Tag Archives: accreditation

Navigating the World of Ultrasound: The ABCs of Accreditation

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In the fast-evolving world of healthcare, technological advancements have played a pivotal role in enhancing diagnostic accuracy and patient care. Ultrasound imaging has made significant strides in ease of use and availability. Ensuring the highest quality standards is where accreditation enters the scene, setting the gold standard for ultrasound practices. In this blog post, we will explore the ABCs of accreditation and understand its importance in the context of ultrasound imaging.

A is for the AIUM: The Beacon of Accreditation

Ultrasound accreditation is at the heart of the American Institute of Ultrasound in Medicine (AIUM). Established with the mission to advance the safe and effective use of ultrasound in medicine, the AIUM has become the trusted source for healthcare professionals seeking accreditation. The AIUM’s comprehensive guidelines set the stage for quality assurance, encompassing everything from equipment specifications to the competence of the personnel operating the ultrasound machines.

The AIUM’s accreditation program acts as a seal of approval, signifying that a facility meets or exceeds the rigorous standards set by the institute. This commitment to excellence ensures that patients receive accurate diagnoses while maintaining the highest levels of safety.

B is for Benefits: The Value Proposition of Accreditation

Accreditation offers a myriad of benefits that contribute to the overall improvement of healthcare services. First and foremost, it instills confidence in both healthcare providers and patients. When a facility proudly displays its accreditation credentials, it is a tangible testament to the facility’s commitment to delivering quality care.

Furthermore, the accreditation process encourages continuous improvement. Facilities seeking accreditation undergo thorough evaluations, identifying areas that may need refinement. This self-assessment leads to an ongoing improvement cycle, fostering an environment of innovation and excellence.

From a patient’s perspective, choosing an accredited facility ensures they are in capable hands. Accreditation signifies that the healthcare professionals have undergone rigorous training, adhere to industry best practices, and utilize state-of-the-art equipment, all of which contribute to accurate diagnoses and effective treatment plans.

C is for Compliance: Navigating the Accreditation Criteria To achieve and maintain accreditation, healthcare facilities must navigate a set of criteria meticulously outlined by the AIUM. These criteria cover a broad spectrum, ensuring that every facet of ultrasound imaging is held to the highest standards.

  1. Personnel Qualifications: Accreditation requires personnel operating ultrasound equipment to have the necessary education, training, and experience. This criterion ensures that professionals have the expertise to produce accurate and reliable results.
  2. Equipment Specifications: Accredited facilities must adhere to stringent guidelines regarding the specifications of ultrasound equipment. This includes regular calibration and maintenance to guarantee optimal performance.
  3. Image Quality: The core of ultrasound lies in the clarity and accuracy of the images produced. Accreditation demands that facilities consistently achieve high-quality images, promoting precision in diagnosis and treatment.
  4. Patient Safety: Ensuring the safety of patients during ultrasound procedures is a top priority. Accredited facilities implement and adhere to strict safety protocols, minimizing risks and providing a secure environment for both patients and staff.
  5. Record-Keeping and Reporting: Accurate and thorough record-keeping is essential for effective patient care. Accreditation requires facilities to maintain comprehensive records and produce detailed reports, contributing to a seamless continuum of care.

In conclusion, the ABCs of accreditation in ultrasound imaging represent the cornerstone of quality and safety. As technology continues to advance, the AIUM’s accreditation program ensures that healthcare facilities keep pace with these changes while maintaining the highest standards. Choosing an accredited facility not only benefits healthcare providers in terms of professional development but, most importantly, ensures that patients receive the best possible care. So, whether you’re a healthcare professional or a patient seeking ultrasound services, remember the ABCs – because when it comes to quality healthcare, accreditation is the key to unlocking excellence.

Catherine Knight, BS, RDMS, is a Quality of Practice Specialist for the AIUM, and Cynthia Owens, BA, is the Publications Coordinator for the AIUM.

Why Have Your Ultrasound Done at an Accredited Practice?

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Ultrasound scans are being performed everywhere. Not only in the standard radiology department in your local hospital, but also in the emergency room, urgent care clinics, your doctor’s office, and even at the local mall. But are you getting the same value for your money at each of these different sites? I have personally witnessed a very wide variety of skill levels within each of these departments. What can help you identify a reputable ultrasound unit? Look for an accredited ultrasound practice.

