS & GYNECOLOGY 149