Development and Implementation of a Quality Improvement Process for Echocardiographic Laboratory Accreditation

Abstract

We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation.

It Works

“…We recognize that achieving and maintaining accreditation requires significant staff time and expense that could be devoted to other options to improve quality of care, particularly for larger laboratories embedded in complex healthcare systems, where multiple entities offer an almost overwhelming variety of general and cardiovascular accreditation choices and registries. 2 Reviewing the literature for robust, quantitative evidence supporting the value of laboratory accreditation for quality improvement has until recently been a fruitless search, which is unsurprising when one considers the absence of strong evidence supporting any type of accreditation, including the most global forms like that obtainable from the Joint Commission. 3 It is important to recognize, however, that the absence of this evidence does not disprove the hypothesis that accreditation improves quality of care.…”

Echocardiographic assessment of myocardial ischemia

“…The associated broad clinical expertise provides more options compared with scenarios in which echocardiography is performed by a technician and is based solely on visual expertise. Discussion about the quality improvement process is on-going (31,32).…”

Competency-Based Methods in Adult Cardiac Sonography and its Application to Credentialing

“…However, it is recommended, and an individual likely will not become employed without being credentialed; in addition, labs that employ such individuals will not receive reimbursement from particular health insurance companies. [5][6][7][8] Sonography credentialing bolsters the field and patient care. 4 This work was focused on the American Registry of Diagnostic Medical Sonography (ARDMS) 9 as the credentialing body of sonography, which before 2020 had nine different mechanisms to become credentialed, but currently has only five pathways.…”