Applying for and obtaining your ultrasound accreditation is a vigorous process. It requires that all physician and sonographer staff have earned the appropriate credentials for the scans being performed and that they are up to date on their CME (continued medical education). Studies must be submitted for review to the accrediting team to ensure that the appropriate anatomy is being captured, image quality is optimal, and images are labeled. The ultrasound report is reviewed to confirm that the patient information and required imaging components for the study have been assessed and documented correctly.

Accreditation can help reassure the patient and the referring physician that their selected ultrasound department is aware of and following the current accepted standard guidelines for their exam. This can lead to reduced patient anxiety regarding the quality of the ultrasound scan. The goal is to help ultrasound departments achieve the best imaging possible to improve overall patient care and safety.

Each specialty area has an accreditation system that provides confirmation that an ultrasound department has achieved and is maintaining the current national standards. Each system provides guidelines and learning resources to help departments meet these standards.

Accreditation Systems:

Why is accreditation important? So that images like these are not reported as normal.

The initial scan was done in a physician’s office. The gestational age by the known last menstrual period was 11 weeks, 2 days; however, the crown-rump length (CRL) by ultrasound measured 10 weeks. This pregnancy was re-dated using the ultrasound-estimated delivery date.

At 19 weeks, 6 days, the patient was referred for an anatomy scan and was diagnosed with acrania-exencephaly-anencephaly sequence. This malformation has no calvarium and the fetal brain is exposed to the amniotic fluid. The amniotic fluid is toxic to the exposed brain and eventually causes the disintegration of this tissue. Exencephaly is a precursor to anencephaly. The absence of the fetal skull (acrania) exposes the brain (exencephaly), which eventually leads to anencephaly. The degenerative process of the brain gives the amniotic fluid an echogenic appearance.

This patient’s maternal serum alpha-fetoprotein (MSAFP) was 7.69 MoM (multiple of the median); the cutoff for a normal scan is <2.50 MoM.

Ultrasound technology and image quality have improved tremendously. The accreditation process helps a department discover where its deficiencies are and can provide guidance on how to meet the minimum standards. Further training and education of the Sonographers and Sonologists will lead to improved patient safety and outcomes.

Why pursue an ultrasound-accredited practice? Maybe the better question would be, why not make accreditation mandatory?

Headshot of Jane K. Burns, RDMS

Jane K. Burns, RDMS, is the MFM Ultrasound Manager at Texas Children’s Hospital/Pavilion for Women.

How Our Ultrasound Practice Flourished

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My name is Barbara, and I have been an Ultrasound tech for more than 30 years now. Part of my job for the last 25 years has been to get and keep our labs accredited. We recently changed the accrediting body to the American Institute of Ultrasound in Medicine (AIUM). Our initial accrediting body has always been a pleasure to work with, but inside I felt that the AIUM must be more in tune with what our concerns are, being it is strictly ultrasound.

We changed up 2 years ago, and wonderful things started to happen. First, we added more heart views, as, before, only the 4-chamber view was required. We changed that. Many of our younger techs were not proficient with all of the views, so we all pulled together. Our boss let us set up multiple hands-on training sessions from the older, more experienced Sonographers. He let us have as much time as we needed. It was beautiful to watch everyone working together.

Also, as a requirement of our Diagnostic Breast accreditation, every tech in our department got Breast certified; at least 15 techs needed to. Which everyone did willingly. The Radiologist now having to get 15 credits in breast ultrasound, did that willingly too. Everyone was on the same page.

Then what is even more astonishing is our boss came to me and asked if I would set up a quality assurance program. He realized that our exams are so tech-dependent that the techs need a resource to help them grow. And in a busy department, he wanted to make sure they all get what they need to be the best they can be.

As a part of that quality assurance program, management has allowed me to take time in my schedule to review a Sonographer’s ultrasound images. I review at least 30 exams to see a pattern or determine what the sonographer may lack. I then go over my results with the individual tech about image quality, image technique, etc. And, if we noticed the tech may need help in a certain area, we set up a one-on-one or place that tech with a tech that is more experienced to build the less-experienced tech’s confidence and skills.

I am so proud of our management and staff…Thank You, AIUM, for being a catalyst for such good things!!!!

Barbara A. Fennen, RT(M), RDMS, RVT, is a Sonographer at Beebe Healthcare in Rehoboth Beach, DE.

