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Question: Are our reports complete, and do they meet The ICACTL Standards?
Interpretation of any CT cases performed within the laboratory must be performed by individuals who are either the Medical Director and/or medical staff. The reports must be standardized within the laboratory, including any applicable multiple sites or mobile sites that are considered part of the laboratory. Reports must accurately reflect the content and results of the examination. The following elements are required within each report:

• The date of the examination
• The clinical indications leading to the performance of the examination
• An adequate description of the test performed, including:
  • The name of the examination
  • The protocol used in the examination
  • The quality of the study
  • Details of any pertinent patient preparation
  • Drug administration
  • Contrast, if used, to include amount, type, and route of administration
• An overview of the results of the examination, including pertinent findings. Where appropriate, this must include localization and quantification of abnormal findings
• Appropriate recommendation for follow-up of incidental findings
• The reasons for limited examinations
• A summary of the test findings
• Comparison with previous studies, if available
• Reports must be typewritten
• Physician signature line

Question: What is required of our laboratory in terms of Quality Assurance (QA)?
The ICACTL Accreditation program is comprised of several separate, yet integrated aspects of quality assurance in the laboratory. The focus and goal of these components collectively is to provide quality patient care. Each laboratory that applies for ICACTL accreditation must develop and implement a quality assurance program that provides:

• qualified trained and experienced medical and technical staff
• an environment for patients that is safe and private
• education about the CT test to include contraindications; pre-test preparation, and the associated risks involved
• emergency care procedures
• infection control
• equipment maintenance, and performance measures
• dose assessment
• diagnostic image quality
• standardized interpretations

The ICACTL's mission is for laboratories to develop and implement a comprehensive quality assurance program that is ongoing. The program should be a continuous process of education, evaluation, corrective action, development and implementation with the ultimate goal of providing quality patient care.

Radiation exposure to patients in CT is a concern. The potential exists to deliver a dose of radiation that is higher than most diagnostic imaging studies. The ICACTL Standards require that all laboratories develop protocols that are specific to the clinical indication, and that dose reduction techniques are utilized where appropriate, as long as this technique does not interfere with making the diagnosis. Separate pediatric protocols must be developed based on patient age and weight. Comprehensive QC testing is required, as well as initial (prior to clinical use) and annual dose assessment by a qualified professional. The results of the dose assessment and the QC testing are to be reviewed by the QA Committee.

The Quality Assurance Committee is required to oversee and monitor the assessment of the quality assurance program.

Question: How can we be sure if our laboratory performs enough CT exams to be eligible to apply for accreditation?
There is not a minimum volume requirement that must be met in order to apply for accreditation. It is recommended, however, that a minimum of 300 exams be performed in each testing area in which you are applying, in order to maintain staff competency. Specifically, each member of the medical staff should interpret a minimum of 300 CT examinations annually and each member of the technical staff should perform a minimum of 300 CT examinations annually. However, laboratories performing less than 300 exams should not be dissuaded from applying for accreditation if otherwise compliant with The Standards, but will be required to submit additional case studies for evaluation.

In Conclusion

In addition to referencing The Standards, laboratories are encouraged to participate in the ICACTL's Accreditation On Demand webcast series. This new series is available, free of charge, through the ICACTL website and enables laboratory staff members to learn about accreditation at their leisure, at any time, from any computer. Participants learn about topics ranging from ensuring that protocols meet minimum requirements to documenting the laboratory's accuracy. Sessions to help ensure that final reports are complete and accurate and that the case studies prepared for submission accurately reflect the quality produced by the laboratory are also available as online webcasts.

Through the process of reviewing The Standards and implementing any necessary changes in preparation for submitting an application, laboratories not only succeed by meeting the requirements of accreditation, but most importantly, by enhancing the quality of patient care provided.