GENERAL APPLICATION REQUIREMENTS
Often
at the time of reaccreditation, the application completers assume
that information previously submitted to the ICANL need not
be sent again. However, due to the volume of paperwork received
by the ICANL, previously submitted applications are stored offsite
in a secured location and not available to the application reviewers.
- Submit
two printed copies of the application documents, the required
attachments and the case studies.
- Organize
the application information into two sets. Do not place the
information into binders or page protectors.
- Review
the case study requirements. The most current requirements
can be found in the ICANL application.
- Submit
all diagnostic imaging protocols, including acquisition, processing
and display protocols as well as clinical procedures including
diagnostic criteria, with every reaccreditation application
submission.
ORGANIZATION APPLICATION
At
approximately 12%, the fewest number of reaccreditation delays
are a result of problems in the Organization Application.
- All
staff data must be updated at the time of reaccreditation.
- The
Continuing Medical Education (CME) requirements must be documented
for all staff members. A minimum of 15 CME hours relevant
to nuclear cardiology is required if the application is for
nuclear cardiology alone. General nuclear medicine and PET
applications should include CME specific to those areas and
must be obtained by all staff members within three years of
the application submission. For medical staff members, the
15 hours must be AMA Category I credits. The CME requirements
can be reviewed in the Organization Standards or on the website
at www.icanl.org/icanl/apply/standards.htm.
To assist laboratory staff members with meeting this requirement,
a CME Opportunities section of the website includes an up-to-date
listing of upcoming courses and conferences, as well as self-study
and recurring courses, at www.icanl.org/icanl/community/cme.htm.
IMAGING PROTOCOLS AND CASE STUDIES
Though
the procedures specific to each area of testing differ, the
most common reasons for delay in each particular testing application
are generally very similar.
- IMAGING
PROTOCOLS - Acquisition, processing and display protocols
submitted with the application must reflect the most current
requirements of the Standards as well as define the
contemporary practice of the laboratory. Protocols included
with the applications are often vague or outdated and do not
clearly define the site-specific procedures performed in the
laboratory. This often becomes evident to the application
reviewers when they are evaluating the submitted case studies.
Diagnostic protocols must include all aspects of the procedures
performed, including exercise, pharmacologic stress, radiopharmaceutical
and non-radioactive drugs used for testing, all patient preparation,
treatment of adverse effects, and all other components of
testing for cardiac, general nuclear medicine and PET procedures.
- QUALITY
ASSURANCE - At the time of reaccreditation, it is mandatory
that the laboratory has a policy in place and is able to show
documentation of the quality assurance performed in the laboratory
at the time of the site visit. The ICANL requires a formal
QA policy in administrative, technical and interpretive areas
to demonstrate laboratory quality and self-evaluation. Examples
of QA policies and procedures can be found on the ICANL website
at www.icanl.org/icanl/apply/sampledocs.htm.
- FINAL
REPORTS - Final reports submitted with the case studies
must include the content and meet the standards for reporting,
as written in Part II Section 6 under Image Interpretation
and Reporting Protocols in the Standards. Nuclear cardiology
laboratories applying for reaccreditation who have not already
revised their reports to meet the ASNC Report Consensus Guidelines
are advised to review them at: www.asnc.org/yourpractice/reporting_rmp_imaging.pdf.
- DIAGNOSTIC
CRITERIA - Lack of adherence to the laboratory's diagnostic
criteria is often a reason for delay in a reaccreditation
application. It is required that all medical staff members
interpreting examinations in the laboratory adhere to one
standardized criteria. Again, compliance to this standard
becomes evident to the application reviewers and site visitor
when they are evaluating the case studies.
- CASE
STUDIES
- A primary factor resulting in the delay of reaccreditation
applications is incomplete documentation and overall poor
quality of submitted case studies. The cases must include
all of the hardcopy documentation required by the Standards,
while demonstrating good techniques. Nuclear cardiology applications
are required to submit digital raw data images for review
as well as hard copy image data. Again, a thorough and regular
review of the ICANL Standards, ASNC, ACC/AHA and SNM
guidelines, the laboratory's protocols, diagnostic criteria
and quality assurance will assist in assuring that testing
procedures are being performed and documented in a standardized
method, in compliance with the requirements of the ICANL process.
Laboratories
that receive notification that their reaccreditation application
has been delayed are often surprised and frustrated with the
results of the application review. Previous granting of accreditation
does not ensure that the laboratory will automatically be granted
accreditation at the time of reaccreditation. It is the
philosophy of the ICANL that with each reaccreditation cycle,
the applicant laboratory should be coming ever closer to being
in compliance with every one of the ICANL Standards,
thus offering the best possible quality of nuclear medicine
testing available to its patients.
While
this expectation of the laboratories seeking ICANL reaccreditation
is high, it has enabled the ICANL process to gain recognition
as the gold standard in the field and for ICANL accredited laboratories
to be highly regarded.
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