The Best of the Scan, 5 Years in the Making

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The Scan has been a home for all things ultrasound, from accreditation to zoos, since its debut 5 years ago, on February 6, 2015.MISC_SCAN_5_YR_ANN_DIGITAL_ASSETS_FB

In its first 5 years, the Scan has seen exponential growth, in large part due to the hard work of our 110 writers, who have volunteered their time to provide the 134 posts that are available on this anniversary. And it all began with Why Not Start? by Peter Magnuson, the AIUM’s Director of Communications and Member Services, who spearheaded the blog’s development.

In honor of this 5th Anniversary, here are some of your favorites:

Top 5 Most Viewed Posts

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1. Ultrasound Can Catch What NIPT Misses
by Simcha Yagel
(August 4, 2015)

Sonographer Stretches2. Sonographer Stretches for an ‘A’ Game
by Doug Wuebben and Mark Roozen
(January 31, 2017)

Keepsake3. The Issue with Keepsake Ultrasounds
by Peter Magnuson
(April 30, 2015)

Hip Flexor Stretch4. 3 Stretches All Sonographers Should Do
by Doug Wuebben and Mark Roozen
(January 19, 2016)

Anton5. From Sonographer to Ultrasound Practitioner: My Career Journey
by Tracy Anton
(October 23, 2018)

The Fastest Growing Posts
That Are Not Already in the Top 5

And we have plenty more great posts, such as:

Why SonoStuff.com
Why Teach Ultrasound?
A Personal Vignette From the ’60s and ’70s
The Buzz in Orlando
Ultrasound at the Zoo
Menstrual Pain: Is it Adenomyosis?
Vascular Access for Fiona
How Portable Ultrasound Got Me a Bottle of Wine
Therapy Dogs

Credentialing, Licensure, Certification, Accreditation: What’s the Difference?

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Within the medical arena it seems like the terms credential, license, certification, and accreditation are used frequently and interchangeably. As an accrediting body, the AIUM wanted some help in showing and explaining how these terms differ. Luckily credentialing expert Mickie Rops, CAE, agreed to help out. In this post, she explains the differences.aium_accred

  1. Credentialing: Process by which an agent qualified to do so grants formal recognition to and records such status of entities (individuals, organizations, processes, services, or products) meeting pre-determined and standardized criteria. Credentialing is the umbrella term for all the types of programs like the ones that follow.
  2. Licensure: Mandatory process by which a governmental agency grants time-limited permission to an individual to engage in a given occupation after verifying that he or she has met predetermined and standardized criteria. Licenses are typically granted at the state level and have ongoing maintenance requirements. Associations do not grant professional licensure.
  3. Professional Certification: Voluntary process by which a nongovernmental entity grants a time-limited recognition to an individual after verifying that he or she has met predetermined and standardized criteria. Historically association-based programs, many companies (Microsoft, for example) now offer and manage certification programs. Professional certification also has ongoing maintenance requirements.
  4. Accreditation: Voluntary process by which a nongovernmental entity grants a time-limited recognition to an organization after verifying that it has met predetermined and standardized criteria. The focus of accreditation’s assessment is on safe and effective processes and outcomes. Accreditation usually has ongoing maintenance requirements.
  5. Certificates: A training program, class, or session on a focused topic for which participants receive a certificate after completion of the coursework and successful demonstration of attaining the course learning objectives. While certificates may be dated, once they are awarded, they are awarded. There are no ongoing maintenance requirements.

The AIUM is an accrediting body, which means it recognizes practices, not individuals, that meet its published parameters. These parameters are focused on safe and effective processes and outcomes. The AIUM also issues certificates for those who earn CME credits by attending an event, taking a test, or participating in a webinar. These certificates, however, must be submitted to the entity that issues the appropriate licensee, certification, or accreditation.

Do these terms confuse you? What tricks do you use to keep them straight? Have an questions about AIUM Accreditation?  Comment below or let us know on Twitter: @AIUM_Ultrasound.

Mickie S. Rops, CAE, is a credentialing expert who helps organizations make the right credentialing decisions. She can be reached at www.msrops.com or mickie@msrops.com.

Our Accreditation Experience

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Ultrasound accreditation.

I’m sure you’ve heard about it, but you may be wondering: what does it really mean? Does it really matter if my practice site is accredited?

At one point I know that I wondered this myself! However, as a 17-year chief sonographer, and as the Ultrasound Technical Consultant for Allina Health Clinics, I can now tell you that for our sites, it absolutely does.

