Ultrasound accreditation efforts boost performance

Keeping up with accreditation requirements enhances the quality of service in ultrasound practices, according to a multicenter study in the August issue of the Journal of Ultrasound in Medicine.

Principal investigator Dr. Alfred Z. Abuhamad of the Eastern Virginia Medical School in Norfolk and colleagues tried to determine whether the voluntary accreditation program set up by the American Institute of Ultrasound in Medicine improved practice standards and performance for ob/gyn examinations.

They compared ultrasound case scores that participating practices submitted with their initial accreditation application with those submitted three years later for reaccreditation. They found that these practices had improved their compliance with published guidelines and their case study scores.

The investigators picked their sample cases out of 82 practices chosen at random from a consecutive list of applicants that had successfully completed both accreditation cycles (group A). As a control group, they included cases from 97 practices that had completed first-time accreditation only (group B).

Reaccreditation scores were significantly higher (p

Almost 92% of practices earned their gynecologic credentialing at reaccreditation compared with 61.4% after their first application. Also, 78.1% of 32 practices that had not met their AIUM requirements for obstetrics during the initial cycle earned them at reaccreditation.

The proportion of practices from groups A and B meeting AIUM requirements with their first accreditation application was not significantly different. Group A practices undergoing reaccreditation and group B practices undergoing first-time accreditation completed their respective cycles in the same time frame.

The RADIUS trial (Am J Obstet Gynecol 1994;171[2]:392-399) failed to demonstrate a significant clinical benefit to the routine use of ultrasound in pregnancy. It did, however, reveal that tertiary-care facilities had a much higher rate of detecting fetal abnormalities than non-tertiary-care practices.

Accreditation was developed to address that variation in the quality of sonographic studies and provide a way for practices to demonstrate that they meet or exceed national standards, said coauthor Paula S. Woletz, AIUM's director of accreditation.

The AIUM aims to recognize practices that already meet or exceed the organization's standards and also help bring other practices up to par. The accreditation effort is improving the overall quality of diagnostic ultrasound, benefiting patients nationwide. It may even motivate some subspecialties, such as endocrinologists doing thyroid sonograms, to seek accreditation in the future, Woletz said.

AIUM accreditation looks at several factors:

• training, experience, credentials, and continuing medical education of interpreting physicians and sonographers

• volume of sonographic procedures performed

• maintenance of ultrasound equipment

• exam protocols

• quality assurance

• actual case studies

Site visits are rarely required unless the practice is very large or the Ultrasound Practice Accreditation Council feels that questions can be answered only by seeing the practice in its day-to-day operations. Random site visits do happen occasionally, but practices are always notified in advance, Woletz said.

The total number of ultrasound practices is unknown, and very few are accredited, according to Woletz. As of Oct. 1, 2004, however, the AIUM has accredited 939 practices with a total of 1328 sites. Some practices operate in more than one site and hold accreditation in more than one specialty.

The AIUM's latest breakdown shows 105 abdominal/general ultrasound practices at 161 sites, 17 breast ultrasound practices at 30 sites, 684 gynecological ultrasound practices at 882 sites, and 880 obstetric ultrasound practices at 1254 sites.

For more information from the Diagnostic Imaging archives:

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