As a quality measure to ensure all ultrasound examinations are being performed and reported with the same standards of excellence, we decided to seek accreditation with the AIUM. Included under one AIUM accreditation, we have multiple clinic sites where the OB/GYN physicians read the ultrasound studies. It is a strict policy in our organization that any OB/GYN physician who wishes to read and bill for ultrasound exams must be added to our current AIUM accreditation.

With so many employees included in our accreditation, we knew that we needed to come up with a way to be able to facilitate new additions in a proficient manner, so that all sites received the same information and training. Thus (cue the climactic music), the “AIUM Physician Orientation and Mentoring” program was born!

We created this program for our organization as a virtual checklist of education and documentation needs, report over-reads, and competencies for the new physicians wishing to be added to our accreditation. We have a similar program for the sonographers that incorporates information and requirements for protocols, procedures, processes, and safety.

The Process

When I first started working with site accreditations everything was done on paper and case studies were submitted either on film or CDs. Now this process has been streamlined and all information that is required is easily uploaded to the AIUM site for their review.

For an accreditation such as ours that includes multiple sites, it was essential that we create a timeline to help us stay on track of what needed to be done and by when. The truth is, this is a very good way for any size site to make sure it stays on task and on time.
AIUM Accred Timeline

For us, this time around was a reaccreditation. So it is good to note that our information and supporting documents were due to the AIUM 6 months before the end of our current accreditation cycle. As you can see by the timeline, I set a goal of submitting 1 month before the due date. And that ended up being a good call because our actual submission date was only one week before the AIUM deadline.

Once all of our information was submitted, the Accreditation Team at the AIUM responded to us with any items that needed tweaking or were not quite hitting the mark. We replied to the AIUM on the changes that we would make and the education that we would provide our staff, and have been able to improve our services even more based on what we learned from those responses.

As one item of note, for us, the case submission selection and preparation was the longest and most time-consuming aspect of the process. Next time, we will start this task even earlier than outlined. Live and learn!

The Questions, Oh the Questions!
I had gone through an accreditation process before, but not with the AIUM. Since this was the first time for me, I had a ton of questions. I can’t even count how many times I emailed or called the AIUM staff, but I am sure they were groaning every time they heard from me.

However, each person that I spoke with was very understanding, helpful, and friendly. In fact, we communicated on such a regular basis that by the time I had submitted all of our information, they felt like good friends to me and I was tempted to invite them over for Thanksgiving dinner!

So Was It Worth It?
We expect our multiple sites to operate as one to ensure that patients are getting the same level of high-quality care when they go to site “A” for an OB/GYN  ultrasound, as when they go to site “B” for an OB/GYN ultrasound. For us accreditation has helped us accomplish that. The result has been higher patient satisfaction levels and improved quality and proficiency of our work.

Continuity of care. Improved quality. Higher patient satisfaction levels. Is accreditation worth it?

You bet it is!

Thinking about going through the AIUM practice accreditation process? Have any insights, tips, or ideas to share? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Laura M. Johnson, RDMS, RVT, is an Ultrasound Technical Consultant with Allina Health.

15 Tips to Accreditation Success

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Every day, the AIUM receives applications for AIUM accreditation. Some of these are pristine and go quickly through the process. Others require follow up which can delay the process—sometimes significantly. If your practice has decided that 2015 is the year it will seek accreditation, we have come up with 15 ways to help you improve your application.

For all practices: aium_accred

  1. Contact information—You’d be amazed at how many applications fail to include contact information on reports. Make sure you also include accurate email addresses, street addresses and phone numbers on the application. Doing so helps the overall process run more smoothly.
  2. Support all information—If you are reporting information that can be supported by an image or a short video clip, make sure it is included in your case submission. AIUM receives numerous applications where things like measurements, pathology and anatomy are reported but no supporting images are included.
  3. Sign and date your reports—Even if the report is dated, the physician needs to not only sign the report but also date his or her signature. This shows the timeliness of the report as well as your internal review process.
  4. Report your CME credits—Accreditation requires that all physicians have a certain number of CME credits. Before you submit your application, double check that all the included physicians have the necessary CME credits.

For OB practices:

  1. Image the adnexa—This is one of the required images so make sure you include and label it!
  2. M-mode not Doppler— In order to be compliant with ALARA, use M-mode first. If M-mode is unsuccessful then Doppler can be used keeping in mind the AIUM Statement on Measurement of Fetal Heart Rate.
  3. Report number of fetuses—There are multiple ways to report the number of fetuses and can be documented anywhere on the report. Some examples include: Fetal 1/1, singleton, Number of fetus = 1.
  4. Be careful of the thermal index—Monitor the thermal index. Keep this displayed at all times, if possible. Review the AIUM Statement on Heat.
  5. Include ALL third trimester anatomy—This is true even if you perform mostly growth sonograms in the third trimester. For accreditation purposes, make sure your third trimester submission is a complete anatomy study.

For GYN practices:

  1. Get correct volume measurements—When reporting uterine volume the measurement of the uterine corpus must be submitted. If your practice does not report uterine volume then measuring the length of the uterus must be from the fundus to the external os.
  2. Report uterine orientation with sonographic terminology—Anteverted, retroverted, anteflexed or retroflexed must be used to report uterine orientation. “Normal” is not appropriate sonographic terminology.
  3. Report the use of transvaginal probe/transducer—If you used a transvaginal probe/transducer, make sure you report it.

A few more:

  1. Limit images with anisotropy (MSK practices)—Aligning the transducer perpendicular to the structure will eliminate anisotropy.
  2. Images not labeled (MSK, dedicated Thyroid, Fetal Echo practices)—A good mantra to follow is, “If it’s an image, label it.” If you follow that, you will avoid one of the most common mistakes that slow down the review of an accreditation application.
  3. Include images of all cardiac biometry (Fetal Echo practices)—This is required for accreditation and yet practices fail to submit these images. Don’t forget.

Following these tips will help ensure your application is complete and goes through the accreditation process as smoothly as possible. At any time, however, feel free to call the AIUM at 800-638-5352 or email accreditation@aium.org if you have any questions. Good luck!

Is your practice accredited or considering the accreditation process? What questions do you have? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Therese Cooper, BS, RDMS, is AIUM’s Director of Accreditation.

Why 76811 Accreditation?

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Starting in 2013, the AIUM and the Society for Maternal-Fetal Medicine (SMFM) co-led a task force of medical societies to explore what distinguished a 76811 examination from the more routine 76805 examination. The result of that task force was the “Consensus Report on the Detailed Fetal Anatomic Ultrasound Examination,” which was published in the February 2014 edition of the Journal of Ultrasound in Medicine.

aium_accredThe report concludes that the 76811 is a distinct examination that requires special expertise. While many obstetricians and radiologists perform the 76805 on a routine basis, the skills and detail required for a 76811 generally require additional training and expertise—frequently through a Maternal-Fetal Medicine fellowship or similar targeted radiology fellowship.

Unfortunately in practice, what constitutes a “detailed obstetrical ultrasound” (or a 76811 examination) varies tremendously. It was for this reason that the AIUM felt it was critically important to promote standardization of what is required of such an examination and work to ensure that individuals performing these are competent and qualified. Additionally, given the move by some payors to reimburse only examinations performed by accredited practices, the AIUM felt it was prudent to have a mechanism in place to accredit practices that would be qualified to perform these examinations before it was directed by the insurers.

To address these concerns the AIUM developed the 76811 accreditation. This new accreditation is an “adjunctive” accreditation for practices that have, or are seeking, accreditation in 2nd/3rd trimester obstetrical ultrasound. It operates very similarly to how 3-D gynecologic ultrasound accreditation is an adjunct to the basic GYN ultrasound accreditation.

If your practice is performing detailed ultrasound examinations for women at high risk of, or who are suspected of having, an anomaly, you should consider adding the 76811 accreditation.

The structure for this accreditation submission is a little different however. Because the consensus statement provided a long list of “always must show” anatomy, and an additional list of “when clinically indicated” anatomy, the accreditation submission must show all of the “always” anatomy on each of the normals, but only needs to show an example of a selection of the “when clinically indicated anatomy” structures on at least one of the studies. In this way, you can exhibit competence getting the views that are occasionally, but not always, needed without having to add a lot of extra views to all of your study submissions.

This newly added accreditation option is live now. The AIUM is excited about letting you demonstrate your expertise so that you can get the credit and recognition that you deserve. Once again, the AIUM is involved in setting the standards for quality, and we know our members are up to the challenge!

Have questions about this new accreditation option? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Dr. David C. Jones is Director, Univerisity of Vermont Medical Center Fetal Diagnostic Center and Professor, Obstetrics, Gynecology & Reproductive Sciences at the University of Vermont, Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Maternal-Fetal Medicine. He serves as Vice Chair of the AIUM’s Ultrasound Practice Accreditation Council.